Post-acute COVID-19 Syndrome - PubMed

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Title & authors Abstract Figures Comment in References Publication types MeSH terms Supplementary concepts Grants and funding LinkOut - more resources Full text links CiteDisplay options Display options Format AbstractPubMedPMID

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.

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Figures

Fig. 1 |

Fig. 1 |. Timeline of post-acute COVID-19.

Fig. 1 |. Timeline of post-acute COVID-19.

Acute COVID-19 usually lasts until 4 weeks from…

Fig. 1 |. Timeline of post-acute COVID-19. Acute COVID-19 usually lasts until 4 weeks from the onset of symptoms, beyond which replication-competent SARS-CoV-2 has not been isolated. Post-acute COVID-19 is defined as persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. The common symptoms observed in post-acute COVID-19 are summarized.
Fig. 2 |

Fig. 2 |. Interdisciplinary management in COVID-19…

Fig. 2 |. Interdisciplinary management in COVID-19 clinics.

Multidisciplinary collaboration is essential to provide integrated…

Fig. 2 |. Interdisciplinary management in COVID-19 clinics. Multidisciplinary collaboration is essential to provide integrated outpatient care to survivors of acute COVID-19 in COVID-19 clinics. Depending on resources, prioritization may be considered for those at high risk for post-acute COVID-19, defined as those with severe illness during acute COVID-19 and/or requirement for care in an ICU, advanced age and the presence of organ comorbidities (pre-existing respiratory disease, obesity, diabetes, hypertension, chronic cardiovascular disease, chronic kidney disease, post-organ transplant or active cancer). The pulmonary/cardiovascular management plan was adapted from a guidance document for patients hospitalized with COVID-19 pneumonia. HRCT, high-resolution computed tomography; PE, pulmonary embolism.
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Comment in

  • [Long covid syndrome and real world evidence.]. Martini N. Martini N. Recenti Prog Med. 2021 May;112(5):335-337. doi: 10.1701/3608.35869. Recenti Prog Med. 2021. PMID: 34003184 Italian.
  • The four most urgent questions about long COVID. Marshall M. Marshall M. Nature. 2021 Jun;594(7862):168-170. doi: 10.1038/d41586-021-01511-z. Nature. 2021. PMID: 34108700 No abstract available.
  • How Are We Handling the Post-COVID Patients? The Dance of Uncertainties. Lacedonia D, Scioscia G, De Pace CC, Laricchiuta A, Tondo P, Sabato R, Foschino Barbaro MP. Lacedonia D, et al. Respiration. 2022;101(2):210-213. doi: 10.1159/000518330. Epub 2021 Sep 3. Respiration. 2022. PMID: 34515235 Free PMC article. No abstract available.
  • One year follow-up of physical performance and quality of life in patients surviving COVID-19: a prospective cohort study. Betschart M, Rezek S, Unger I, Ott N, Beyer S, Böni A, Gisi D, Shannon H, Spruit MA, Sieber C. Betschart M, et al. Swiss Med Wkly. 2021 Oct 28;151:w30072. doi: 10.4414/smw.2021.w30072. eCollection 2021 Oct 25. Swiss Med Wkly. 2021. PMID: 34751538

References

    1. Dong E, Du H & Gardner L An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect. Dis 20, 533–534 (2020). - PMC - PubMed
    1. Gupta A et al. Extrapulmonary manifestations of COVID-19. Nat. Med 26, 1017–1032 (2020). - PMC - PubMed
    1. Carfi A, Bernabei R, Landi F & Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. J. Am. Med. Assoc 324, 603–605 (2020). - PMC - PubMed
    1. Tenforde MW et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network—United States, March–June 2020. Morb. Mortal. Wkly Rep 69, 993–998 (2020). - PMC - PubMed
    1. Huang C et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 397, 220–232 (2021). - PMC - PubMed
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  • PR181960/U.S. Department of Defense (United States Department of Defense)
  • K23 DK111847/DK/NIDDK NIH HHS/United States
  • U01 DK116066/DK/NIDDK NIH HHS/United States
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  • P30 AG066462/AG/NIA NIH HHS/United States
  • R01 MD014161/MD/NIMHD NIH HHS/United States
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  • R01 HL152236/HL/NHLBI NIH HHS/United States
  • K08 HL122526/HL/NHLBI NIH HHS/United States
  • 2032726/National Science Foundation (NSF)
  • R01-MD014161/U.S. Department of Health & Human Services | National Institutes of Health (NIH)
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