Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
Chest. 2021 Mar;159(3):949-958. doi: 10.1016/j.chest.2020.10.067. Epub 2020 Nov 4.
The severe acute respiratory syndrome coronavirus 2 pandemic poses extraordinary challenges. The tremendous number of coronavirus disease 2019 (COVID-19) cases in the United States has resulted in a large population of survivors with prolonged postinfection symptoms. The creation of multidisciplinary post-COVID-19 clinics to address both persistent symptoms and potential long-term complications requires an understanding of the acute disease and the emerging data regarding COVID-19 outcomes. Experience with severe acute respiratory syndrome and Middle East respiratory syndrome, post-acute respiratory distress syndrome complications, and post-intensive care syndrome also informs anticipated sequelae and clinical program design. Post-COVID-19 clinical programs should be prepared to care for individuals previously hospitalized with COVID-19 (including those who required critical care support), nonhospitalized individuals with persistent respiratory symptoms following COVID-19, and individuals with preexisting lung disease complicated by COVID-19. Effective multidisciplinary collaboration models leverage lessons learned during the early phases of the pandemic to overcome the unique logistical challenges posed by pandemic circumstances. Collaboration between physicians and researchers across disciplines will provide insight into survivorship that may shape the treatment of both acute disease and chronic complications. In this review, we discuss the aims, general principles, elements of design, and challenges of a successful multidisciplinary model to address the needs of COVID-19 survivors.
严重急性呼吸系统综合症冠状病毒 2 型大流行带来了巨大的挑战。美国出现了大量的 2019 年冠状病毒病(COVID-19)病例,导致大量感染者出现长期感染后症状。为了解决持续存在的症状和潜在的长期并发症问题,需要建立多学科的 COVID-19 后诊所,这就需要了解急性疾病和 COVID-19 结局的最新数据。对严重急性呼吸系统综合症、中东呼吸系统综合症、急性呼吸窘迫综合征并发症和重症监护后综合征的经验也为预期的后遗症和临床方案设计提供了信息。COVID-19 后临床方案应准备好为以前因 COVID-19 住院的个人(包括需要重症监护支持的个人)、COVID-19 后持续存在呼吸道症状的非住院个人以及因 COVID-19 使原有肺部疾病复杂化的个人提供治疗。有效的多学科合作模式利用了大流行早期阶段所获得的经验教训,克服了大流行环境带来的独特后勤挑战。医生和跨学科研究人员之间的合作将深入了解生存情况,这可能会影响急性疾病和慢性并发症的治疗。在这篇综述中,我们讨论了多学科模式的目标、一般原则、设计要素和成功的挑战,以满足 COVID-19 幸存者的需求。