Permanent Board of the Catalan Society of Family and Community Medicine (CAMFiC), 08009 Barcelona, Spain.
Primary Care Centre Les Corts, Consorci d'Atenció Primària de Salut Barcelona Esquerra (CAPSBE), 08028 Barcelona, Spain.
Int J Environ Res Public Health. 2021 Apr 20;18(8):4350. doi: 10.3390/ijerph18084350.
Long COVID-19 may be defined as patients who, four weeks after the diagnosis of SARS-Cov-2 infection, continue to have signs and symptoms not explainable by other causes. The estimated frequency is around 10% and signs and symptoms may last for months. The main long-term manifestations observed in other coronaviruses (Severe Acute Respiratory Syndrome (SARS), Middle East respiratory syndrome (MERS)) are very similar to and have clear clinical parallels with SARS-CoV-2: mainly respiratory, musculoskeletal, and neuropsychiatric. The growing number of patients worldwide will have an impact on health systems. Therefore, the main objective of these clinical practice guidelines is to identify patients with signs and symptoms of long COVID-19 in primary care through a protocolized diagnostic process that studies possible etiologies and establishes an accurate differential diagnosis. The guidelines have been developed pragmatically by compiling the few studies published so far on long COVID-19, editorials and expert opinions, press releases, and the authors' clinical experience. Patients with long COVID-19 should be managed using structured primary care visits based on the time from diagnosis of SARS-CoV-2 infection. Based on the current limited evidence, disease management of long COVID-19 signs and symptoms will require a holistic, longitudinal follow up in primary care, multidisciplinary rehabilitation services, and the empowerment of affected patient groups.
长新冠可被定义为在 SARS-CoV-2 感染诊断后四周，持续出现无法用其他原因解释的体征和症状的患者。估计发病率约为 10%，且体征和症状可能持续数月。在其他冠状病毒（严重急性呼吸综合征（SARS）、中东呼吸综合征（MERS））中观察到的主要长期表现与 SARS-CoV-2 非常相似，且具有明确的临床相似性：主要为呼吸系统、肌肉骨骼和神经精神。全球范围内患者人数的增加将对卫生系统产生影响。因此，这些临床实践指南的主要目标是通过协议化的诊断流程，在初级保健中识别出具有长新冠体征和症状的患者，该流程研究可能的病因并建立准确的鉴别诊断。该指南是通过汇编迄今为止发表的少数关于长新冠的研究、社论和专家意见、新闻稿以及作者的临床经验，以务实的方式制定的。应根据 SARS-CoV-2 感染诊断后的时间，使用基于结构化的初级保健访视来管理长新冠患者。根据目前有限的证据，长新冠体征和症状的疾病管理将需要在初级保健中进行整体、纵向的随访、多学科康复服务以及受影响患者群体的赋权。
