Respiration | 2021
How Are We Handling the Post-COVID Patients? The Dance of Uncertainties
Abstract
Dear Editor, The emergence of severe acute respiratory syndrome coronavirus 2 disease (COVID-19) has caught off guard and shattered the entire scientific and medical world system [1, 2]. Similar 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 [3, 4]. The post-acute COVID-19 syndrome (PACS) is a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms (long COVID) [5, 6]. PACS affects many organ systems like pulmonary/cardiovascular (fatigue, dyspnea, and chest pain), hematologic (thromboembolic events), dermatologic, neuropsychiatric, and endocrine and results in decline in quality of life. We present the results of a survey we submitted to 83 pulmonologists (sharing a form on JotForm www.jotform.com) from all over Italy during the month of March 2021. The results were then analyzed with Prism (GraphPad software). In this survey, we asked these specialists how they manage PACS, and then we divided the answers on the basis of groups per the patients affected by PACS (group 1: <100 and group 2: >100) visited. The survey composed of 15 questions. The first question concerned the time of visit: after what time from the clinical recovery and negativization on nasopharyngeal swab the pulmonologist suggest to make the first followup: 50% of the specialists suggested to make a visit after 1 month, but when we divided by the number of patients visited, we could see that almost 75% of pulmonologists of group 2 suggested to schedule a visit after 3 months (shown in Fig. 1a). As for how much time after the first medical check is more appropriate to revisit the patient, most agreed to set a follow-up after 3 or 6 months based on the symptoms referred to (no difference rose between the 2 groups of specialists). The second part of the survey was about the functional and radiological exams to include in the follow-ups. Spirometry and diffusion lung carbon monoxide were the most common answers (almost 80% of the specialists believe that these exams are indicated for each follow-up). About the request of CT, most specialists (75%), regardless of the number of patients evaluated, believe to schedule the exam during the 3 months of the follow-up visit (shown in Fig. 1b). We then asked if it is necessary to repeat CT during follow-up: 50% of the specialists suggested to make a control after 6 months, while 12% consid-