Italian good practice recommendations on management of persons with Long-COVID

Abstract

A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms or new symptoms that are sustained over time, often affecting different body systems. This condition, commonly referred to as Long-COVID, requires a complex clinical management. In Italy new health facilities specifically dedicated to the diagnosis and care of Long-COVID were implemented. However, the activity of these clinical centers is highly heterogeneous, with wide variation in the type of services provided, specialistic expertise and, ultimately, in the clinical care provided. Recommendations for a uniform management of Long-COVID were therefore needed. Professionals from different disciplines (including general practitioners, specialists in respiratory diseases, infectious diseases, internal medicine, geriatrics, cardiology, neurology, pediatrics, and odontostomatology) were invited to participate, together with a patient representative, in a multidisciplinary Panel appointed to draft Good Practices on clinical management of Long-COVID. The Panel, after extensive literature review, issued recommendations on 3 thematic areas: access to Long-COVID services, clinical evaluation, and organization of the services. The Panel highlighted the importance of providing integrated multidisciplinary care in the management of patients after SARS-CoV-2 infection, and agreed that a multidisciplinary service, one-stop clinic approach could avoid multiple referrals and reduce the number of appointments. In areas where multidisciplinary services are not available, services may be provided through integrated and coordinated primary, community, rehabilitation and mental health services. Management should be adapted according to the patient’s needs and should promptly address possible life-threatening complications. The present recommendations could provide guidance and support in standardizing the care provided to Long-COVID patients.

Co-Morbidity Clusters in Post-COVID-19 Syndrome

“…It is not known which individuals will experience full recovery and which individuals will experience a persistence of symptoms after hospitalization. Keeping in mind the long-standing multiorgan dysfunctions in a large number of patients, we support the notion that planned regular follow-ups need to be started early for patients discharged from hospitals after acute COVID-19 [42]. Furthermore, our data draw the attention to the need for a multidisciplinary approach and educational need for care givers to be prepared for monitoring and treating multiorgan dysfunctions.…”

“…Furthermore, our data draw the attention to the need for a multidisciplinary approach and educational need for care givers to be prepared for monitoring and treating multiorgan dysfunctions. A growing body of evidence shows that the active use of comprehensive, well-targeted rehabilitation is able to enhance recovery from post-COVID-19 [ 42 , 43 ]. Although there is no established curative therapy for it, further studies to characterize its different clinical and biochemical subgroups could facilitate the development of targeted therapies [ 29 , 44 , 45 ].…”

The Potential Role of Hypothalamic Phospholipid Liposomes in the Supportive Therapy of Some Manifestations of Post-COVID-19 Condition: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Brain Fog

“…In fact, the WHO defines PCC as a condition occurring 3 months after acute infection, lasting for at least 2 months [3]. However, the 4-week threshold allows a rapid identification and treatment of PCC [8]. The CDC uses the 4-week period to define PCC and emphasizes the importance of initial clinical evaluation and supportive care during the initial 4-12 weeks after acute COVID-19 [7].…”

“…Additionally, hypothalamic phospholipid liposomes, by providing a rapid clinical improvement [47,48,[81][82][83][84], may also decrease the excess costs of patients suffering from PCC, another important burden of this condition [91]. Nevertheless, it must be emphasized that pharmacotherapy should be part of an integrated multidisciplinary approach including treatments such as physical and neuro-cognitive rehabilitation [8].…”

Potential Anti-Inflammatory and Anti-Fatigue Effects of an Oral Food Supplement in Long COVID Patients

“…CFS patients report asthenia, brain fog, muscle weakness, delayed recovery after physical exercise and non-restorative sleep. Fatigue, in fact, is closely correlated with sleep disorders, which can be both a cause and/or a consequence of chronic fatigue [ 10 , 11 ]. There is a strong correlation between CFS and long COVID.…”