Models of Care for Postacute COVID-19 Clinics

Verduzco‐Gutierrez, Monica; Estores, Irene M.; Graf, Min Jeong P.; Barshikar, Surendra; Carrillo, Juan Antonio Cabrera; Chang, Lynn E.; Eapen, Blessen C.; Bell, Kathleen R.

doi:10.1097/phm.0000000000001892

Cited by 19 publications

(16 citation statements)

References 20 publications

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“…PM&R has been in the forefront of the multidisciplinary care models to date, and physical, occupational, and speech/cognitive therapies have played a vital role in these programs. 14 Targets for physical therapy include management of respiratory insufficiencies, gait and balance disorders, poor endurance, and other mobility-related issues. Occupational therapists perform activity analysis addressing the management of fatigue and post-exertional malaise.…”

Section: Approachmentioning

confidence: 99%

“…Early adopters such as University of Texas Southwestern Medical Center, University of Texas Health Science Center at San Antonio Program, and the Veterans Administration Greater Los Angeles Health Care System provided unique frameworks for their differing PASC patient populations. 14 New York-Presbyterian/Weill Cornell Medical Center established a model which included a 30-bed unit for patients preparing to transition out of the acute phase that was led by a hospital medicine physician and a physiatrist. 15 A similar unit was established at the Los Angeles VA Hospital for patients with active infection but not requiring high-acuity services.…”

Section: Introductionmentioning

confidence: 99%

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Integrated Care Models for Long Coronavirus Disease

Barshikar

Laguerre

Gordon

et al. 2023

Physical Medicine and Rehabilitation Clinics of North America

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Section: Approachmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Integrated Care Models for Long Coronavirus Disease

Barshikar

Laguerre

Gordon

et al. 2023

Physical Medicine and Rehabilitation Clinics of North America

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“…Health care systems should support the development of PCC clinics with multidisciplinary care teams prepared to address the physical and mental health needs of this growing patient population, recognizing that the various presentations of PCC necessitate tailored models of care. 16 Moreover, given the sustained increased risk of adverse cardiovascular events [5][6][7][8][9] and all-cause mortality, 5,8,9 enhanced monitoring should be considered for conditions in which prevention, earlier detection, and effective treatment can improve outcomes.…”

Section: Conflict Of Interestmentioning

confidence: 99%

Cardiovascular Risks in Patients With Post–COVID-19 Condition

Czeisler

Ibrahim

2023

JAMA Health Forum

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Post-COVID-19 condition (PCC) following SARS-CoV-2 infection (also known as long COVID) describes a variety of symptoms and health conditions, including both direct and indirect effects of the virus.The constellation of symptoms was initially identified by members of the public on social media in May 2020. 1 As recurrent waves of COVID-19 have led to large numbers of infections and reinfections, PCC has garnered increased attention from policy makers, clinicians, and the public.To date, more than 200 signs and symptoms and 50 health conditions have been identified in PCC. 2 In a US Centers for Disease Control and Prevention study, new-onset symptoms consistent with PCC were reported by 38.2% of adults with and 16.0% of adults without prior SARS-CoV-2 infection-greater than a 2-fold increased risk after prior infection. 3 Beyond impaired health and suffering, the enormous medical spending and earning losses attributable to PCC in the US may measure in the trillions of dollars. 4 Therefore, PCC is a defining challenge for health care systems.A study in this issue of JAMA Health Forum by DeVries and colleagues directly addresses this evolving public health challenge. 5 The study of US adults in a large commercial insurance database describes markedly increased risks of adverse cardiovascular events and excess all-cause mortality in the postacute phase of COVID-19. These findings, together with increasing evidence of long-term consequences of SARS-CoV-2 infections spanning a wide range of organ systems, 6 call for enhanced and extended health monitoring of individuals with SARS-CoV-2 infections and raise questions about public health goals at this stage of the pandemic.DeVries and colleagues used propensity score matching on a comprehensive set of variables in commercial insurance claims to compare a cohort of 13 435 persons who had experienced PCC symptoms with a cohort of 26 870 persons without evidence of COVID-19. 5 Additional analyses were conducted among persons who had experienced PCC and been hospitalized within a month of SARS-CoV-2 infection. For both analyses, claims-based utilization tied to cardiovascular disorders, chronic respiratory disorders, and mortality over 12 months were compared between cohorts.Between 1 month and 12 months postinfection, individuals who had experienced COVID-19 exhibited increased incident cardiovascular disease relative to those who had not, including more than a doubling in the relative risk (RR) of pulmonary embolism or deep vein thrombosis (8.0% vs 2.2%; RR, 3.64), cardiac arrhythmias (29.5% vs 12.5%; RR, 2.35), and ischemic stroke (3.9% vs 1.8%; RR, 2.17). Individuals with SARS-CoV-2 infections also experienced a comparable relative increase in all-cause mortality (2.8% vs 1.2%) during the 12-month follow-up period. Even greater increases in the RRs of these adverse outcomes were observed among individuals hospitalized within a month of SARS-CoV-2 infection.The findings of DeVries and colleagues 5 extend those of several recently published studies of postacute cardiovascu...

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“…In the initial phase of the pandemic, monographic units and multidisciplinary teams were created for the follow-up and care of these patients. In the current phase, many of these devices have considered restructuring these monographic units, given the reduced number of COVID patients, assigning symptom control to the usual consultations of different specialties without having defined the optimal model to offer effective, efficient, equitable and accessible care to all patients [ 92 ].…”

Section: What Will Be the Status Of The So-called Extended Or Long-te...mentioning

confidence: 99%

Insights for COVID-19 in 2023

Sánchez¹,

Martínez‐Sellés²,

García³

et al. 2022

Rev Esp Quimioter

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Predictions for a near end of the pandemic by the World Health Organization should be interpreted with caution. Current evidence indicates that the efficacy of a fourth dose of classical mRNA vaccines (BT162b2 or mRNA-1273) is low and short-lived in preventing SARS-CoV-2 infection in its predominant variant (Omicron). However, its efficacy is high against severe symptomatic infection, hospitalization and death. The new vaccines being introduced are bivalent and active against the Omicron variants. Potential new vaccines to be introduced in the coming year include a vaccine based on a recombinant protein that emulates the receptor binding domain of the Spike protein under development by the Spanish company Hipra, as well as vaccines for nasal or oral administration. Available information suggests that vaccines against COVID-19 can be administered in association with influenza vaccination without particular complications. New drugs against COVID-19, both antiviral and anti-inflammatory, are under investigation, but this does not seem to be the case with monoclonal antibodies. The indication to use masks in some circumstances will be maintained next year in view of the accumulation of scientific data on their efficacy. Finally, the long COVID or Post-COVID syndrome may continue to affect a very high proportion of patients who have had the disease, requiring combined diagnostic and therapeutic resources.

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Models of Care for Postacute COVID-19 Clinics

Abstract: Supplemental digital content is available in the text.

Cited by 19 publications

References 20 publications

Integrated Care Models for Long Coronavirus Disease

Integrated Care Models for Long Coronavirus Disease

Cardiovascular Risks in Patients With Post–COVID-19 Condition

Insights for COVID-19 in 2023

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