Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of breathing discomfort and respiratory sequelae in patients with post‐acute sequelae of SARS‐CoV‐2 infection (PASC)

Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection

“…Typically, symptoms are triggered or worsened by upright posture. As with other respiratory infections, some patients may experience a persistent breathing discomfort and other respiratory sequelae including chronic cough 73 . Some patients will describe generalized pain in joints, muscle, and soft tissues.…”

“… 1 , 2 Imaging may be appropriate in some cases but are usually reserved for specialist centers. Pulmonary Function Testing and Chest imaging are reasonable in patients with chronic breathlessness and/or evidence of oxygen desaturation on exertion 73 . Transthoracic echocardiogram, cardiac stress testing and cardiopulmonary testing should be considered on an individual basis based on the patient’s associated symptoms and treatment plan.…”

“…Although there are few studies of treatment in Long COVID that have shown efficacy or effectiveness, consensus guidance on best approaches to treat these patients based on the lived experience of patient and clinicians are emerging 71 , 72 , 73 , 80 . The overall approach to treatment of Long COVID is to focus on managing symptoms, improving function, and working with the patient to settle on reasonable treatments targets that have the potential to improve their quality of life.…”

Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of cardiovascular complications in patients with post‐acute sequelae of SARS‐CoV‐2 infection (PASC)

“…Qualifying criteria for and details of pulmonary rehabilitation are detailed in the Collaborative's Consensus Guidance Statement on Breathing and Respiratory Sequelae. 42 Some individuals with PASC who qualify for CR will also require other rehabilitative services (physical therapy, occupational therapy, speech therapy) for coexistent physical and functional limitations. Treatment interventions, such as CR and physical therapy, may be limited by the cost of copayments and deductibles, even in patients who have medical insurance.…”

“…Differentiating the cause of PASC‐related dyspnea between heart disease, COVID‐19 lung disease (including viral pneumonia, pulmonary fibrosis, pulmonary embolus), preexisting lung disease (chronic obstructive pulmonary disease), pain syndromes, anxiety disorder, deconditioning, or other etiologies is recommended. Characterizing breathing using standard measures of breathing discomfort can help direct the assessment and treatment plan as outlined in a prior PASC Collaborative Guidance statement on the assessment and management of breathing disorders 42 Lower extremity edema : New onset leg swelling has been reported in PASC.…”