Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease

• DOI: 10.5588/ijtld.23.0248
• Publication Date: 2023-09-26T04:32:56Z
• Authors: D. Visca; R. Centis; E. Pontali; E. Zampogna; A.-M. Russell; G. B. Migliori; C. Andrejak; M. Aro; H. Bayram; K. Berkani; J. Bruchfeld; J. M. Chakaya; J. Chorostowska-W...; B. Crestani; M. P. Dalcolmo; L. D’Ambrosio; A-T. Dinh-Xuan; S. Duong-Quy; C. Fernandes; J.-M. García-García; A de Melo Kawassaki; L. Carrozzi; M. A. Martinez-Ga...; P. Carreiro Martins; M. Mirsaeidi; Y. Mohammad; R. N. Naidoo; N. Neuparth; L. Sese; D. R. Silva; I. Solovic; T. M. Sooronbaev; A. Spanevello; N. Sverzellati; L. Tanno; S. Tiberi; T. Vasankari; E. Vasarmidi; M. Vitacca; I. Annesi-Maesano
• Keywords: Economics; FOS: Political science; COVID-19*; Guideline; FOS: Health sciences; Critical Care and Intensive Care Medicine; COVID-19 Testing; long COVID; SARS-COV-2; post-COVID conditions; pulmonary rehabilitation; quality of life; HDE ALER; Neurological Manifestations of COVID-19 Infection; Pathology; Management of Delirium in Critical Care Patients; long COVID; Internal medicine; Political science; Quality of Life*; [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology; Quality of life (healthcare); Gold standard (test); Rehabilitation; Statistics; 3. Good health; Neurology; Disease Progression; Educational Status; Medicine; Pulmonary and Respiratory Medicine; Family medicine; MEDLINE; Delphi method; FOS: Law; SARS-COV-2; Nursing; Health Sciences; FOS: Mathematics; Humans; Intensive care medicine; Exercise; post-COVID conditions; Economic growth; *Quality of Life; Post-acute COVID-19 Syndrome; Health care; COVID-19; Likert scale; ta3121; pulmonary rehabilitation; Mechanical Ventilation in Respiratory Failure and ARDS; Pulmonary rehabilitation; quality of life; Clinical Standard; *covid-19; Quality of Life; Physical therapy; Law; Mathematics

BACKGROUND: The aim of these clinical standards is to provide guidance on ‘best practice’ care for the diagnosis, treatment and prevention of post-COVID-19 lung disease.METHODS: A panel of international experts representing scientific societies, associations and groups active in post-COVID-19 lung disease was identified; 45 completed a Delphi process. A 5-point Likert scale indicated level of agreement with the draft standards. The final version was approved by consensus (with 100% agreement).RESULTS: Four clinical standards were agreed for patients with a previous history of COVID-19: Standard 1, Patients with sequelae not explained by an alternative diagnosis should be evaluated for possible post-COVID-19 lung disease; Standard 2, Patients with lung function impairment, reduced exercise tolerance, reduced quality of life (QoL) or other relevant signs or ongoing symptoms ≥4 weeks after the onset of first symptoms should be evaluated for treatment and pulmonary rehabilitation (PR); Standard 3, The PR programme should be based on feasibility, effectiveness and cost-effectiveness criteria, organised according to local health services and tailored to an individual patient’s needs; and Standard 4, Each patient undergoing and completing PR should be evaluated to determine its effectiveness and have access to a counselling/health education session.CONCLUSION: This is the first consensus-based set of clinical standards for the diagnosis, treatment and prevention of post-COVID-19 lung disease. Our aim is to improve patient care and QoL by guiding clinicians, programme managers and public health officers in planning and implementing a PR programme to manage post-COVID-19 lung disease.