Manuela Funke-Chambour1,2, Pierre-Olivier Bridevaux3,4, Christian F Clarenbach5, Paola M Soccal4,6, Laurent P Nicod7,8, Christophe von Garnier8. 1. Department for Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 2. Department for Pulmonary Medicine, BioMedical Research, University of Bern, Bern, Switzerland. 3. Service de Pneumologie, Hôpital du Valais, Sion, Switzerland. 4. Geneva Medical School, University of Geneva, Geneva, Switzerland. 5. Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland. 6. Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland. 7. Pulmonary Medicine, Clinique Cecil du groupe Hirslanden, Lausanne, Switzerland. 8. Division of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
Abstract
INTRODUCTION: Emerging evidence suggests that long-term pulmonary symptoms and functional impairment occurs in a proportion of individuals following SARS-CoV-2 infection. Although the proportion of affected patients remains to be determined, physicians are increasingly being confronted with patients reporting respiratory symptoms and impairment beyond the acute phase of COVID-19. In face of limited evidence, the Swiss Society for Pulmonology established a working group to address this area of unmet need and formulated diagnostic and treatment recommendations for the care of patients with pulmonary long COVID (LC). METHOD: The Swiss COVID Lung Study group and Swiss Society for Pulmonology (SSP) formulated 13 questions addressing the diagnosis and treatment of pulmonary LC. A survey within the SSP special interest groups involved in care of LC patients was conducted in Switzerland. A CORE process/Delphi-like process was used to formulate recommendations. Forty experienced pulmonologists replied to the first survey and 22 completed the second follow-up survey. Agreement of ≥70% consensus led to formulation of a recommendation. RESULTS: The participants in the survey reached consensus and formulated a strong recommendation for regarding the following points. Patients hospitalized for COVID-19 should have a pulmonary assessment including pulmonary function tests. Symptomatic subjects affected by COVID-19, including those with mild disease, should benefit from a pulmonary follow-up. Persistent respiratory symptoms after COVID-19 should be investigated by a pulmonary follow-up including plethysmography, diffusion capacity measurement, and blood gases analysis. Individuals having suffered from COVID-19 and who present with persistent respiratory symptoms should be offered a rehabilitation. Additional questions were given moderateor weak recommendations for. The panel did not reach sufficient consensus for pharmacological therapy (e.g., therapy specifically targeting lung fibrosis) to formulate recommendations for LC drug treatment. CONCLUSION: The formulated recommendations should serve as an interim guidance to facilitate diagnosis and treatment of patients with pulmonary LC. As new evidence emerges, these recommendations may need to be adapted.
INTRODUCTION: Emerging evidence suggests that long-term pulmonary symptoms and functional impairment occurs in a proportion of individuals following SARS-CoV-2 infection. Although the proportion of affected patients remains to be determined, physicians are increasingly being confronted with patients reporting respiratory symptoms and impairment beyond the acute phase of COVID-19. In face of limited evidence, the Swiss Society for Pulmonology established a working group to address this area of unmet need and formulated diagnostic and treatment recommendations for the care of patients with pulmonary long COVID (LC). METHOD: The Swiss COVID Lung Study group and Swiss Society for Pulmonology (SSP) formulated 13 questions addressing the diagnosis and treatment of pulmonary LC. A survey within the SSP special interest groups involved in care of LC patients was conducted in Switzerland. A CORE process/Delphi-like process was used to formulate recommendations. Forty experienced pulmonologists replied to the first survey and 22 completed the second follow-up survey. Agreement of ≥70% consensus led to formulation of a recommendation. RESULTS: The participants in the survey reached consensus and formulated a strong recommendation for regarding the following points. Patients hospitalized for COVID-19 should have a pulmonary assessment including pulmonary function tests. Symptomatic subjects affected by COVID-19, including those with mild disease, should benefit from a pulmonary follow-up. Persistent respiratory symptoms after COVID-19 should be investigated by a pulmonary follow-up including plethysmography, diffusion capacity measurement, and blood gases analysis. Individuals having suffered from COVID-19 and who present with persistent respiratory symptoms should be offered a rehabilitation. Additional questions were given moderateor weak recommendations for. The panel did not reach sufficient consensus for pharmacological therapy (e.g., therapy specifically targeting lung fibrosis) to formulate recommendations for LC drug treatment. CONCLUSION: The formulated recommendations should serve as an interim guidance to facilitate diagnosis and treatment of patients with pulmonary LC. As new evidence emerges, these recommendations may need to be adapted.
Authors: Toby M Maher; Tamera J Corte; Aryeh Fischer; Michael Kreuter; David J Lederer; Maria Molina-Molina; Judit Axmann; Klaus-Uwe Kirchgaessler; Katerina Samara; Frank Gilberg; Vincent Cottin Journal: Lancet Respir Med Date: 2019-09-29 Impact factor: 30.700
Authors: Frederik Trinkmann; Michael Müller; Alexandra Reif; Nicolas Kahn; Michael Kreuter; Franziska Trudzinski; Monika Eichinger; Claus-Peter Heussel; Felix J F Herth Journal: Eur Respir J Date: 2021-02-25 Impact factor: 16.671
Authors: Phool Iqbal; Muhammad Bilal Jamshaid; Aamir Shahzad; Zohaib Yousaf; Saba Nabavi Monfared; Nagham D Sadik; Ibrahim Fawzy Hassan Journal: Qatar Med J Date: 2022-02-18