Your browser doesn't support javascript.
loading
Recommendations for the recognition, diagnosis, and management of long COVID: a Delphi study.
Nurek, Martine; Rayner, Clare; Freyer, Anette; Taylor, Sharon; Järte, Linn; MacDermott, Nathalie; Delaney, Brendan C.
Afiliación
  • Nurek M; Department of Surgery and Cancer, Imperial College London, London.
  • Rayner C; Department of Acute Medicine, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham.
  • Freyer A; Department of Acute Medicine, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham.
  • Taylor S; Central and North West London NHS Foundation Trust and honorary senior clinical lecturer, Imperial College School of Medicine, London.
  • Järte L; Anaesthetics Department, Morriston Hospital, Swansea Bay University Health Board, Swansea.
  • MacDermott N; King's College London, St Thomas' Hospital, London.
  • Delaney BC; Department of Surgery and Cancer, Imperial College London, London, and principal in general practice, Albion Street Group Practice, London.
Br J Gen Pract ; 71(712): e815-e825, 2021 11.
Article en En | MEDLINE | ID: mdl-34607799
BACKGROUND: In the absence of research into therapies and care pathways for long COVID, guidance based on 'emerging experience' is needed. AIM: To provide a rapid expert guide for GPs and long COVID clinical services. DESIGN AND SETTING: A Delphi study was conducted with a panel of primary and secondary care doctors. METHOD: Recommendations were generated relating to the investigation and management of long COVID. These were distributed online to a panel of UK doctors (any specialty) with an interest in, lived experience of, and/or experience treating long COVID. Over two rounds of Delphi testing, panellists indicated their agreement with each recommendation (using a five-point Likert scale) and provided comments. Recommendations eliciting a response of 'strongly agree', 'agree', or 'neither agree nor disagree' from 90% or more of responders were taken as showing consensus. RESULTS: Thirty-three clinicians representing 14 specialties reached consensus on 35 recommendations. Chiefly, GPs should consider long COVID in the presence of a wide range of presenting features (not limited to fatigue and breathlessness) and exclude differential diagnoses where appropriate. Detailed history and examination with baseline investigations should be conducted in primary care. Indications for further investigation and specific therapies (for myocarditis, postural tachycardia syndrome, mast cell disorder) include hypoxia/desaturation, chest pain, palpitations, and histamine-related symptoms. Rehabilitation should be individualised, with careful activity pacing (to avoid relapse) and multidisciplinary support. CONCLUSION: Long COVID clinics should operate as part of an integrated care system, with GPs playing a key role in the multidisciplinary team. Holistic care pathways, investigation of specific complications, management of potential symptom clusters, and tailored rehabilitation are needed.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 Tipo de estudio: Diagnostic_studies / Guideline Límite: Humans Idioma: En Revista: Br J Gen Pract Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 Tipo de estudio: Diagnostic_studies / Guideline Límite: Humans Idioma: En Revista: Br J Gen Pract Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido