Post-acute COVID-19 syndrome.

Allan Schwartz, Akinpelumi A Beckley, David S Seres, Toni K Choueiri, Nir Uriel, John C Ausiello, Domenico Accili, Daniel E Freedberg, Matthew Baldwin, Sumit Mohan, Daniel Brodie, Christine Kim Garcia, Mitchell S V Elkind, Jean M Connors, John P Bilezikian, Donald W Landry, Elaine Y Wan, Tejasav S Sehrawat, Kartik Sehgal, Aakriti Gupta, Mahesh V Madhavan, Claire McGroder, Jacob S Stevens, Joshua R Cook, Anna S Nordvig, Daniel Shalev, Ani Nalbandian, Neha Ahluwalia, Behnood Bikdeli, Donald Dietz, Caroline Der-Nigoghossian, Nadia Liyanage-Don, Gregg F Rosner, Elana J Bernstein

Journal: Nature medicine 2021;27(4):601-615

PMID: 33753937

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.

Address: Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA. [email protected].; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. [email protected].; Harvard Medical School, Boston, Massachusetts, USA. [email protected].; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, USA.; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Division of Nephrology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Division of Endocrinology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Department of Neurology, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Department of Psychiatry, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, and New York State Psychiatric Institute, New York, New York, USA.; Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.; Division of Cardiology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA.; Harvard Medical School, Boston, Massachusetts, USA.; Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Division of Infectious Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Clinical Pharmacy, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA.; Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Division of Rheumatology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Department of Rehabilitation and Regenerative Medicine, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Institute of Human Nutrition and Division of Preventive Medicine and Nutrition, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Division of Digestive and Liver Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.; Division of Hematology, Brigham and Women's Hospital, Boston, Massachusetts, USA.; Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA. [email protected].
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