Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease
2 Uninsubria - Universitá degli Studi dell’Insubria = University of Insubria [Varese]
3 Galliera Hospital
4 University of Exeter
5 RDEH - Royal Devon and Exeter Hospital [Exeter, UK]
6 North Bristol NHS Trust [Bristol, UK]
7 AGIR - Agents infectieux, résistance et chimiothérapie - UR UPJV 4294
8 CHU Amiens-Picardie
9 Finnish Lung Health Association
10 Koç University
11 KUH - Karolinska University Hospital [Solna, Sweden]
12 Karolinska Institutet = Karolinska Institute [Stockholm]
13 KU - Kenyatta University of Nairobi
14 LSTM - Liverpool School of Tropical Medicine
15 ITLD - Institute of Tuberculosis and Lung Diseases [Warsaw, Poland]
16 PHERE (UMR_S_1152 / U1152) - Physiopathologie et Epidémiologie des Maladies Respiratoires
17 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
18 FIOCRUZ - Fundação Oswaldo Cruz / Oswaldo Cruz Foundation
19 Service de physiologie et explorations fonctionelles [CHU Cochin]
20 DLU - Dalat University [Vietnam]
21 USP - Universidade de São Paulo = University of São Paulo
22 Spanish Society of Pneumology and Thoracic Surgery (SEPAR)
23 ICESP - Instituto do Câncer do Estado = Cancer Institute of the State of São Paulo
24 UniPi - University of Pisa [Italy] = Università di Pisa [Italia] = Université de Pise [Italie]
25 Azienda Ospedaliera Universitaria Pisana
26 Hospital Universitari i Politècnic La Fe = University and Polytechnic Hospital La Fe
27 CIBERES - Centro de Investigación Biomédica en Red Enfermedades Respiratorias
28 Centro Hospitalar de Lisboa Central E.P.E
29 NMS - NOVA Medical School - Faculdade de Ciências Médicas
30 UNF - University of North Florida [Jacksonville]
31 Tishreen University
32 UKZN - University of KwaZulu-Natal [Durban, Afrique du Sud]
33 Hôpital Avicenne [AP-HP]
34 H&P - U1272 Inserm - Hypoxie et Poumon : pneumopathologies fibrosantes, modulations ventilatoires et circulatoires
35 UFRGS - Universidade Federal do Rio Grande do Sul [Porto Alegre – Brasil] = Federal University of Rio Grande do Sul [Porto Alegre – Brazil]
36 Catholic Univ RuzomberoK
37 National Centre of Cardiology and Internal Medicine
38 UNIPR - Università degli studi di Parma = University of Parma
39 IDESP - Institut Desbrest d'Epidémiologie et de Santé Publique
40 Département pneumologie et addictologie [Montpellier]
41 Barts & The London School of Medicine and Dentistry
42 QMUL - Queen Mary University of London
43 University of Turku
44 UOC - University of Crete [Heraklion]
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Résumé
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.
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