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Post-COVID-19 Syndrome Comprehensive Assessment: From Clinical Diagnosis to Imaging and Biochemical-Guided Diagnosis
Michael Zhipeng Yan1, Ming Yang2, Ching-Lung Lai1
1Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
Insights
Diagnosing Post-COVID-19 Syndrome (PC19S) relies on subjective symptoms, leading to potential errors. A triple assessment of clinical, biochemical, and imaging data is proposed for objective PC19S diagnosis and management.
Area of Science:
- Infectious Diseases
- Pulmonology
- Neurology
Background:
- The COVID-19 pandemic has resulted in a significant number of survivors experiencing Post-COVID-19 Syndrome (PC19S).
- Current PC19S diagnosis relies heavily on subjective patient history and symptomatology, lacking objective measures.
- This diagnostic approach presents challenges in patient management, resource allocation, and monitoring clinical progression.
Purpose of the Study:
- To review current evidence for diagnosing Post-COVID-19 Syndrome using a triple assessment approach.
- To explore the development of objective assessment tools for PC19S.
- To evaluate existing rehabilitation programs and identify research gaps.
Main Methods:
- Narrative review of existing literature on Post-COVID-19 Syndrome diagnosis.
- Analysis of diagnostic criteria including clinical symptomatology, biochemical markers, and imaging evidence.
- Evaluation of current rehabilitation strategies and clinical trials for PC19S patients.
Main Results:
- The current diagnostic methods for PC19S are subjective and prone to reporting errors.
- A triple assessment (clinical, biochemical, imaging) offers a potential pathway towards more objective diagnosis.
- Existing rehabilitation efforts primarily focus on cardiorespiratory and psychiatric aspects, with a need for broader approaches.
Conclusions:
- Objective diagnostic tools are crucial for effective Post-COVID-19 Syndrome management and resource allocation.
- A comprehensive triple assessment strategy can improve patient monitoring, prognosis, and rehabilitation planning.
- Further research is essential to develop and validate objective assessment tools for PC19S.
Abstract:
The COVID-19 outbreak was first reported in 2019, causing massive morbidity and mortality. The majority of the COVID-19 patients survived and developed Post-COVID-19 Syndrome (PC19S) of varying severity. Currently, the diagnosis of PC19S is achieved through history and symptomatology that cannot be explained by an alternative diagnosis. However, the heavy reliance on subjective reporting is prone to reporting errors. Besides, there is no unified diagnostic assessment tool to classify the clinical severity of patients. This leads to significant difficulties when managing patients in terms of public resource utilization, clinical progression monitorization and rehabilitation plan formulation. This narrative review aims to review current evidence of diagnosis based on triple assessment: clinical symptomatology, biochemical analysis and imaging evidence. Further assessment tools can be developed based on triple assessment to monitor patient's clinical progression, prognosis and intervals of monitoring. It also highlights the high-risk features of patients for closer and earlier monitoring. Rehabilitation programs and related clinical trials are evaluated; however, most of them focus on cardiorespiratory fitness and psychiatric presentations such as anxiety and depression. Further research is required to establish an objective and comprehensive assessment tool to facilitate clinical management and rehabilitation plans.
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