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Algorithmic approach in the management of COVID-19 patients with residual pulmonary symptoms
Albina Guri1, Lauren Groner2, Joanna Escalon2
1Division of Pulmonary and Critical Care, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, NY, USA.
Insights
Post-COVID-19 syndrome can cause severe pulmonary fibrosis, a major respiratory health crisis. This review presents an algorithmic approach to managing patients with this emerging condition.
Area of Science:
- Pulmonology
- Infectious Diseases
- Public Health
Background:
- Coronavirus-19 (COVID-19) has caused millions of deaths globally.
- Long-term symptoms in COVID-19 survivors, known as post-COVID-19 syndrome (PCS), affect multiple organ systems.
- Pulmonary fibrosis is a severe manifestation of PCS, posing a significant future respiratory health challenge.
Purpose of the Study:
- To address the emerging threat of post-COVID-19 pulmonary fibrosis.
- To provide an algorithmic approach for managing patients with PCS-related pulmonary issues.
- To synthesize current data on pulmonary manifestations of PCS.
Main Methods:
- Comprehensive literature review of post-COVID-19 pulmonary symptoms, imaging, and physiology.
- Analysis of existing clinical data and experience.
- Development of a management algorithm based on best available evidence.
Main Results:
- PCS can lead to severe and persistent pulmonary complications.
- An algorithmic approach is crucial for effective patient management.
- Further research is needed for surveillance and understanding of pathophysiologic mechanisms.
Conclusions:
- Post-COVID-19 pulmonary fibrosis represents a potential large-scale respiratory crisis.
- An evidence-based algorithmic approach is essential for managing these patients.
- Continued research and surveillance are critical to mitigate the impact of PCS-pulmonary fibrosis.
Abstract:
Coronavirus-19 emerged about 3 years ago and has proven to be a devastating disease, crippling communities worldwide and accounting for more than 6.31 million deaths. The true disease burden of COVID-19 will come to light in the upcoming years as we care for COVID-19 survivors with post-COVID-19 syndrome (PCS) with residual long-term symptoms affecting every organ system. Pulmonary fibrosis is the most severe long-term pulmonary manifestation of PCS, and due to the high incidence of COVID-19 infection rates, PCS-pulmonary fibrosis has the potential of becoming the next large-scale respiratory health crisis. To confront the potentially devastating effects of emerging post-COVID-19 pulmonary fibrosis, dedicated research efforts are needed to focus on surveillance, understanding pathophysiologic mechanisms, and most importantly, an algorithmic approach to managing these patients. We have performed a thorough literature review on post-COVID-19 pulmonary symptoms/imaging/physiology and present an algorithmic approach to these patients based on the best available data and extensive clinical experience.
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