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Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection A State-of-the-Art Review

Author/s: 
Jiang, D. H., Roy, D. J., Gu, B. J., Hassett, L. C., McCoy, R. G.

The vast majority of patients (>99%) with severe acute respiratory syndrome coronavirus 2 survive immediate infection
but remain at risk for persistent and/or delayed multisystem. This review of published reports through May 31, 2021,
found that manifestations of postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC)
affect between 33% and 98% of coronavirus disease 2019 survivors and comprise a wide range of symptoms and
complications in the pulmonary, cardiovascular, neurologic, psychiatric, gastrointestinal, renal, endocrine, and musculoskeletal systems in both adult and pediatric populations. Additional complications are likely to emerge and be identified
over time. Although data on PASC risk factors and vulnerable populations are scarce, evidence points to a disproportionate impact on racial/ethnic minorities, older patients, patients with preexisting conditions, and rural residents.
Concerted efforts by researchers, health systems, public health agencies, payers, and governments are urgently needed
to better understand and mitigate the long-term effects of PASC on individual and population health.
(J Am Coll Cardiol Basic Trans Science 2021;-:-–-) © 2021 The Authors. Published by Elsevier on behalf of the American
College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license

Keywords 
COVID-19 coronavirus Postacute Secuelae Acute Respiratory Syndrome Infection

Post COVID-19 Syndrome (Long Haul Syndrome): Description of a Multidisciplinary Clinic at the Mayo Clinic and Characteristics of the Initial Patient Cohort

Author/s: 
Vanichkachorn, G., Newcomb, R., Cowl, C. T., Trenary, M., Higgins, S., Neveau, D., Murad, M. H., Breeher, L., Miller, S.

Objective

To describe characteristics of a series of patients reporting prolonged symptoms after an infection with COVID-19.

Methods

This study describes the multidisciplinary COVID-19 Activity Rehabilitation Program (CARP), established at Mayo Clinic to evaluate and treat post-COVID-19 syndrome (PCS) patients, and reports the clinical characteristics of the first 100 patients receiving evaluation and management during the timeframe of June 1, 2020 and December 31, 2020.

Results

The cohort consisted of 100 patients (mean age 45 years, 68% women, BMI 30.2, presenting a mean of 93 days after infection). Common pre-existing conditions were respiratory (23%) and mental health, including depression and/or anxiety (34%.) The majority (75%) had not been hospitalized for COVID-19. Common presenting symptoms ware fatigue (80%), respiratory complaints (59%), and neurologic complaints (59%) followed by subjective cognitive impairment, sleep disturbance, and mental health symptoms. More than one-third of the patients (34%) reported difficulties with performing basic activities of daily living. Only 1 in 3 patients had returned to unrestricted work duty at the time of the analysis. For most patients, laboratory and imaging studies were normal or non-diagnostic despite debilitating symptoms. Most patients required physical therapy, occupational therapy, or brain rehabilitation. Face-to-face and virtual care delivery modalities were feasible.

Conclusion

Many of the patients did not experience COVID-19-related symptoms that were severe enough to require hospitalization, were younger than 65 years of age, more likely to be female, and most had no pre-existing comorbidities prior to SARS-CoV-2 infection. Symptoms including mood disorders, fatigue, and perceived cognitive impairment resulted in severe negative impacts on resumption of functional and occupational activities in patients experiencing prolonged effects.

Keywords 
COVID-19 depression anxiety fatigue,
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