Post-acute COVID-19 is a syndrome characterized by the persistence of clinical symptoms beyond four weeks from the onset of acute symptoms.
The Center for Disease Control (CDC) has formulated “post-Covid conditions” to describe health issues that persist more than four weeks after being infected with COVID-19. These include
- Long Covid (which consists of a wide range of symptoms that can last weeks to months) or persistent post-Covid syndrome (PPCS)
- Multiorgan effects of COVID-19
- Effects of COVID-19 treatment/hospitalization
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The typical Long Covid symptoms are
- Tiredness / Easy Fatiguability
- Dyspnea
- Fatigue
- Brain fogginess
- Autonomic dysfunction
- Headache
- Persistent loss of smell or taste
- Cough
- Depression
- Low-grade fevers
- Palpitation
- Dizziness
- Muscle pain
- Joint pains
Multiorgan effects of COVID-19 include clinical manifestations pertaining to the cardiovascular, pulmonary, renal, and neuropsychiatric organ systems, although the duration of these multiorgan system effects is unclear.
Long-term “effects of COVID-19 treatment or hospitalization” are similar to other severe infections. They include post-intensive care syndrome(PICS), resulting in extreme weakness and posttraumatic stress disorder. Many of the patients with these complications from COVID-19 are getting better with time. Post COVID-19 care clinics are being opened at multiple medical centers across the USA to address these specific needs.
The restrictions of movement in many parts of the world due to COVID-19 has caused governments to recognise the potential of telehealth, and amend laws and regulations seemingly overnight to enable healthcare providers to deploy telehealth solutions. Many governments have adopted telehealth reforms in a matter of weeks, which may otherwise have taken years to be considered and introduced.
Telemedicine was successfully used to address different aspects of health care services and delivery during the COVID-19 pandemic. Studies have reported its use in triaging and screening COVID-19 symptoms; contact tracing; the monitoring of COVID-19 symptoms, the provision of specialized care for hospitalized COVID-19 patients; the provision of mental health services and support to COVID-19 patients, their caregivers and frontline health care workers with psychological issues; the monitoring of recovering COVID-19 patients and the provision of essential health care services for non-COVID-19 patients such as those with hypertension and diabetes mellitus15. O’Leary18 also reported the development of various apps to slow the spread of COVID-19. These apps are used to track the spread and symptoms of COVID-19.
All these apps require a smartphone as the app uses information from the user’s phone to determine if they have been in contact with any person with the virus18. In the same vein, Song et al.15 reported the efficacy of telemedicine during the COVID-19 pandemic in reducing spread of coronavirus among health workers, patients and the community. Quarantined health care workers have also used telemedicine options to offer their expertise without being physically present with their patients.
There is a publication from the Royal New Zealand College of General Practitioners (a non-regulatory professional body), supporting telehealth and the use of cloud technologies, with notes on security of patient information. The College has a page of telehealth resources in response to COVID-19. Another body, the Royal Australian & New Zealand College of Psychiatrists has also issued Practice Standards and
Guidelines for telepsychiatry. The College has provided updates for psychiatrists using telehealth for the first time in response to COVID-19, and has links to technification specifications for telepsychiatry.
Vidal-Alaball et al. posited that telemedicine is not only capable of providing support to health care systems in the midst of the pandemic, but advocates for its continued use even after the pandemic.
These authors reported that China, South Korea, Spain, United States, Japan and many European countries are at different stages of experimenting and implementing telemedicine. In the same vein, O’Leary reiterated the fact that there is a strong likelihood that business, organizations, culture, and society will be forever changed as ICT solutions generated will be used even in future settings and post-COVID-19
Due to the successful use of various forms of telemedicine options during the present pandemic, it is obvious that this form of medicine may become one of the tools that will be used in the delivery of health care services beyond the pandemic. This will be a welcome option to complement the traditional delivery of healthcare and a means of improving access to healthcare in line with the United Nations UHC Agenda under the SDGs.
References
- WHO, author. Telemedicine; opportunities and development in member states. Available from: https://www.who.int/goe/publications/goe_telemedicine_2010.pdf.
- Uses of Telehealth during COVID-19 in low resource non-U.S. settings. Available from: https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/telehealth-covid19-nonUS.html.
- Vidal-Alaball J, Acosta-Roja R, Pastor N, Sanchez U, Morrison D, Narejos S, et al. Telemedicine in the face of the COVID-19 pandemic. Aten Primaria. 2020;52(6):418–422.
- Hollander JE, Carr BG. Virtually perfect? Telemedicine for Covid-19. N Engl J Med. 2020;328:1679–1681
- Monaghesh, E.; Hajizadeh, A. The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence. BMC Public Health 2020, 20, 1193.
- Pappot, N.; Taarnhøj, G.A.; Pappot, H. Telemedicine and e-Health Solutions for COVID-19: Patients’ Perspective. Telemed. e-Health 2020, 26, 847–849.
- Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. 2020 Aug 11;370:m3026.