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. 2022 Aug 23;22(1):1076.
doi: 10.1186/s12913-022-08384-6.

Possible long COVID healthcare pathways: a scoping review

Affiliations

Possible long COVID healthcare pathways: a scoping review

Sarah Wolf et al. BMC Health Serv Res. .

Abstract

Background: Individuals of all ages and with all degrees of severity of the coronavirus disease (COVID) can suffer from persisting or reappearing symptoms called long COVID. Long COVID involves various symptoms, such as shortness of breath, fatigue, or organ damage. The growing number of long COVID cases places a burden on the patients and the broader economy and, hence, has gained more weight in political decisions. This scoping review aimed to give an overview of recommendations about possible long COVID healthcare pathways and requirements regarding decision-making and communication for healthcare professionals.

Methods: A systematic search in four databases and biweekly update-hand searches were conducted. In addition to guidelines and reviews, expert opinions in consensus statements or clinical perspectives were also considered. Data were systematically extracted and subsequently narratively and graphically summarised.

Results: Fourteen references, five guidelines, four reviews, one consensus paper, and four clinical perspectives were included. The evidence recommended that most long COVID-related healthcare should be in primary care. Patients with complex symptoms should be referred to specialized long COVID outpatient assessment clinics. In contrast, patients with one dominant symptom should be directed to the respective specialist for a second assessment. Depending on the patients' needs, further referral options include, e.g. rehabilitation or non-medical health services. Self-management and good communication between healthcare professionals and patients are crucial aspects of the long COVID management recommendations.

Conclusions: The quality of the included guidelines and reviews is limited in the methods applied due to the novelty of this topic and the associated urgency for research. Hence, an update review with more rigorous data is recommended. Furthermore, the systematic collection of real-world data on long COVID surveillance needs to be set up soon to gather further information on the duration and severity of long COVID and thereby facilitate long COVID care planning.

Keywords: Guidelines; Healthcare pathways; Long COVID; Recommendations; Scoping review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Literature selection process (PRISMA flow diagram)
Fig. 2
Fig. 2
Possible long COVID healthcare pathways (original figure)

References

    1. Greenhalgh T, Ladds E, Knight M, Ravindran D. Long Covid: evidence, recommendations and priority research questions. 2021.
    1. Maxwell E, Poole R, Oustric P. NIHR themed review: living with Covid19 - second review: National Institute for Health Research (NIHR) Centre for Engagement and Dissemination (NIHR CED) 2021.
    1. Rajan S, Khunti K, Alwan N, Steves C, MacDermott N, Morsella A, et al. In the wake of the pandemic: preparing for long COVID. European Observatory on Health Systems and Policies. 2021. - PubMed
    1. Sipahi S, DheIr H, ToCoGlu A, Bekta SM, Açıkgöz SB, Gen CA, et al. Characteristics and mortality determinants of COVID-19 patients undergoing Haemodialysis. Turk. 2021;51:421–427. - PMC - PubMed
    1. COVID-19 rapid guideline: managing the long-term effects of COVID-19. NICE. 2020 [Available from: https://www.nice.org.uk/guidance/ng188]. - PubMed

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