COVID-19 and its sequelae: a platform for optimal patient care, discovery and training

Richard C Becker, Richard C Becker

Abstract

COVID-19- related patient care and research have focused on short-term outcomes, particularly among those with underlying or preexisting medical conditions. A major focus has been on mortality rates. Broadening the dialogue is neither meant nor intended to disparage the near-term devastation felt globally each day, but rather to begin preparation for optimally caring for and addressing the needs of survivors. The sequelae of COVID-19 includes acute, subacute and chronic stages of the condition. If one applies current World Health Organization (WHO) statistics to calculate the global burden of disease, there are 98,000,000 COVID-19 survivors. The following editorial focuses on post-COVID sequelae as a continuum of patient care needs, as well as discovery and training opportunities in an academic setting.

Keywords: COVID-19 sequelae; Long-COVID-19 syndrome.

Figures

Fig. 1
Fig. 1
COVID-19 cases reported weekly by World Health Organization region as of 20 December 2020. www.who.int/covid; accessed 20 December 2020
Fig. 2
Fig. 2
Clinical criteria for patients with COVID-19 according to site of care (hospital or home) and acuity (see text for follow-up care algorithm)
Fig. 3
Fig. 3
The COVID-19 sequelae criteria and subtypes characterized by organ system involvement. While many survivors have symptoms originating from more than one system, others have one dominant system that is responsible for a majority of the signs, symptoms and overall phenotype. The SARS-CoV-2 virus, shown in the center is a starting point for COVID-19, but emerging data support humoral immunity, autoimmunity, poorly regulated inflammatory responses, vascular injury and dysfunction, preexisting medical conditions, genetic factors and the residual effects of acute target organ injury as determinants of protracted illness. Organs systems shown (top panel, clockwise): central and peripheral nervous system, heart and circulatory system, musculoskeletal system, integumentary system, pulmonary system and gastrointestinal–hepatobiliary system

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Source: PubMed

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