长期 COVID 管理:对当前建议和未充分利用模式的小型审查

Tiffany K. Dietz, Kirsten N. Brondstater
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摘要

长COVID是指一部分患者在感染COVID-19后出现的症状,症状轻重不一,涉及多个器官系统。目前,对于长COVID的正式定义、可识别的生物标志物和有效的治疗方法尚未达成共识。对于一部分患者来说,长 COVID 可能是一种长期慢性疾病,会给患者带来痛苦和丧失工作能力。基层医疗机构急需制定明确的管理指南,因为基层医疗机构在与更专业的医疗机构进行沟通以改善长期慢性阻塞性肺气肿患者的生活质量和功能方面起着至关重要的作用。本微型综述旨在为初级医疗服务提供者提供现有文献中关于最常见的长COVID症状和当前管理建议的最新要点。本综述还重点介绍了未被充分利用的星状神经节阻滞和小剂量纳曲酮干预措施,这两种方法的安全性已得到充分证实,可改善患有某些长COVID症状的患者的生活质量和功能,并鼓励及时转诊至介入疼痛治疗中心。
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Long COVID management: a mini review of current recommendations and underutilized modalities
Long COVID is a condition that develops in a subset of patients after COVID-19 infection comprising of symptoms of varying severity encompassing multiple organ systems. Currently, long COVID is without consensus on a formal definition, identifiable biomarkers, and validated treatment. Long COVID is expected to be a long-term chronic condition for a subset of patients and is associated with suffering and incapacity. There is an urgent need for clear management guidelines for the primary care provider, who is essential in bridging the gap with more specialized care to improve quality of life and functionality in their patients living with long COVID. The purpose of this mini review is to provide primary care providers with the latest highlights from existing literature regarding the most common long COVID symptoms and current management recommendations. This review also highlights the underutilized interventions of stellate ganglion blocks and low-dose naltrexone, both with well-established safety profiles demonstrated to improve quality of life and functionality for patients suffering with some symptoms of long COVID, and encourages prompt referral to interventional pain management.
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