Joseph Bailey, Bianca Lavelle, Janet Miller, Millenia Jimenez, Patrick H Lim, Zachary S Orban, Jeffrey R Clark, Ria Tomar, Amy Ludwig, Sareen T Ali, Grace K Lank, Allison Zielinski, Ruben Mylvaganam, Ravi Kalhan, Malek El Muayed, R Kannan Mutharasan, Eric M Liotta, Jacob I Sznajder, Charles Davidson, Igor J Koralnik, Marc A Sala
{"title":"长期COVID综合征的多学科中心护理-回顾性队列研究","authors":"Joseph Bailey, Bianca Lavelle, Janet Miller, Millenia Jimenez, Patrick H Lim, Zachary S Orban, Jeffrey R Clark, Ria Tomar, Amy Ludwig, Sareen T Ali, Grace K Lank, Allison Zielinski, Ruben Mylvaganam, Ravi Kalhan, Malek El Muayed, R Kannan Mutharasan, Eric M Liotta, Jacob I Sznajder, Charles Davidson, Igor J Koralnik, Marc A Sala","doi":"10.1016/j.amjmed.2023.05.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Persistent multi-organ symptoms after coronavirus disease 2019 (COVID-19) have been termed \"long COVID\" or \"post-acute sequelae of SARS-CoV-2 infection.\" The complexity of these clinical manifestations posed challenges early in the pandemic as different ambulatory models formed out of necessity to manage the influx of patients. Little is known about the characteristics and outcomes of patients seeking care at multidisciplinary post-COVID centers.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients evaluated at our multidisciplinary comprehensive COVID-19 center in Chicago, Ill, between May 2020 and February 2022. We analyzed specialty clinic utilization and clinical test results according to severity of acute COVID-19.</p><p><strong>Results: </strong>We evaluated 1802 patients a median of 8 months from acute COVID-19 onset, including 350 post-hospitalization and 1452 non-hospitalized patients. Patients were seen in 2361 initial visits in 12 specialty clinics, with 1151 (48.8%) in neurology, 591 (25%) in pulmonology, and 284 (12%) in cardiology. Among the patients tested, 742/916 (81%) reported decreased quality of life, 284/553 (51%) had cognitive impairment, 195/434 (44.9%) had alteration of lung function, 249/299 (83.3%) had abnormal computed tomography chest scans, and 14/116 (12.1%) had elevated heart rate on rhythm monitoring. Frequency of cognitive impairment and pulmonary dysfunction was associated with severity of acute COVID-19. Non-hospitalized patients with positive SARS-CoV-2 testing had findings similar to those with negative or no test results.</p><p><strong>Conclusions: </strong>The experience at our multidisciplinary comprehensive COVID-19 center shows common utilization of multiple specialists by long COVID patients, who harbor frequent neurologic, pulmonary, and cardiologic abnormalities. Differences in post-hospitalization and non-hospitalized groups suggest distinct pathogenic mechanisms of long COVID in these populations.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":"108-120"},"PeriodicalIF":2.5000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10200714/pdf/","citationCount":"0","resultStr":"{\"title\":\"Multidisciplinary Center Care for Long COVID Syndrome-A Retrospective Cohort Study.\",\"authors\":\"Joseph Bailey, Bianca Lavelle, Janet Miller, Millenia Jimenez, Patrick H Lim, Zachary S Orban, Jeffrey R Clark, Ria Tomar, Amy Ludwig, Sareen T Ali, Grace K Lank, Allison Zielinski, Ruben Mylvaganam, Ravi Kalhan, Malek El Muayed, R Kannan Mutharasan, Eric M Liotta, Jacob I Sznajder, Charles Davidson, Igor J Koralnik, Marc A Sala\",\"doi\":\"10.1016/j.amjmed.2023.05.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Persistent multi-organ symptoms after coronavirus disease 2019 (COVID-19) have been termed \\\"long COVID\\\" or \\\"post-acute sequelae of SARS-CoV-2 infection.\\\" The complexity of these clinical manifestations posed challenges early in the pandemic as different ambulatory models formed out of necessity to manage the influx of patients. Little is known about the characteristics and outcomes of patients seeking care at multidisciplinary post-COVID centers.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients evaluated at our multidisciplinary comprehensive COVID-19 center in Chicago, Ill, between May 2020 and February 2022. We analyzed specialty clinic utilization and clinical test results according to severity of acute COVID-19.</p><p><strong>Results: </strong>We evaluated 1802 patients a median of 8 months from acute COVID-19 onset, including 350 post-hospitalization and 1452 non-hospitalized patients. Patients were seen in 2361 initial visits in 12 specialty clinics, with 1151 (48.8%) in neurology, 591 (25%) in pulmonology, and 284 (12%) in cardiology. Among the patients tested, 742/916 (81%) reported decreased quality of life, 284/553 (51%) had cognitive impairment, 195/434 (44.9%) had alteration of lung function, 249/299 (83.3%) had abnormal computed tomography chest scans, and 14/116 (12.1%) had elevated heart rate on rhythm monitoring. Frequency of cognitive impairment and pulmonary dysfunction was associated with severity of acute COVID-19. Non-hospitalized patients with positive SARS-CoV-2 testing had findings similar to those with negative or no test results.</p><p><strong>Conclusions: </strong>The experience at our multidisciplinary comprehensive COVID-19 center shows common utilization of multiple specialists by long COVID patients, who harbor frequent neurologic, pulmonary, and cardiologic abnormalities. Differences in post-hospitalization and non-hospitalized groups suggest distinct pathogenic mechanisms of long COVID in these populations.</p>\",\"PeriodicalId\":50807,\"journal\":{\"name\":\"American Journal of Medicine\",\"volume\":\" \",\"pages\":\"108-120\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10200714/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amjmed.2023.05.002\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/5/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjmed.2023.05.002","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/5/22 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Multidisciplinary Center Care for Long COVID Syndrome-A Retrospective Cohort Study.
Background: Persistent multi-organ symptoms after coronavirus disease 2019 (COVID-19) have been termed "long COVID" or "post-acute sequelae of SARS-CoV-2 infection." The complexity of these clinical manifestations posed challenges early in the pandemic as different ambulatory models formed out of necessity to manage the influx of patients. Little is known about the characteristics and outcomes of patients seeking care at multidisciplinary post-COVID centers.
Methods: We performed a retrospective cohort study of patients evaluated at our multidisciplinary comprehensive COVID-19 center in Chicago, Ill, between May 2020 and February 2022. We analyzed specialty clinic utilization and clinical test results according to severity of acute COVID-19.
Results: We evaluated 1802 patients a median of 8 months from acute COVID-19 onset, including 350 post-hospitalization and 1452 non-hospitalized patients. Patients were seen in 2361 initial visits in 12 specialty clinics, with 1151 (48.8%) in neurology, 591 (25%) in pulmonology, and 284 (12%) in cardiology. Among the patients tested, 742/916 (81%) reported decreased quality of life, 284/553 (51%) had cognitive impairment, 195/434 (44.9%) had alteration of lung function, 249/299 (83.3%) had abnormal computed tomography chest scans, and 14/116 (12.1%) had elevated heart rate on rhythm monitoring. Frequency of cognitive impairment and pulmonary dysfunction was associated with severity of acute COVID-19. Non-hospitalized patients with positive SARS-CoV-2 testing had findings similar to those with negative or no test results.
Conclusions: The experience at our multidisciplinary comprehensive COVID-19 center shows common utilization of multiple specialists by long COVID patients, who harbor frequent neurologic, pulmonary, and cardiologic abnormalities. Differences in post-hospitalization and non-hospitalized groups suggest distinct pathogenic mechanisms of long COVID in these populations.
期刊介绍:
The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice. AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more than 125 medical schools across the U.S. Each issue carries useful reviews as well as seminal articles of immediate interest to the practicing physician, including peer-reviewed, original scientific studies that have direct clinical significance and position papers on health care issues, medical education, and public policy.