Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease

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Visca, D. | Centis, R. | Pontali, E. | Zampogna, E. | Russell, A.-M. | Migliori, Giovanni Battista | Andrejak, C. | Aro, M. | Bayram, Hasan | Berkani, K. | Bruchfeld, Judith | Chakaya, Jeremiah | Chorostowska-Wynimko, Joanna | Crestani, Bruno | Dalcolmo, M. | D’ambrosio, L. | Dinh-Xuan, Anh Tuan | Duong-Quy, S. | Fernandes, C. | García-García, José-María | de Melo Kawassaki, A | Carrozzi, L. | Martinez-Garcia, M. | Carreiro‐martins, Pedro | Mirsaeidi, M. | Mohammad, Y. | Naidoo, R. | Neuparth, N. | Sesé, Lucile | Silva, D., R. | Solovic, I. | Sooronbaev, T. | Spanevello, Antonio | Sverzellati, Nicola | Tanno, Lk | Tiberi, Simon | Vasankari, T. | Vasarmidi, Eirini | Vitacca, Michele | Annesi-Maesano, I.

Edité par CCSD ; International Union Against Tuberculosis and Lung Disease -

International audience. BACKGROUND: The aim of these clinical standards is to provide guidance on ‘best practice’ care for the diagnosis, treatment and prevention of post-COVID-19 lung disease. METHODS: A panel of international experts representing scientific societies, associations and groups active in post-COVID-19 lung disease was identified; 45 completed a Delphi process. A 5-point Likert scale indicated level of agreement with the draft standards. The final version was approved by consensus (with 100% agreement). RESULTS: Four clinical standards were agreed for patients with a previous history of COVID-19: Standard 1, Patients with sequelae not explained by an alternative diagnosis should be evaluated for possible post-COVID-19 lung disease; Standard 2, Patients with lung function impairment, reduced exercise tolerance, reduced quality of life (QoL) or other relevant signs or ongoing symptoms ≥4 weeks after the onset of first symptoms should be evaluated for treatment and pulmonary rehabilitation (PR); Standard 3, The PR programme should be based on feasibility, effectiveness and cost-effectiveness criteria, organised according to local health services and tailored to an individual patient’s needs; and Standard 4, Each patient undergoing and completing PR should be evaluated to determine its effectiveness and have access to a counselling/health education session. CONCLUSION: This is the first consensus-based set of clinical standards for the diagnosis, treatment and prevention of post-COVID-19 lung disease. Our aim is to improve patient care and QoL by guiding clinicians, programme managers and public health officers in planning and implementing a PR programme to manage post-COVID-19 lung disease.

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