Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease
Dina Visca, Rosella Centis, Emanuele Pontali, Elisabetta Zampogna, Anne‐Marie Russell, Giovanni Battista Migliori, Claire Andréjak, Miia Aro, Hasan Bayram, K. Berkani, Judith Bruchfeld, Jeremiah Chakaya, J Chorostowska-Wynimko, Bruno Crestani, Margareth Pretti Dalcolmo, Lia D’Ambrosio, Anh Tuan Dinh‐Xuan, Sy Duong‐Quy, Caio Júlio César dos Santos Fernandes, José-María García-García, Alexandre de Melo Kawassaki, Laura Carrozzi, M.a José Martínez-García, Pedro Martins, Mehdi Mirsaeidi, Yousser Mohammad, R N Naidoo, Nuno Neuparth, Lucile Sésé, D. R. Silva, Ivan Solovič, Talant Sooronbaev, Antonio Spanevello, Nicola Sverzellati, Luciana Kase Tanno, Simon Tiberi, Tuula Vasankari, Eirini Vasarmidi, Michele Vitacca, Isabella Annesi‐Maesano
Abstract
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.