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In these guidelines, we also used the term “Long COVID-19”, which includes both ongoing and post-COVID-19 syndrome according to the NICE definitions.
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It does not focus on hospitalized patients, whose follow-up and management will be carried out by the hospital outpatient department. The CPG focuses on patients with long COVID-19 not requiring hospitalization, whose diagnosis and follow-up has been made in primary care (probably > 80% of affected people). In the absence of evidence-based clinical practice guidelines (CPGs) for the management of long COVID-19, Catalan Society of Family and Community Medicine (CAMFiC) established a working group to develop a CPG, consisting mainly of primary care professionals (90%), together with specialists in internal medicine, autoimmune diseases, infectious disease, epidemiology and statistics.
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The abnormal persistence of signs and symptoms for >4 weeks after the resolution of SARS-CoV-2 infection has been little studied, and there are no studies in primary care, where most COVID-19 diagnoses are made. the ICU admission rate was 9.3% in the general population. According to a recently published study by Rubio-Rivas et al. The main studies show a mean symptom duration ranging from 11 days to 28 days in patients admitted to the ICU. Other signs and symptoms, such as odynophagia, anosmia, ageusia, muscle aches, diarrhea, chest pain and headaches, among others, are part of the acute infection ( Table 1). The most common clinical presentation of COVID-19 is mild respiratory infection and, less commonly, pneumonia with fever, cough and dyspnea. ĬOVID-19, the disease caused by SARS-CoV-2, has a very broad clinical spectrum.
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As of January 13, 2021, there are >90 million confirmed cases worldwide and 2 million deaths. The rapid and unpredictable worldwide spread of SARS-CoV-2, with most infected people having no or only mild signs and symptoms, appears to have initially been related to cases imported from the first countries affected. The lack of pre-virus immunity has led to an exponential increase in infected patients worldwide and the pandemic is one of the biggest health challenges facing humanity in the last 100 years. Severe acute respiratory syndrome 2 coronavirus (SARS-CoV-2), first detected in December 2019 in Wuhan, China, is the seventh coronavirus known to infect humans after the identification, in this century, of SARS and Middle East Respiratory Syndrome (MERS) viruses. Based on the current limited evidence, disease management of long COVID-19 signs and symptoms will require a holistic, longitudinal follow up in primary care, multidisciplinary rehabilitation services, and the empowerment of affected patient groups. Patients with long COVID-19 should be managed using structured primary care visits based on the time from diagnosis of SARS-CoV-2 infection. The guidelines have been developed pragmatically by compiling the few studies published so far on long COVID-19, editorials and expert opinions, press releases, and the authors’ clinical experience. Therefore, the main objective of these clinical practice guidelines is to identify patients with signs and symptoms of long COVID-19 in primary care through a protocolized diagnostic process that studies possible etiologies and establishes an accurate differential diagnosis. The growing number of patients worldwide will have an impact on health systems. The main long-term manifestations observed in other coronaviruses (Severe Acute Respiratory Syndrome (SARS), Middle East respiratory syndrome (MERS)) are very similar to and have clear clinical parallels with SARS-CoV-2: mainly respiratory, musculoskeletal, and neuropsychiatric. The estimated frequency is around 10% and signs and symptoms may last for months. Long COVID-19 may be defined as patients who, four weeks after the diagnosis of SARS-Cov-2 infection, continue to have signs and symptoms not explainable by other causes.