A worldwide look into long COVID-19 management: an END-COVID survey

Mattia Nigro; Claudia Valenzuela; Francisco Arancibia; Mark Cohen; David C L Lam; Ryan C Maves; Barbara Rath; Steven Q Simpson; Yuanlin Song; Sotirios Tsiodras; James D Chalmers; Stefano Aliberti

doi:10.1183/23120541.00096-2024

A worldwide look into long COVID-19 management: an END-COVID survey

ERJ Open Res. 2024 Nov 11;10(6):00096-2024. doi: 10.1183/23120541.00096-2024. eCollection 2024 Nov.

Authors

Mattia Nigro^{1

2}, Claudia Valenzuela³, Francisco Arancibia⁴, Mark Cohen⁵, David C L Lam⁶, Ryan C Maves⁷, Barbara Rath⁸, Steven Q Simpson⁹, Yuanlin Song¹⁰, Sotirios Tsiodras^{11

12}, James D Chalmers¹³, Stefano Aliberti^{1

2}

Affiliations

¹ Department of Biomedical Sciences, Humanitas University, Milan, Italy.
² IRCCS Humanitas Research Hospital, Respiratory Unit, Milan, Italy.
³ Pulmonology Department, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain.
⁴ Pulmonology Department, Instituto Nacional del Tórax, Universidad de Chile, Santiago, Chile.
⁵ Pulmonary and Critical Care, Hospital Centro Médico, Guatemala.
⁶ Department of Medicine, School of Clinical Medicine, University of Hong Kong, Hong Kong SAR, China.
⁷ Sections of Infectious Diseases and Critical Care Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
⁸ Vaccine Safety Initiative, Div. Infectious Diseases, Berlin, Germany.
⁹ Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
¹⁰ Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai Respiratory Research Institute, Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
¹¹ National and Kapodistrian University of Athens, Athens, Greece.
¹² University Hospital of Athens Attikon, Athens, Greece.
¹³ Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.

Abstract

Background: Long COVID is a heterogeneous clinical syndrome characterised by a variety of reported symptoms and signs. Its clinical management is expected to differ significantly worldwide.

Methods: A survey-based study investigating long COVID-related standard operating procedures (SOPs) has been conducted by the European Respiratory Society (ERS) END-COVID clinical research collaboration with the support of other international societies (ALAT, APSR, CHEST, ESCMID and PATS). A global analysis of the results is provided here, alongside sub-population analysis based on continents, national income levels, type of involved healthcare professional and inclusion or exclusion of paediatric patients.

Findings: 1015 healthcare professionals from 110 different countries worldwide participated in this study, the majority of them being respiratory physicians (60.6%). A dedicated long COVID programme was present in 55.4% of the investigated institutions, with hospital admission during the acute infection being the main inclusion criteria to access them. Consistent differences in long COVID-related procedures were identified among centres, mainly regarding the multidisciplinary approach, the availability of telemedicine and psychological support, the type of requested exams and the total amount of visits in the centre.

Interpretation: Long COVID management shows important differences related to geographical areas and national income levels. SOPs were significantly different when centres were managed by a pulmonologist or when paediatric patients were included.