For professionals - Post-COVID HUB

Latest post-COVID evidence and guidelines

About
Resource Hub
Guidance
— Assessing lung damage
— Rehabilitation
— Treatments for the lung

About

Working with leading respiratory experts and professional bodies, including the British Thoracic Society and the Primary Care Respiratory Society, we have created this hub to facilitate the sharing of the latest evidence and guidance for the care and rehabilitation of people with breathing difficulties post-COVID.

Globally, tens of thousands of people are being admitted to hospital for acute care, with a proportion of these people requiring ICU care. Early studies suggest COVID-19 may leave some people with breathing problems following discharge. There are early reports of people developing Acute Respiratory Distress Syndrome (ARDS) during the acute infection, and post-ARDS complications.

It is important to acknowledge the potential psychological impact of post-COVID recovery too, particularly for those who receive intensive care treatment. This may not only be in those who receive intensive care treatment, but also those being treated in isolation from family and friends by health care professionals in full Personal Protective Equipment (PPE).

Resource hub

Our resource hub curates the latest evidence related to post-COVID breathing difficulties and interventions, including the incidence of ARDS following coronavirus.

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Guidance

There is currently limited data on the incidence, causes, long-term implications, or best practice for managing people with breathing difficulties post-COVID. Working with partners we have curated the most relevant guidance and will continue to update.

To ensure we are signposting to the latest and most relevant clinical guidance for post-COVID breathing difficulties, we are looking for feedback from those providing care to those with potential post-COVID breathing difficulties and associated professional bodies. Please email us.

If you would like to discuss embedding any of the below guidance into care pathways for post-COVID breathing difficulties, please email us.

Relevant guidance:

NHS England – After-care needs of inpatients recovering from COVID-19

BTS guidance on respiratory follow up of patients with radiologically confirmed COVID-19 pneumonia

Assessing lung damage

In order to identify post-COVID lung damage, including ARDS, chest radiograph (CXR) and computed tomography (CT) scans may be helpful. This data will also help us better understand and assess the impact of COVID-19 on lung in the short and longer term.

The British Society of Thoracic Imaging are establishing a database, allowing the imaging of COVID-19 patients to be uploaded anonymously to allow onward training, learning, and upskilling.

Relevant guidance:

COVID-19 for the radiologist – A British Society of Thoracic Imaging statement

Rehabilitation

For people that have been admitted to critical care, the below guidance for rehabilitation after critical illness may be helpful, alongside guidance for pulmonary rehabilitation.

According to NICE’s rehabilitation after critical guidance, adults who were in critical care and at risk of long-term problems, should get on discharge:

an individualised, structured rehabilitation programme (if identified as being at risk during critical care)
review by a healthcare professional (2 to 3 months after leaving critical care) to talk about their recovery and identify any physical, cognitive and psychological issues

Relevant guidance

BTS Pulmonary Rehabilitation Resource Pack

BTS Guideline on Pulmonary Rehabilitation

NICE Guideline Generalised anxiety disorder and panic disorder in adults: management

NICE Guideline Depression in adults: recognition and management

NICE Guideline Post-traumatic stress disorder: management

Other relevant information

Report of an ad-hoc international task force to develop an expert-based opinion on early and short-term rehabilitative interventions (after the acute hospital setting) in COVID-19 survivors

British Lung Foundation: Pulmonary Rehabilitation

Italian Thoracic Society – Joint statement on the role of respiratory rehabilitation in the COVID-19 crisis: the Italian position paper

Treatments for the lung

Below we have included the clinical guidelines for the management of post-COVID breathing difficulties, including the management of Acute Respiratory Distress Syndrome (ARDS), as early reports suggest this could be relevant after COVID-19.

Relevant guidance

Post-COVID Helpline: Our team of experts are here to support people with post-COVID breathlessness on 0300 222 5942

We are keen to work with professional bodies to ensure the content and guidelines on this hub are relevant and up to date. Please email us if you would like to partner with us.