An integrated multidisciplinary model of COVID-19 recovery care

Ir J Med Sci. 2021 May;190(2):461-468. doi: 10.1007/s11845-020-02354-9. Epub 2020 Sep 7.

Abstract

Background: In January 2020, the WHO declared the SARS-CoV-2 outbreak a public health emergency; by March 11, a pandemic was declared. To date in Ireland, over 3300 patients have been admitted to acute hospitals as a result of infection with COVID-19.

Aims: This article aims to describe the establishment of a COVID Recovery Service, a multidisciplinary service for comprehensive follow-up of patients with a hospital diagnosis of COVID-19 pneumonia.

Methods: A hybrid model of virtual and in-person clinics was established, supported by a multidisciplinary team consisting of respiratory, critical care, infectious diseases, psychiatry, and psychology services. This model identifies patients who need enhanced follow-up following COVID-19 pneumonia and aims to support patients with complications of COVID-19 and those who require integrated community care.

Results: We describe a post-COVID-19 service structure together with detailed protocols for multidisciplinary follow-up. One hundred seventy-four patients were discharged from Beaumont Hospital after COVID-19 pneumonia. Sixty-seven percent were male with a median age (IQR) of 66.5 (51-97). Twenty-two percent were admitted to the ICU for mechanical ventilation, 11% had non-invasive ventilation or high flow oxygen, and 67% did not have specialist respiratory support. Early data suggests that 48% of these patients will require medium to long-term specialist follow-up.

Conclusions: We demonstrate the implementation of an integrated multidisciplinary approach to patients with COVID-19, identifying those with increased physical and mental healthcare needs. Our initial experience suggests that significant physical, psychological, and cognitive impairments may persist despite clinical resolution of the infection.

Keywords: COVID-19; Critical care; Multidisciplinary model; Psychiatry; Respiratory.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 / rehabilitation*
  • Delivery of Health Care / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • SARS-CoV-2 / isolation & purification