Post-acute COVID-19 syndrome.

Nalbandian, Ani; Sehgal, Kartik; Gupta, Aakriti; Madhavan, Mahesh V; McGroder, Claire; Stevens, Jacob S; Cook, Joshua R; Nordvig, Anna S; Shalev, Daniel; Sehrawat, Tejasav S; Ahluwalia, Neha; Bikdeli, Behnood; Dietz, Donald; Der-Nigoghossian, Caroline; Liyanage-Don, Nadia; Rosner, Gregg F; Bernstein, Elana J; Mohan, Sumit; Beckley, Akinpelumi A; Seres, David S; Choueiri, Toni K; Uriel, Nir; Ausiello, John C; Accili, Domenico; Freedberg, Daniel E; Baldwin, Matthew; Schwartz, Allan; Brodie, Daniel; Garcia, Christine Kim; Elkind, Mitchell S V; Connors, Jean M; Bilezikian, John P; Landry, Donald W; Wan, Elaine Y

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.