Abstract
(1) Background: Long COVID syndrome refers to long-term sequelae of the novel viral disease, which occur even in patients with initially mild disease courses. However, there is still little evidence of the actual organic consequences and their frequency, and there is no standardized workup to diagnose long COVID syndrome yet. In this study, we aim to determine the efficiency of a stepwise diagnostic approach for reconvalescent COVID-19 patients with cardiopulmonary symptoms. (2) Methods: The diagnostic workup for long COVID syndrome included three steps. In the first step, the focus was on broad applicability (e.g., blood tests and body plethysmography). In the second step, cardiopulmonary exercise testing (CPET) and cardiac MRI (CMR) were used. The third step was tailored to the individual needs of each patient. The observation period lasted from 22 February to 14 May 2021. (3) Results: We examined 231 patients in our long COVID unit (mean [SD] age, 47.8 [14.9], 132 [57.1%] women). Acute illness occurred a mean (SD) of 121 (77) days previously. Suspicious findings in the first visit were seen in 80 (34.6%) patients, prompting further diagnostics. Thirty-six patients were further examined with CPET and CMR. Of those, 16 (44.4%) had pathological findings. The rest had functional complaints without organ damage (“functional long COVID”). Cardiopulmonary sequelae were found in asymptomatic as well as severe courses of the initial COVID-19 disease. (4) Conclusions: A structured diagnostic pathway for the diagnosis of long COVID syndrome is practicable and rational in terms of resource allocation. With this approach, manifest organ damage can be accurately and comprehensively diagnosed and distinguished from functional complaints.
Highlights
The main findings of this study are as follows: (1) our proposed stepwise diagnostic approach is suitable for patients with long COVID syndrome; (2) suspicious findings requiring further investigation were noted in 34.6% of the patients in our cohort; and
Since these data are based on the collection of new ICD-10 codes after having contracted COVID-19, there is a possibility of underdiagnosis
There is a discrepancy between functional complaints and the actual occurrence of organ damage in the extended diagnostics
Summary
The ongoing COVID-19 pandemic is placing heavy burdens on health care systems, including requiring high intensive care unit (ICU) capacities to jeopardizing established processes of medical care [1,2]. While new confirmed cases and deaths are being added daily, the number of patients who have recovered is steadily increasing. Severe effects on various organ systems in the context of acute disease are already known [3,4,5,6]. The number of patients with more diffuse symptoms, including neuropsychiatric and cardiopulmonary symptoms, is rising. Such cases are currently described by the term “long COVID syndrome.”. Little is currently known about the causes. What is clear is the heavy symptom burden of those affected and the urgent need for specialized contact points
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