Keywords: Long Covid, Primary Health Care, Clinical Pathways, Europe, Health Information Systems
Introduction:
Prolonged effects of COVID-19, known as Long COVID (LC), present a multifaceted challenge to healthcare systems globally. This study aims to identify commonalities and variations in clinical pathways for LC across Europe, focusing on primary healthcare (PHC) and secondary care (SC). We examine the clinical pathway for LC patients through a survey-based approach,
Method:
A comprehensive survey was conducted across 31 European countries to gather data on clinical practices for LC. The analysis encompassed guidelines and healthcare features, patient examination processes, symptoms, and treatment pathways in PHC and SC settings. Data from respondents were compiled into structured datasets, enabling a comparative analysis of similarities and disparities among countries. A peer review process for data accuracy was performed.
Results:
14/31 countries (56%) have Long-Covid guidelines from their Ministry of Health, with 80% implementing coordinated care pathways. Recognized symptoms include fatigue, dyspnea, and cognitive impairment, while less frequent menstrual changes and unexplained symptoms. Physical examinations, such as lung and heart auscultation, basic vital signs (oxygen saturation, heart rate) are widely monitored. PHC diagnostic tests include blood counts (92%) and inflammatory markers (88%). Home visits (72%) and online consultations (60%) are frequently provided. SC offers CT lungs (92%) and CT brain (88%). SC follow-up involves specialists such as internal medicine (92%), pneumologists (88%), cardiologists (84%). Rehabilitation options, such as respiratory physiotherapy and cardiac rehabilitation, are reimbursed in 14–16 countries, though physical therapy for dysautonomia is less accessible. Medications like NSAIDs for chest discomfort and paracetamol for myalgias are widely used (20/31 countries), Therapies such as glucocorticoids for pneumonia show variability in availability. Social determinants of health are considered in 64% of countries.
Conclusions:
Findings highlight the need for harmonized guidelines to address LC effectively. Tailored strategies reflecting local healthcare capabilities and patient needs are essential. Future efforts should focus on fostering collaboration to optimize care delivery.
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