June 22, 2021
Continuing Education Opportunity Addressing
Evaluation & Management of Post-COVID Conditions
- Post-COVID conditions can include but are not limited to persistent fatigue, cough, dyspnea, impaired cognition (“brain fog”), dysautonomia (e.g., postural orthostatic tachycardia syndrome), and neurologic disturbances (e.g., stroke; losses of smell, taste, or hearing; headache; insomnia).
- Prevalence estimates vary widely from 5-80% depending on the studies’ population, methodology, and case definition. Although the phenomenon appears to be more common in patients recovering from severe acute COVID and older patients, post-COVID conditions also occur in patients who had mild-to-negligible clinical illness and young, healthy patients.
- Experts suggest a conservative approach to evaluation during the initial 4-12 weeks after acute COVID, with more extensive evaluation for those with longer post-COVID syndromes. However, comprehensive work-ups should not be delayed for urgent or potentially life-threatening clinical presentations.
- Management goals are to optimize quality of life and function through a comprehensive rehabilitation plan involving physical therapy, occupational therapy and other modalities and specialists when indicated.
- Experts caution against dismissing patient reports that seem out of proportion to objective findings. Misdiagnosis of such dissociated presentations as a mental health problem is reported as being more common in BIPOC groups.
- Nevertheless, care coordination often may need to include behavioral health specialists for support and management (e.g., post-traumatic stress disorder, depression, anxiety, adjustment to post-COVID conditions).
- Understanding of post-COVID conditions remains incomplete and guidance for healthcare professionals will likely change over time as the evidence evolves.
- Transparent communication with patients should include acknowledgement that our understanding of post-COVID syndromes is still developing and outcomes are uncertain.
- Coding for post-COVID-associated visits can utilize ICD-10 code B94.8 (sequelae of other specified infectious and parasitic diseases). Note: code U09.9 (post COVID-19 condition, unspecified) is currently under review by national ICD-10 authorities and is not available for use yet in the United States.
- The webinar includes a compelling personal account of the acute and post-COVID experience of an infectious diseases specialist.