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      Post-acute COVID-19 syndrome.

      1 , 2 , 3 , 4 , 1 , 5 , 6 , 1 , 5 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 5 , 6 , 15 , 16 , 17 , 18 , 1 , 19 , 8 , 20 , 21 , 22 , 23 , 14 , 1 , 9 , 9 , 24 , 7 , 1 , 7 , 7 , 10 , 25 , 14 , 26 , 9 , 8 , 27
      Nature medicine
      Springer Science and Business Media LLC

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          Abstract

          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.

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          Author and article information

          Journal
          Nat Med
          Nature medicine
          Springer Science and Business Media LLC
          1546-170X
          1078-8956
          April 2021
          : 27
          : 4
          Affiliations
          [1 ] Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [2 ] Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA. Kartik_sehgal@dfci.harvard.edu.
          [3 ] Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. Kartik_sehgal@dfci.harvard.edu.
          [4 ] Harvard Medical School, Boston, Massachusetts, USA. Kartik_sehgal@dfci.harvard.edu.
          [5 ] Clinical Trials Center, Cardiovascular Research Foundation, New York, New York, USA.
          [6 ] Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut, USA.
          [7 ] Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [8 ] Division of Nephrology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [9 ] Division of Endocrinology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [10 ] Department of Neurology, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [11 ] Department of Psychiatry, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, and New York State Psychiatric Institute, New York, New York, USA.
          [12 ] Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
          [13 ] Division of Cardiology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
          [14 ] Harvard Medical School, Boston, Massachusetts, USA.
          [15 ] Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
          [16 ] Division of Infectious Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [17 ] Clinical Pharmacy, New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA.
          [18 ] Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [19 ] Division of Rheumatology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [20 ] Department of Rehabilitation and Regenerative Medicine, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [21 ] Institute of Human Nutrition and Division of Preventive Medicine and Nutrition, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [22 ] Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
          [23 ] Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
          [24 ] Division of Digestive and Liver Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
          [25 ] Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
          [26 ] Division of Hematology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
          [27 ] Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA. eyw2003@cumc.columbia.edu.
          Article
          10.1038/s41591-021-01283-z NIHMS1783601
          10.1038/s41591-021-01283-z
          8893149
          33753937
          8ab29879-98dd-410d-91c0-54e213f49f48
          History

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