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Long COVID Definitions and Models of Care
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Definitions of long COVID are evolving, and optimal models of care are uncertain.
PURPOSE
To perform a scoping review on definitions of long COVID and provide an overview of care models, including a proposed framework to describe and distinguish models.
DATA SOURCES
English-language articles from Ovid MEDLINE, PsycINFO, the Cochrane Library, SocINDEX, Scopus, Embase, and CINAHL published between January 2021 and November 2023; gray literature; and discussions with 18 key informants.
STUDY SELECTION
Publications describing long COVID definitions or models of care, supplemented by models described by key informants.
DATA EXTRACTION
Data were extracted by one reviewer and verified for accuracy by another reviewer.
DATA SYNTHESIS
Of 1960 screened citations, 38 were included. Five clinical definitions of long COVID varied with regard to timing since symptom onset and the minimum duration required for diagnosis; 1 additional definition was symptom score-based. Forty-nine long COVID care models were informed by 5 key principles: a core "lead" team, multidisciplinary expertise, comprehensive access to diagnostic and therapeutic services, a patient-centered approach, and providing capacity to meet demand. Seven characteristics provided a framework for distinguishing models: home department or clinical setting, clinical lead, collocation of other specialties, primary care role, population managed, use of teleservices, and whether the model was practice- or systems-based. Using this framework, 10 representative practice-based and 3 systems-based models of care were identified.
LIMITATIONS
Published literature often lacked key model details, data were insufficient to assess model outcomes, and there was overlap between and variability within models.
CONCLUSION
Definitions of long COVID and care models are evolving. Research is needed to optimize models and evaluate outcomes of different models.
Additional Info
Disclosure statements are available on the authors' profiles:
Long COVID Definitions and Models of Care : A Scoping Review
Ann. Intern. Med 2024 May 21;[EPub Ahead of Print], R Chou, E Herman, A Ahmed, J Anderson, S Selph, T Dana, L Williams, I IvlevFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.