Authors: (including presenting author): :
Wong SN (1), Lai KPL (1), Chan PF (1)
Affiliation: :
(1) Department of Family Medicine and Primary Health Care, Kowloon East Cluster (KEC)
Introduction: :
According to the World Health Organization, approximately 10-20% of people infected with COVID-19 might continue to experience mid- and long-term effects of COVID-19. These patients consulted General Out-patient Clinics (GOPCs) repeatedly due to the lingering symptoms. Therefore, a Post COVID-19 Clinic was set up in a GOPC in October 2022 to manage adult patients with post-COVID conditions which affected daily life functioning so as to reduce the number of attendances in GOPCs. Updated evidence-based clinical guidelines, enhanced drug formulary and investigations including spirometry were available in the clinic.
Objectives: :
To review the demographic characteristics, symptoms and outcomes of patients referred to a Post COVID-19 Clinic.
Methodology: :
All patients who attended the Post COVID-19 Clinic from October 2022 to August 2023 were included in the review. Relevant clinical data were retrieved from Clinical Management System for analysis.
Result & Outcome: :
Results:
53 patients attended the Post COVID-19 clinic during the review period, with a mean age of 67.3 years old and 64.2% were female. 37.7% of the patients were prescribed with antiviral during the infection. 5.7% needed admission and none of the patient required intensive in-patient care. The mean duration of long COVID symptoms was 7.9 months (range 2-15 months) on 1st attendance to the clinic.
The most common post COVID-19 symptoms were respiratory symptoms (83.0%), followed by impaired memory (41.5%) and fatigue (37.7%). Other less common symptoms included gastrointestinal symptoms (5.7%), mood problems (5.7%), cardiac symptoms (5.7%) and headache (5.7%). For those presented with respiratory symptoms (N=44), 4 patients were found to have fibrotic changes on CXR and 2 patients were found to have suspected lung nodule; 43.2% of patients were arranged to have spirometry in which 21.1% was found to have obstructive pattern. For those presented with impaired memory (N=22), all patients with Abbreviated Mental test (AMT) or Hong Kong Montreal Cognitive Assessment (HK-MoCA) scores above cut-off.
10 referrals to various Specialist Out-patient Clinics were made. The reasons of referral included lung nodule, chest discomfort, abnormal ECG, hoarseness, globus sensation and goiter. 45.2% (N=24) of patients could be discharged, after a mean attendance of 2.54 times.
Conclusion:
Although most post COVID-19 symptoms would improve and resolve with time but some of the symptoms might persist and require medical attention. The setup of a Post COVID-19 Clinic could provide timely assessment, investigation and treatment for these patients. Through education and addressing patient’s concern, it helped patients to have better understanding of their conditions, reducing anxiety and potentially minimizing unnecessary medical attendance.
