We are grateful for the opportunity to respond to correspondence from Joanne McPeake and colleagues highlighting the socio-economic challenges faced by critical disease survivors, particularly with regard to returning to work. As the authors describe, these difficulties are undoubtedly applicable to the post-COVID-19 cohort. Indeed, the COVID-19 pandemic has widened existing social inequalities, making the economically disadvantaged more vulnerable to COVID-19 exposure and mortality, as well as adverse effects on employment

  • Patel YES
  • Nielsen FBH
  • Badiani AA
  • et al.

Poverty, Inequality and COVID-19: The Forgotten Vulnerable., 2

  • Fana M.
  • Torrejon Perez S.
  • Fernández-Macías E.

Impact of the Covid-19 crisis on employment: from short-term effects to long-term prospects. The UK-based guidelines address these issues and highlight the need for clinicians to assess the effects of financial stress and unemployment as part of a holistic assessment following COVID-19. 3NHS England
National guidelines for clinics to assess post-COVID syndrome. The involvement of occupational therapists to provide a job-oriented approach to assessment and referral of patients to relevant sources of support, including advice on financial matters, employment, welfare and housing, is advocated. 4National Institute for Excellence in Health and Nursing
COVID-19 Express Policy: Managing the Long Term Effects of COVID-19. We thank the authors for directing our attention to the possible merging of social services into basic services and the positive effects of this integration on improvements in housing, income, and mental health and well-being.When we first developed and implemented our post-COVID-19 service, clinical resources were under significant strain and the medium- and long-term physical and psychosocial effects of acute COVID-19 infection were unclear. With the advent of national guidelines and prospective clinical data, 3NHS England
National guidelines for clinics to assess post-COVID syndrome., 4National Institute for Excellence in Health and Nursing
COVID-19 Express Policy: Managing the Long-Term Effects of COVID-19., 5

  • D’Cruz RF
  • Waller MD
  • Perrin F.
  • et al.

Chest x-rays are a poor predictor of respiratory symptoms and dysfunction in survivors of severe COVID-19 pneumonia. As a result, we have adapted our service to include the professional assessment of patients recovering from severe COVID-19 pneumonia or who have been diagnosed with post-COVID-19 syndrome.

We do not declare any competing interests. RFD was awarded a doctoral scholarship from the National Institute for Health Research (NIHR) (DRF-2018-11-ST2-037). The NIHR was not involved in any element of the writing or submission of this manuscript. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Welfare.

References

  1. 1.
    • Patel YES
    • Nielsen FBH
    • Badiani AA
    • et al.

    Poverty, Inequality, and COVID-19: The Forgotten Vulnerable.

    Healthcare. 2020; 183:: 110-111

  2. 2.
    • Fana M.
    • Torrejon Perez S.
    • Fernández-Macías E.

    Impact of the Covid-19 crisis on employment: from short-term effects to long-term prospects.

    Econ Polit Ind. 2020; 47:: 391-410

  3. 3.

    National guidelines for clinics to assess post-COVID syndrome.

    NHS England and NHS Improvement,
    London2020

  4. 4th
    • National Institute for Excellence in Health and Nursing

    COVID-19 Express Policy: Managing the Long Term Effects of COVID-19.

    National Institute for Excellence in Health and Nursing,
    London2020

  5. 5.
    • D’Cruz RF
    • Waller MD
    • Perrin F.
    • et al.

    Chest x-rays are a poor predictor of respiratory symptoms and dysfunction in survivors of severe COVID-19 pneumonia.

    ERJ Open Res. 2020; ()

Article information

Publication history

Published: February 05, 2021

identification

DOI: https://doi.org/10.1016/S2213-2600(21)00014-X

Copyright ©

© 2021 Elsevier Ltd. All rights reserved.

ScienceDirect

Access this article on ScienceDirect

Linked articles

  • Providing holistic care after severe COVID-19 pneumonia
    • We read with interest the overview of a COVID-19 recovery service developed by Rebecca D’Cruz and colleagues in the UK. This multidisciplinary approach, implemented in response to the expected long-term exposure to COVID-19 infections, will undoubtedly be of benefit to patients.1 The design of this clinical pathway is based on prior knowledge of post-critical disease recovery, along with many other international findings and the previous major acute respiratory syndrome pandemic.

    • Full text

    • PDF

  • Providing Holistic Care for Severe COVID-19 Pneumonia: Anticipating Clinical Needs and Managing Resources
    • The COVID-19 pandemic continues to pose extraordinary challenges for doctors, patients and health services around the world. In anticipation of considerable stress from multisystem and psychological morbidity, many organizations have set up clinical services after COVID-19. An exponential increase in the number of cases at the height of the pandemic required the rapid implementation of follow-up pathways that evolved in response to clinical needs and in the absence of robust COVID-19 specific data by extrapolating post-critical disease evidence and observations during previous coronavirus outbreaks made.

    • Full text

    • PDF

Read More Now