Post-COVID-19 Syndrome Clinical Pathway for the US Veterans Health Administration.
Post-COVID-19 Syndrome Clinical Pathway for the US Veterans Health Administration.
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DOI：
10.25270/jcp.2023.01.02
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发表时间：
2023
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退伍军人健康事务部（VHA）在美国各地推出了22个多专业COVID-19后诊所，为越来越多的急性COVID-19感染后经历长期后遗症的退伍军人提供服务。虽然这种综合征的循证治疗正在调查中，但迫切需要根据这些诊所获得的知识和经验建立和传播临床路径（CPW）。本VHA CPW旨在指导在COVID-19后综合征（PCS）期间出现呼吸困难和/或咳嗽的患者的初级保健临床医生，PCS包括急性COVID-19发作后持续或存在超过12周的症状和异常。这一努力将有助于指导和规范整个VHA的退伍军人护理，改善健康结果，并有效地利用医疗保健资源。本文总结了我们对初级保健中出现PCS呼吸困难和/或咳嗽的患者的逐步诊断方法;它还强调远程会诊和远程康复是接触农村地区或交通障碍患者的机会，并提高了专业服务的覆盖率。
The Department of Veterans Health Affairs (VHA) has launched 22 multispecialty post–COVID-19 clinics across the US for the growing number of veterans experiencing long-term sequelae after acute COVID-19 infection. While evidence-based treatments for this syndrome are under investigation, there is a critical need to establish and disseminate clinical pathways (CPWs) based on knowledge and experience gained in those clinics. This VHA CPW is intended to guide primary care clinicians who care for patients experiencing dyspnea and/or cough during post–COVID-19 syndrome (PCS), which includes symptoms and abnormalities persisting or present beyond 12 weeks of the onset of acute COVID-19. This effort will help guide and standardize the care of veterans across the VHA, improve health outcomes, and effectively utilize health care resources. This article summarizes our stepwise diagnostic approach for patients presenting with PCS dyspnea and/or cough in primary care; it also highlights teleconsultation and telerehabilitation as opportunities to reach those in rural areas or with transportation barriers and improve reach for specialized services.