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Long COVID: What does it mean for the healthcare system and programs to deal with it?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc386
Document Type
Evidence Search Report
Review Code
EOC021901v2 ESR
Question Submitted
February 19, 2021
Date Completed
October 21, 2021
Status
5. Updated review
Research Team
EOC
More detail
Document Type
Evidence Search Report
Review Code
EOC021901v2 ESR
Question Submitted
February 19, 2021
Date Completed
October 21, 2021
Status
5. Updated review
Research Team
EOC
Category
Healthcare Services
Clinical Presentation
Subject
Long Covid
Clinical Presentation
Health Planning
Symptoms
Population
All
Clinical Setting
Ambulatory
Long Term Care
Primary care
Priority Level
Level 5 Four weeks+ (28 days+)
Cite As
Mueller, M; Dalidowicz, M. Long COVID: What does it mean for the healthcare system and programs to? 2021 Oct 21, Document no.: EOC021901v2 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 70 p. (CEST rapid review report).
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Long COVID: What does it mean for the healthcare system and programs to deal with it?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc397
Document Type
Table
Review Code
EOC021901v2 RR Table
Question Submitted
February 19, 2021
Date Completed
October 29, 2021
Status
5. Updated review
Research Team
EOC
More detail
Document Type
Table
Review Code
EOC021901v2 RR Table
Question Submitted
February 19, 2021
Date Completed
October 29, 2021
Status
5. Updated review
Research Team
EOC
Category
Healthcare Services
Clinical Presentation
Subject
Long Covid
Clinical Presentation
Health Planning
Symptoms
Population
All
Clinical Setting
Ambulatory
Long Term Care
Primary care
Priority Level
Level 5 Four weeks+ (28 days+)
Cite As
Williams-Roberts, H; Groot, G; Mueller, M; Dalidowicz, M. Long COVID: What does it mean for the healthcare system and programs? 2021 Oct 29. Document no.: EOC021901v2 RR Table. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. (CEST Table).
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Long COVID: What does it mean for the healthcare system and programs to deal with it?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc398
Document Type
Rapid Review
Review Code
EOC021901v2 RR
Question Submitted
February 19, 2021
Date Completed
October 29, 2021
Status
5. Updated review
Research Team
EOC
More detail
Document Type
Rapid Review
Review Code
EOC021901v2 RR
Question Submitted
February 19, 2021
Date Completed
October 29, 2021
Status
5. Updated review
Research Team
EOC
Updated Key Findings
October 29, 2021
In October, WHO released a consensus definition of post COVID-19 condition that includes 12 domains. This development should lead to better standardization of reporting and contribute to more precise prevalence estimates and better understanding of associated risk factors.
The effects of Variants of Concern (VoC) and COVID vaccination on progression of Long COVID symptoms remains unclear.
Risk factors for developing Long COVID symptoms were similar but limited evidence suggests that pre-pandemic psychological distress and poor general health were associated with developing persistent symptoms. Evidence is too limited to determine whether vaccination reduces the risk of developing Long COVID among persons with breakthrough infections.
Given the protean manifestations of Long COVID symptoms, the underlying causes are likely multifactorial; however, strong evidence to substantiate the theories of causation remains limited.
Research related to longer-term consequences of SARS CoV-2 infections in pediatric populations is growing but remains limited.
Key Findings
March 15, 2021
There is a lack of consensus around the clinical definition of Long COVID which in turn causes challenges with understanding the incidence and prevalence as well as the potential impact for the health care system
Information about the natural history of Long COVID is incomplete but limited evidence suggests that the immune response trajectories differ for those with few or no symptoms compared to those with severe disease. Individuals with severe disease are more likely to exhibit immunological marker abnormalities but anyone can experience functional limitations.
The mechanisms underlying the development of persistent symptoms in Long COVID remain an enigma. Despite multiple theories, there is little empirical evidence for specific immunological and or biochemical abnormalities in samples of individuals with symptoms consistent with Long COVID.
Risk factors for Long COVID include female gender, older age, higher body mass index, pre-existing asthma and the number of symptoms.
Few studies explored the short-term impact of Long COVID on health care utilization patterns and found a higher impact for those with severe disease compared with mild disease.
Category
Healthcare Services
Clinical Presentation
Subject
Long Covid
Clinical Presentation
Health Planning
Symptoms
Population
All
Clinical Setting
Ambulatory
Long Term Care
Primary care
Priority Level
Level 5 Four weeks+ (28 days+)
Cite As
Williams-Roberts, H; Groot, G; Mueller, M; Dalidowicz, M. Long COVID: What does it mean for the healthcare system and programs? 2021 Oct 29. Document no.: EOC021901v2 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 14 p. (CEST rapid review report).
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What are long COVID's demands on the healthcare system, and its severity of the illness?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc345
Document Type
Table
Review Code
EPM210602v002 RR Table
Question Submitted
June 22, 2021
Date Completed
June 20, 2022
Status
5. Updated review
Research Team
Epidemiology & Modelling
More detail
Document Type
Table
Review Code
EPM210602v002 RR Table
Question Submitted
June 22, 2021
Date Completed
June 20, 2022
Status
5. Updated review
Research Team
Epidemiology & Modelling
Category
Clinical Presentation
Epidemiology
Subject
Long Covid
Health Planning
Clinical Presentation
Population
All
Clinical Setting
Ambulatory
Community
Emergency
ICU
Long Term Care
Medicine Unit
Primary care
Public Health
Priority Level
Level 1 2-3 days
Cite As
Groot, G; Reeder, B; Hammond, B; Badea, A; Howell-Spooner, B; Ellsworth, C. What are long COVID's demands on the healthcare system, and its severity of the illness? 2022 Jun 20, Document no.: EPM210602v002 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. (CEST table).
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What are long COVID's demands on the healthcare system, and its severity of the illness?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc460
Document Type
Evidence Search Report
Review Code
EPM210602v2 ESR
Question Submitted
June 22, 2021
Date Completed
March 11, 2022
Status
5. Updated review
Research Team
Epidemiology & Modelling
More detail
Document Type
Evidence Search Report
Review Code
EPM210602v2 ESR
Question Submitted
June 22, 2021
Date Completed
March 11, 2022
Status
5. Updated review
Research Team
Epidemiology & Modelling
Category
Clinical Presentation
Epidemiology
Population
All
Clinical Setting
Ambulatory
Community
Emergency
ICU
Long Term Care
Medicine Unit
Primary care
Public Health
Priority Level
Level 1 2-3 days
Cite As
Howell-Spooner, B; Ellsworth, C. What are long COVID's demands on the healthcare system, and its severity of the illness? 2022 Mar 11, Document no.: EPM210602v2 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 64 p. (CEST rapid review report).
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What are long COVID's demands on the healthcare system, and its severity of the illness?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc494
Document Type
Evidence Search Report
Review Code
EPM210602v003 ESR
Question Submitted
June 22, 2021
Date Completed
June 3, 2022
Status
5. Updated review
Research Team
Epidemiology & Modelling
More detail
Document Type
Evidence Search Report
Review Code
EPM210602v003 ESR
Question Submitted
June 22, 2021
Date Completed
June 3, 2022
Status
5. Updated review
Research Team
Epidemiology & Modelling
Category
Clinical Presentation
Epidemiology
Population
All
Clinical Setting
Ambulatory
Community
Emergency
ICU
Long Term Care
Medicine Unit
Primary care
Public Health
Priority Level
Level 1 2-3 days
Cite As
Howell-Spooner, B. What are long COVID's demands on the healthcare system, and its severity of the illness? 2022 Jun 03, Document no.: EPM210602v003 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 22 p. (CEST rapid review report).
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What are long COVID's demands on the healthcare system, and its severity of the illness?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc505
Document Type
Rapid Review
Review Code
EPM210602v002 RR
Question Submitted
June 22, 2021
Date Completed
June 20, 2022
Status
5. Updated review
Research Team
Epidemiology & Modelling
care and support, whether that be in hospital or ambulatory, such as: older patients and women, those
More detail
Document Type
Rapid Review
Review Code
EPM210602v002 RR
Question Submitted
June 22, 2021
Date Completed
June 20, 2022
Status
5. Updated review
Research Team
Epidemiology & Modelling
Updated Key Findings
June 17, 2022 Case Definition
A case definition for long COVID has yet to be adopted but is referred to by the WHO as “usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis”; the CDC considers persistent symptoms, or the onset of long-term symptoms, =4 weeks after acute COVID-19 infection.
Many studies and systematic reviews refer to COVID-related symptoms that persist or emerge beyond 4 weeks of infection as consisting of two subsequent phases: 1) Ongoing Symptomatic COVID-19 (OSC; signs and symptoms from 4 to 12 weeks from initial infection) and 2) Post-COVID-19 Syndrome (PCS; signs and symptoms beyond 12 weeks) with respect to symptomatology, abnormal functioning, psychological burden, and quality of life.
Post Acute Sequalae of COVID (PASC) is often referred to in studies and systematic reviews and is commonly understood as “the presence of at least 1 abnormality diagnosed by (1) laboratory investigation, (2) radiologic pathology, or (3) clinical signs and symptoms that were present at least 1 month after COVID-19 diagnosis or after discharge from the hospital”. It can be further classified as short-term PASC as 1 month; intermediate-term, 2 to 5 months; and long-term, as 6 or more months after COVID-19 diagnosis or hospital discharge.
In previous reviews, we have referred to “long COVID” synonymously to the above terms (ie. OSC, PCS, PASC) but for clarity, will move toward using these specific terms as they appear in the literature as well as simply using the time frames reported in each study/review. For example, where needed, we have replaced “long COVID” with the more concise “PASC” or “symptoms beyond 4 weeks of infection”. General
Recommendations set out in our 2021 report can be relied upon with an important update to follow-up times (previously 2-3 months). Now, a 4-week follow-up is recommended for diagnosing and managing any PASC, especially for patients who suffered severe acute COVID-19 manifestation, where severe typically refers to those requiring medical attention, such as hospitalization for respiratory difficulty, to manage symptoms during the acute phase. In addition, these follow-ups should include mental health assessments in addition to any relevant clinical testing in response to each patient’s specific symptoms.
The clinical care burden of ongoing COVID-19 symptoms (OCS) is significant in the 3 months after infection and can place great demands on primary care services. Both OSC and PCS have consistently been shown to affect a large portion of the population with complex and persistent challenges that will also place strain on healthcare systems. This involves: o Complications pertaining to multiple care specialties, with 20-75% of individuals reporting at least 1 persistent symptom 12 or more weeks following COVID-19 diagnosis. o Neuropsychiatric manifestations (or “NeuroCOVID”) such as smell/taste disorder, memory complaints, anxiety, depression, post traumatic stress disorder (PTSD), concentration difficulties, and sleep disturbances are reported in 20-50% of individuals beyond 4 weeks from infection.
Functional disabilities and incapacity to return to work has been reported in 5% to 90% of individuals, where some are unable to reach their pre-COVID employment level at 12 weeks or longer post-infection; this has the potential to impact all sectors, including various levels of healthcare.
A significant number of individuals suffer from severe clinical conditions, such as acute cardiac, lung, and kidney injury.
A key focus will be to support individuals and populations who experience other persistent yet less severe conditions and symptoms such as fatigue, dyspnea, and mental health challenges including depression, anxiety, and sleep disorders.
Key Findings
July 12, 2021
Long COVID-19 is likely to increase demands across the health system, including emergency departments, hospital admissions, primary care visits, specialist appointments, and home care and rehabilitation services.
The clinical care burden of long COVID-19 is the greatest in the first 3 months after infection (revised from ‘testing’ in the previous report) and is likely to place the greatest demand on primary care services.
Patients with severe COVID-19 illness are more likely to place longer-term demands (4-6 months after the infection) on specialist care due to respiratory, circulatory, endocrine, metabolic, psychiatric and unspecified conditions.
Category
Clinical Presentation
Epidemiology
Subject
Long Covid
Health Planning
Clinical Presentation
Population
All
Clinical Setting
Ambulatory
Community
Emergency
ICU
Long Term Care
Medicine Unit
Primary care
Public Health
Priority Level
Level 1 2-3 days
Cite As
Groot, G; Reeder, B; Hammond, B; Badea, A; Howell-Spooner, B; Ellsworth, C. What are long COVID's demands on the healthcare system, and its severity of the illness? 2022 Jun 20, Document no.: EPM210602v002 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 23 p. (CEST rapid review report).
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What is the (case) definition of hospitalization for COVID-19 in similar jurisdictions?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc424
Document Type
Evidence Search Report
Review Code
CAC220101 ESR
Question Submitted
January 11, 2022
Date Completed
January 14, 2022
Status
3. Completed
Research Team
Clinical/Acute Care
More detail
Document Type
Evidence Search Report
Review Code
CAC220101 ESR
Question Submitted
January 11, 2022
Date Completed
January 14, 2022
Status
3. Completed
Research Team
Clinical/Acute Care
Category
Administration
Healthcare Services
Subject
Decision Making
Health Planning
Hospitalization
Population
All
Clinical Setting
Ambulatory
Cardiac unit
Community
Dialysis unit
Emergency
EMS
ICU
Long Term Care
Medicine Unit
NICU
Oncology
Primary care
Public Health
Other
Priority Level
Level 2 One week (7 days)
Cite As
Howell-Spooner, B; Young, C. What is the (case) definition of hospitalization for COVID-19 in similar? 2022 Jan 14. Document no.: CAC220101 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 13 p. (CEST rapid review report).
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What is the (case) definition of hospitalization for COVID-19 in similar jurisdictions?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc441
Document Type
Table
Review Code
CAC220101 RR Table
Question Submitted
January 11, 2022
Date Completed
February 10, 2022
Status
3. Completed
Research Team
Clinical/Acute Care
More detail
Document Type
Table
Review Code
CAC220101 RR Table
Question Submitted
January 11, 2022
Date Completed
February 10, 2022
Status
3. Completed
Research Team
Clinical/Acute Care
Category
Administration
Healthcare Services
Subject
Decision Making
Health Planning
Hospitalization
Population
All
Clinical Setting
Ambulatory
Cardiac unit
Community
Dialysis unit
Emergency
EMS
ICU
Long Term Care
Medicine Unit
NICU
Oncology
Primary care
Public Health
Other
Priority Level
Level 2 One week (7 days)
Cite As
Asamoah, G; Badea, A; Reeder, B; Groot, G; Muhajarine, N; Howell-Spooner, B; Young, C. What is the (case) definition of hospitalization for COVID-19 in similar jurisdictions? 2022 Feb 10. Document no.: CAC220101 RR Table. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. (CEST Table).
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What is the (case) definition of hospitalization for COVID-19 in similar jurisdictions?

https://covid19evidencereviews.saskhealthauthority.ca/en/permalink/coviddoc443
Document Type
Rapid Review
Review Code
CAC220101 RR
Question Submitted
January 11, 2022
Date Completed
February 10, 2022
Status
3. Completed
Research Team
Clinical/Acute Care
More detail
Document Type
Rapid Review
Review Code
CAC220101 RR
Question Submitted
January 11, 2022
Date Completed
February 10, 2022
Status
3. Completed
Research Team
Clinical/Acute Care
Key Findings
January 26, 2022
There exists some ambiguity across jurisdictions and thus there is no clear universal case definition of COVID-19 hospitalization.
Public Health Ontario measures hospitalization as “the number of confirmed COVID-19 cases that reported ever being hospitalized during their infection”- i.e., all cases reported as ever being hospitalized during their infection.
The category “incidental COVID-19 hospitalizations” has been proposed. This refers to patients who are primarily admitted for other ailments and test positive as part of routine screening.
Some jurisdictions and health agencies have started differentiating between those who were admitted for COVID-19-related illness and incidental admissions. Ontario and Saskatchewan have begun using this category in their regular reporting of COVID-19 statistics.
New data from Australia, New Zealand, the US, and Canada indicate that 30 to 50 percent of COVID-19 hospitalizations are “incidental COVID-19 hospitalization” – 46% of COVID-19 hospitalizations in Ontario (as of January 11th, 2022) and 40% in Saskatchewan (as of January 26th, 2022)
Some expert opinions caution that such binary categorization may oversimplify clinical reality, and suggests also employing an ‘indeterminate’ category
Category
Administration
Healthcare Services
Subject
Decision Making
Health Planning
Hospitalization
Population
All
Clinical Setting
Ambulatory
Cardiac unit
Community
Dialysis unit
Emergency
EMS
ICU
Long Term Care
Medicine Unit
NICU
Oncology
Primary care
Public Health
Other
Priority Level
Level 2 One week (7 days)
Cite As
Asamoah, G; Badea, A; Reeder, B; Groot, G; Muhajarine, N; Howell-Spooner, B; Young, C. What is the (case) definition of hospitalization for COVID-19 in similar jurisdictions? 2022 Feb 10. Document no.: CAC220101 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 9 p. (CEST rapid review report).
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21 records – page 1 of 3.