ABSTRACT
A COVID-19 pneumonia virtual follow-up service was established within Glasgow Greater and Clyde Health Board in line with national guidance. We aim to evaluate this service and identify patient factors which may predict likelihood of attendance. Using digital clinical systems, we retrospectively collected data on all patients referred to the service between March and August 2020. 802 patients were invited to attend our service. 82.7% of patients were discharged after virtual clinic review;609 patients (75.9%) had radiological resolution and 54 patients (6.7%) failed to attend follow-up chest x-ray. Persistent radiological changes prompted a face to face (13 patients) or telephone (93 patients) clinic review, and patients could self-refer to the service if they had persistent symptoms. Subsequent investigations were organised for 150 patients inclusive of imaging, clinical physiology, blood tests and speciality referrals. Post-COVID19 diagnoses were made in 104 patients (12.9%) of the follow-up population including parenchymal lung disease, pulmonary thromboembolism and long COVID. We identified age, requirement for translator and number of household members as predictors for attending follow up. Patients were more likely to attend with increasing age (p <0.001) and with increased household numbers (p <0.001). The requirement of an interpreter significantly reduced the likelihood to attend (p=0.005). In conclusion, our follow-up service was effective in discharging patients with radiological resolution, identifying complications of COVID-19 and had low non-attendance rate. Developing the service to address language barriers and aid attendance for the elderly would be beneficial.
ABSTRACT
BACKGROUND: Coronavirus disease-19 (COVID-19) infection causes persistent health problems such as breathlessness, chest pain and fatigue, and therapies for the prevention and early treatment of post-COVID-19 syndromes are needed. Accordingly, we are investigating the effect of a resistance exercise intervention on exercise capacity and health status following COVID-19 infection. METHODS: A two-arm randomised, controlled clinical trial including 220 adults with a diagnosis of COVID-19 in the preceding 6 months. Participants will be classified according to clinical presentation: Group A, not hospitalised due to COVID but persisting symptoms for at least 4 weeks leading to medical review; Group B, discharged after an admission for COVID and with persistent symptoms for at least 4 weeks; or Group C, convalescing in hospital after an admission for COVID. Participants will be randomised to usual care or usual care plus a personalised and pragmatic resistance exercise intervention for 12 weeks. The primary outcome is the incremental shuttle walks test (ISWT) 3 months after randomisation with secondary outcomes including spirometry, grip strength, short performance physical battery (SPPB), frailty status, contacts with healthcare professionals, hospitalisation and questionnaires assessing health-related quality of life, physical activity, fatigue and dyspnoea. DISCUSSION: Ethical approval has been granted by the National Health Service (NHS) West of Scotland Research Ethics Committee (REC) (reference: GN20CA537) and recruitment is ongoing. Trial findings will be disseminated through patient and public forums, scientific conferences and journals. TRIAL REGISTRATION: ClinicialTrials.gov NCT04900961 . Prospectively registered on 25 May 2021.