Table 2.

Proposed process for diagnosis of patients presenting with post–COVID-19 syndrome dyspnea or cough

I. Bedside tests	Vital signs including pulse oximetry 12-lead (EKG) if not one on file since COVID-19 Orthostatic measurement 6-minute walk test (when feasible)
II. Labs	Complete blood count Complete metabolic panel High-sensitivity troponin BNP
III. Additional tests	2-view CXR If abnormal, then high-resolution noncontrast chest CT If hypoxemic, then full PFTs with lung volumes and diffusion capacity Ventilation/Perfusion scan if prior pulmonary embolism with residual dyspnea or significantly reduced diffusing capacity Consider pulmonary referral when worsening hypoxemia or dyspnea and when pulmonary fibrosis is detected TTE (if ↑ BNP/troponin or abnormal EKG) If abnormal TTE, then cardiology consult If arrhythmia on EKG, order Holter monitor If abnormal, then cardiology e-consult If troponin abnormal → Cardiology consult (TTE with possible CMR) If exertional chest pain or EKG ischemic changes, consider further cardiac testing

Abbreviations: BNP, B-natriuretic peptide; CMR, cardiovascular magnetic resonance imaging; CT, computed tomography; CXR, chest x-ray; EKG, electrocardiogram; PFT, pulmonary function test; TTE, transthoracic echocardiogram.