It was interesting to read through the letter by Reuken et al (1). The authors elegantly described their work about the prevalence of neuropsychologic symptoms affecting patients who recovered from mild-to-severe coronavirus disease 2019 (COVID-19). Furthermore, they compared these descriptive findings to patients who recovered from Sepsis enrolled in a German sepsis cohort. Interestingly, the authors found that those patients who suffered COVID-19 had a higher rate of chronic fatigue and depression.
We also appreciate the author’s comments about our study (2) published recently in Critical Care Medicine. Still, it is essential to highlight that the objective of our report was to describe the frequency of symptoms affecting the core domains of the postintensive care syndrome (PICS) in patients who had critical illness related to severe COVID-19. PICS is now a well-recognized clinical condition, defined as the presence of any impairment affecting the physical, psychiatric, or cognitive domains resulting from critical illness (3). Similar to the report done by Reuken et al (1), we found that patients who suffered COVID-19 had a high rate of psychiatric manifestations; however, we additionally identified an increased frequency of physical impairments (1, 2).
To date, there have been several observational and case series, studies, and multiple reports from patient advocacy groups that have suggested that patients who suffered even a relatively mild COVID-19 infection may experience a wide range of symptoms after recovery from the acute illness (4, 5). This constellation of symptoms which has adopted multiple terms, including “Post-Acute COVID-19,” “long COVID,” and “post-COVID syndrome,” appears to have multisystem involvement and typically includes fatigue, dyspnea, chest pain, and additional psychologic and cognitive symptoms, similar to PICS (3, 5).
Currently, healthcare professionals caring for patients who recovered from acute COVID-19 have an essential role in investigating and managing ongoing or new symptoms and monitor organ-specific complications that developed during critical illness. We agree with the conclusion by Reuken et al (1) that even patients who suffered from the mild form of the COVID-19 infection spectrum and are affected by postacute COVID-19 need to have outpatient comprehensive multidisciplinary care.
We believe that COVID-19 should be recognized as a chronic disease, so appropriate resources are allocated for rehabilitation interventions, neuropsychologic assessment, and long-term monitoring of symptoms to address this condition’s sequelae, improve quality of life, and facilitate the return to pre-COVID functional status. PICS and postacute COVID-19 seem to share a similar clinical presentation; however, we require further research to characterize different clinical phenotypes associated with this clinical entity.
Footnotes
Dr. Martillo has disclosed that he does not have any potential conflicts of interest.
REFERENCES
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