Dödligt virus från Kina orsakar panik (SARS-CoV-2, COVID-19)

Back to the future for COVID-19 survivors: a tsunami of chronically ill older adults.

Dear Editor,

COVID-19 survivors are a vulnerable population who often develops sequelae from disease which impair their overall health status as well as increase the risk of hospital dependency. Authors (1) with this beautiful retrospective observational study using data from home health care (HHC), described characteristics of patients after COVID-19 hospital discharged showing that about 1 in 4 patients develop functional and hospital-dependence.

COVID-19 symptoms can persist for months considering that the virus can damage the lungs, heart and brain functions, which increases the risk of dependency and long-term health problems (2). Thus, the COVID-19 survivors resemble the picture of the “chronically critically ill patient” who has survived the acute critical illness, but with ongoing organ dysfunctions that need high levels of specialized care for months or years. Management of such a condition requires a special “intermediate care” with a combination of long-term acute care hospitals as well as skilled nursing facilities at home. Also a follow-up service is necessary and must be based on a multidisciplinary model, which includes respiratory evaluation, cardiovascular and cognitive assessment. Indeed, considering that outcomes may be poor, also a culture of care that has a heavy palliated care influence is at moment necessary.

However, such a pandemic has already revealed the existing gaps in long-term care services and supports worldwide. Learning from the past for the next future it is necessary to improve right away, for COVID-19 survivors and families, the transitional care intervention to help patients' transitions from illness to recovery, to prevent their re-hospitalization and to help terminally ill people be as comfortable as possible at the end of their lives (3).