An integrated multidisciplinary model of COVID-19 recovery care
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ORIGINAL ARTICLE
An integrated multidisciplinary model of COVID-19 recovery care Helen O’Brien 1 & Michael J. Tracey 2 & Ciara Ottewill 1 & Michael E. O’Brien 1 & Ross K. Morgan 1 & Richard W. Costello 1,3 & Cedric Gunaratnam 1 & Daniel Ryan 1 & Noel G. McElvaney 1,3 & Samuel J. McConkey 2,4 & Cora McNally 2 & Gerard F. Curley 5 & Siobhan MacHale 6,7 & Diane Gillan 8 & Niall Pender 8,9 & Helen Barry 6,7 & Eoghan de Barra 2,4 & Fiona M. Kiernan 5 & Imran Sulaiman 1 & Killian Hurley 1,3 Received: 14 July 2020 / Accepted: 25 August 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background In January 2020, the WHO declared the SARS-CoV-2 outbreak a public health emergency; by March 11, a pandemic was declared. To date in Ireland, over 3300 patients have been admitted to acute hospitals as a result of infection with COVID-19. Aims This article aims to describe the establishment of a COVID Recovery Service, a multidisciplinary service for comprehensive follow-up of patients with a hospital diagnosis of COVID-19 pneumonia. Methods A hybrid model of virtual and in-person clinics was established, supported by a multidisciplinary team consisting of respiratory, critical care, infectious diseases, psychiatry, and psychology services. This model identifies patients who need enhanced follow-up following COVID-19 pneumonia and aims to support patients with complications of COVID-19 and those who require integrated community care. Results We describe a post-COVID-19 service structure together with detailed protocols for multidisciplinary follow-up. One hundred seventy-four patients were discharged from Beaumont Hospital after COVID-19 pneumonia. Sixty-seven percent were male with a median age (IQR) of 66.5 (51–97). Twenty-two percent were admitted to the ICU for mechanical ventilation, 11% had non-invasive ventilation or high flow oxygen, and 67% did not have specialist respiratory support. Early data suggests that 48% of these patients will require medium to long-term specialist follow-up. Conclusions We demonstrate the implementation of an integrated multidisciplinary approach to patients with COVID-19, identifying those with increased physical and mental healthcare needs. Our initial experience suggests that significant physical, psychological, and cognitive impairments may persist despite clinical resolution of the infection. Keywords COVID-19 . Critical care . Multidisciplinary model . Psychiatry . Respiratory
* Helen O’Brien [email protected]
5
Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland
6
Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland
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Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
1
Department of Respiratory Medicine, Beaumont Hospital, Dublin, Ireland
2
Department of Infectious Diseases, Beaumont Hospital, Dublin, Ireland
3
Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
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Department of Psychology, Beaumont Hospital, Dublin, Ireland
Department of International Health and
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