Colombian consensus for the management of respiratory complications in post-COVID-19 patients. Recommendations based on expert consensus and informed by the evidence

Consenso colombiano para el manejo de las complicaciones respiratorias del paciente Pos-COVID-19. Recomendaciones basadas en el consenso de expertos e informadas en la evidencia

Evidence suggests that long-term lung symptoms and functional impairment occur in a proportion of individuals after SARS-CoV-2 infection. Although the proportion of patients affected has yet to be found, doctors are increasingly faced with patients reporting respiratory symptoms and deterioration beyond the acute phase of COVID-19. Given the need to protocolize treatment behaviors, the Colombian Association of Pneumology and Thoracic Surgery (Asoneumocito) formed a working group to develop informed and evidence-based recommendations, by consensus of experts, for the management of respiratory complications in the post-COVID-19 patient. Recommendations made by professionals from different areas of Asoneumocito to help the clinical professional in primary care in the management of possible respiratory complications that may appear during the months after the acute picture of the disease caused by the coronavirus (COVID-19) and standardize their follow-up. Methods. The document was developed in 6 stages: 1. Definition of the questions subject to research and content, 2. Search, sieving, evaluation, and selection of evidence, 3. Elaboration of summary of evidence answering the question's object, 4. Discussion informal panels, 5. Generation of recommendations and 6. Drafting and construction of the consensus document. Results. The 85 participants reached a consensus and made 71 recommendations regarding the following approaches: 1. Definition of the post-covid syndrome, 2. Pulmonary and neuromuscular rehabilitation, 3. Lung function, 4. Radiology and diagnostic imaging in post-COVID-19 syndrome, 5. Anticoagulant management and post-COVID-19 thromboembolism, 6. Airway sequelae – bronchoscopy, 7. Pulmonary fibrosis and pneumonia of secondary organization and 8. Oxygen therapy considerations. Conclusion. The recommendations made should serve as an interim guide to ease the treatment of patients with the post-COVID-19 pulmonary syndrome. As new evidence appears, these recommendations may need to be carefully reconsidered and revised.