Postacute coronavirus disease‐2019 syndrome: Review of the literature and role of the pharmacist

Abstract

AbstractSevere acute respiratory syndrome coronavirus (SARS‐CoV‐2) has resulted in over 500 million confirmed cases of coronavirus disease‐2019 (COVID‐19) worldwide, causing over 6 million deaths. A wide disease spectrum has been described for COVID‐19 infections with a newer focus on the long‐term impacts termed Postacute COVID‐19 syndrome (PACS). PACS is not formally defined but occurs 4 weeks to 6 months after the acute infection impacting the neurologic, cardiovascular, respiratory, gastrointestinal, endocrine, renal, dermatologic, and hematologic organ systems to varying degrees. Nearly one third of patients will experience a neuropsychiatric manifestation within 6 months of a COVID‐19 diagnosis with anxiety, depression, and posttraumatic stress disorder (PTSD) being the most common symptoms. There is much similarity between PACS and Postintensive care syndrome (PICS). Long‐term follow‐up is necessary to ensure intensive care unit (ICU) survivors are cared for appropriately. The development of PICS clinics across the world has set a groundwork for better managing PACS. The inclusion of clinical pharmacists in these clinics has repeatedly improved outcomes. Implementation of the ABCDEF Bundle prevents the occurrence of PICS and PACS, making it an important discussion point for the entire health care team. Epidemiologic data is still emerging with the National Institute of Health (NIH) researching COVID to enhance recovery (RECOVER) research initiative contributing to our understanding of PACS and how to best manage it. The purpose of this review paper is to characterize PACS and recommend prevention, potential monitoring, and treatment, as well as to highlight the role of the clinical pharmacist in the management of this population.