Postdischarge Evaluation for Individuals Hospitalized with COVID-19

Authors: Gail Berkenblit, MD, PhD, Kaelin O’Connell, MD, Sara Mixter, MD, MPH, Caitlin Dowd-Green, PharmD, Rosalyn W. Stewart, MD, MS


Primary care providers (PCPs) now face a novel clinical scenario: postdischarge care for patients with COVID-19. In a study of 138 patients hospitalized for COVID-19 in Wuhan, China, discharged patients had an average hospital stay of 10 days, with courses that were complicated by ARDS, venous thromboembolism (VTE), arrhythmias, and shock.1 The World Health Organization estimates an overall recovery time from COVID-19 of 2 weeks for mild infections and 3 to 6 weeks for severe disease.2 Thus, many discharged patients will need continuing management of pulmonary conditions, surveillance for secondary infections, monitoring for cardiac complications, and screening for depression or posttraumatic stress disorder (PTSD) in the outpatient setting. Clinicians also must address ending home isolation and safe timelines for returning to work. Here, we discuss special considerations in caring for patients with COVID-19 following hospital discharge.
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Fig. COVID-19 follow-up algorithm. AST/ALT, aspartate transaminase/alanine transaminase; BMI, body mass index; CK, creatine kinase; CKD, chronic kidney disease; COVID-19, coronavirus disease 2019; CT, computed tomography; CXR, chest X-ray; ESR/CRP, erythrocyte sedimentation rate/C-reactive protein; ICU, intensive care unit; IL-6, interleukin-6; LDH, lactate dehydrogenase; mAb, monoclonal antibody; PE, pulmonary embolism; PNA, peptide nucleic acid; pt, patient; WBC, white blood cell count.

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Table 1. Review of systems for patients with COVID-19

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Table 2. Telemedicine physical examination for patients with COVID-19

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