Clinical medicine (London, England)
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Persistent symptoms lasting longer than 3 weeks are thought to affect 10-20% of patients following SARS-CoV-2 infection. No formal guidelines exist in the UK for treating patients with long COVID and services are sporadic and variable, although additional funding is promised for their development. ⋯ These individuals see the healthcare system from both professional and patient perspectives, thus represent an important wealth of expertise to inform service design. We present a set of co-designed quality standards, highlighting equity and ease of access, minimal patient care burden, clinical responsibility, a multidisciplinary and evidence-based approach, and patient involvement; and we apply these to propose a potential care pathway model that could be adapted and translated to improve care of patients long COVID.
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In May 2020, the new 'opt-out' organ donation law was passed in England. This law is a crucial step to help battle the long waiting lists of patients awaiting a transplant. This article aims to explore some of the challenges that the transplant teams may face with the new law, as well as raising awareness among the junior doctors, especially with the new COVID-19 transplant guidelines. ⋯ Organ transplant surgery is a life-changing moment for a patient. Ultimately, commissioning groups, clinicians and managers need to work together, evaluate the changes required and enact thorough business plans to ensure the NHS is not overwhelmed. Together with increasing the awareness of organ donation within the public, the government needs to support the NHS to fund, train and manage transplant centres to welcome this much-awaited 'opt-out' organ donation law in England successfully.
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In this review, we explore the challenges of chronic pain and fatigue in clinical practice. Both pain and fatigue are common, troubling and frequently overlapping symptoms, and we describe both the clinical burden and the 'clinical problem'. We explore commonly associated symptoms and possible pathological associations, including variant connective tissue (joint hypermobility), small fibre neuropathy, mast cell activation, dysregulated inflammatory and interoceptive processes, which may inform treatment targets. We suggest a multidisciplinary management approach.
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Protective immunity following COVID-19 infection is not yet fully understood. An understanding of COVID-19 reinfection will be key in guiding government and public health policy decisions in the coming months. This report describes two distinct infective episodes of COVID-19 occurring in the same individual, at the time of writing the first published case in the UK. ⋯ There was exposure to high viral load prior to reinfection. Overall the second infection was symptomatically milder, with a faster recovery. This evidence for reinfection poses challenges for public health and vaccination efforts to protect against the COVID-19 pandemic.
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Multicenter Study
Prevalence and socio-demographic factors of SARS-CoV-2 antibody in multi-ethnic healthcare workers.
Healthcare workers are particularly susceptible to developing COVID-19 owing to close and frequent contact with COVID-19 patients. This cross-sectional study aimed to describe prevalence of SARS-CoV-2 antibodies among healthcare workers within a hospital trust and examine factors associated with increased prevalence of this antibody. ⋯ This large study has described prevalence of recent exposure to SARS-CoV-2 infection among healthcare workers and determined associations including ethnicity, professional groups and geographical areas within healthcare settings. This information will be useful in future COVID-19 studies examining the role of antibody testing both in general populations and in healthcare settings.