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新冠疫情给医疗环境留下的遗产:德国长期新冠/新冠后状况随访门诊的设立

The legacy of the COVID-19 pandemic for the healthcare environment: the establishment of long COVID/ Post-COVID-19 condition follow-up outpatient clinics in Germany.

作者信息

Adam Lucas C, Boesl Fabian, Raeder Vanessa, Breuer Ameli, Bremer Benno, Audebert Heinrich J, Franke Christiana

机构信息

Department of Neurology and Experimental Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, Berlin, 12203, Germany.

出版信息

BMC Health Serv Res. 2025 Mar 10;25(1):360. doi: 10.1186/s12913-025-12521-2.

Abstract

BACKGROUND

Since 2020, several specialized follow-up outpatient clinics have been established across Germany to address the complex needs of patients with Long COVID/ Post-COVID-19 Condition (PCC). This article reviews the current landscape of these specialized clinics in Germany and critically evaluates their diagnostic and treatment algorithms.

METHODS

This study employed a mixed-method approach, combining publicly available information on post-COVID-19 outpatient clinics with an observational cross-sectional online survey among lead doctors of PCC follow-up outpatient clinics in Germany. The survey was conducted from November 2023 to January 2024. Descriptive statistics and t-tests for group-comparisons were employed, with statistical significance set at p < 0.05.

RESULTS

At the time of the survey, 112 specialized PCC outpatient clinics were identified in Germany through publicly available information. Forty-five PCC outpatient clinic lead doctors (40.2%) responded to our survey. Treatment of PCC patients is personalized and symptom-oriented rather than standardized. Patient characteristics of the two identified main treatment domains, focusing on respiratory and neurocognitive symptoms, differed only in sex distribution. A higher proportion of females (63.9%) presented with pulmonary symptoms compared to patients with neurocognitive impairments (50.2%, p < 0.05). The level of distress among patients is generally perceived as high and outpatient clinic lead doctors are convinced that their outpatient counseling services offer significant benefits.

CONCLUSIONS

As the demand for PCC follow-up outpatient clinics persists, the establishment of new services continues, particularly to address the growing need for neurocognitive care services. PCC outpatient care is currently personalized and symptom-orientated, leading to high variability across clinics. Further standardization of treatment protocols and diagnostic algorithms could improve patient care and facilitate professional exchange.

摘要

背景

自2020年以来,德国各地设立了几家专门的随访门诊,以满足长新冠/新冠后状况(PCC)患者的复杂需求。本文回顾了德国这些专门诊所的现状,并对其诊断和治疗算法进行了批判性评估。

方法

本研究采用混合方法,将关于新冠后门诊诊所的公开信息与对德国PCC随访门诊诊所的主治医生进行的观察性横断面在线调查相结合。调查于2023年11月至2024年1月进行。采用描述性统计和组间比较的t检验,统计学显著性设定为p < 0.05。

结果

在调查时,通过公开信息在德国确定了112家专门的PCC门诊诊所。45位PCC门诊诊所的主治医生(40.2%)回复了我们的调查。PCC患者的治疗是个性化的且以症状为导向,而非标准化的。确定的两个主要治疗领域的患者特征,即关注呼吸和神经认知症状的领域,仅在性别分布上有所不同。与有神经认知障碍的患者(50.2%,p < 0.05)相比,出现肺部症状的女性比例更高(63.9%)。患者的痛苦程度普遍被认为较高,门诊诊所的主治医生确信他们的门诊咨询服务提供了显著益处。

结论

由于对PCC随访门诊诊所的需求持续存在,新服务的设立仍在继续,特别是为了满足对神经认知护理服务日益增长的需求。目前PCC门诊护理是个性化且以症状为导向的,导致各诊所之间存在很大差异。治疗方案和诊断算法的进一步标准化可以改善患者护理并促进专业交流。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f555/11895281/e1dcebf39e71/12913_2025_12521_Fig1_HTML.jpg

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