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Palliative care symptom management expertise for long-COVID
  1. Rachel Tuffnell1,
  2. Pippa Sayers2,
  3. Elena Davis2,
  4. Emily Chan2,
  5. Julie Burkin1,
  6. Catherine Moffat1,
  7. Claire Traub1,
  8. Mara Sheldon1,
  9. Sara Booth2 and
  10. Anna Spathis2
  1. 1 Breathlessness Intervention Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  2. 2 University of Cambridge, Cambridge, UK
  1. Correspondence to Rachel Tuffnell, Breathlessness Intervention Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK; r.tuffnell{at}

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Persistence of symptoms after the acute phase of COVID-19 is well recognised, termed post-COVID syndrome or long-COVID.1 Up to a third of people experience ongoing symptoms such as breathlessness, fatigue and chest pain, and symptom severity is largely unrelated to the severity of the initial infection.1 2 The cause of these intractable symptoms is not yet well understood, although there appears to be an association with systemic inflammation.1

Health professionals working in palliative care are expert in the management uncontrolled symptoms when the underlying condition cannot be changed or is unknown. Dedicated symptom-directed breathlessness services or clinics, predominantly embedded within palliative care services, have developed to support the many people suffering from intractable breathlessness.3 These evidence-based, holistic, multidisciplinary services care mostly for people with life-limiting conditions, such as advanced cancer and cardiorespiratory disease.

In April 2020, when health services were stretched by the rapidly escalating pandemic, the Cambridge Breathlessness Intervention Service started to support people with ongoing post-COVID-19 symptoms, in response to significant unmet patient need. To the best of our knowledge, this is the first time a palliative care-based service has managed the chronic consequences of a communicable disease. We have recently evaluated this novel practice.

Ninety-seven patients, with either confirmed or clinically likely past COVID-19 infection, were seen by the service between May 2020 and December …

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  • Contributors RT, AS, SB and JB were involved in conceptualisation and methods development of this project. RT, AS, EC, ED and AS were directly involved in data collection. All authors were involved in the data analysis and interpretation. RT and AS were involved in drafting the manuscript. RT, AS, MS, JB, CT, CM, EC, ED and PS were involved in critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.