IPCRG COVID-19 and respiratory Q&A

The IPCRG is providing evidence based COVID and respiratory advice to questions driven by our Sentinel Network of practising primary care clinicians. The Sentinel Network is international, representing every continent and over 100 primary care clinicians. Our answers are based on published peer reviewed evidence. Our initial focus is on managing COVID-19 in primary care settings. We will also include other respiratory conditions in the near future.

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IPCRG COVID-19 and respiratory Q&A

Questions and Answers

What are the risk factors for severe illness with common respiratory viruses such as influenza and RSV?

What are the risk factors for long-COVID-19 disease/post-COVID syndrome (PCS)?

How widely is testing for COVID being undertaken and when should we consider testing clinically?

What is the importance of annual double vaccination for SARS-CoV-2 and influenza?

Are we seeing a drop in SARS-CoV-2 vaccinations and boosters and what effect is this likely to have?

Will the wider population need repeated SARS-CoV-2 booster vaccinations for the rest of their lives and how often would these be needed

When can we expect the Respiratory Syncytial Virus (RSV) vaccine to be approved and available?

Does the evidence support pertussis vaccination for adults with chronic respiratory disease?

What is the duration/prognosis of brain fog in individuals with post-COVID syndrome?

What is the role of pulmonary microemboli in breathlessness in post-COVID syndrome and what is the best treatment?

Some countries have stopped recommending isolation of people with a positive SARS-CoV-2 test. How safe is this from the individual and public health perspective?

How long will prolonged cough, tiredness and shortness of breath last in long-COVID/post-COVID syndrome patients?

What is the prognosis of re-infection by the SARS-CoV-2 Omicron variant in patients without prior vaccination?

Can previous COVID vaccinations immunise against the newest OMICRON strain?

What is known about immunity beyond 6 months following a fourth COVID-19 vaccination (2 initial doses plus first and second booster doses), and does the evidence suggest healthcare professionals would benefit from an additional booster dose?

Is the SARS-CoV-2 Omicron variant associated with a re-emergence of asthma symptoms following recovery from the acute phase of the illness in well controlled asymptomatic people with asthma?

Does spirometry really pick up all the people with COPD and should we keep using LLN given issues around this measurement?

What is the variation in symptoms for different variants of SARS-CoV-2, why do we see this variation and are there predictors for acute disease severity?

Is there an algorithm for diagnosing chronic cough in children?

Is there an algorithm for diagnosing chronic cough in adults?

What is known about immunity beyond 6 months following COVID-19 vaccination (2 doses) and first booster dose, and does the evidence suggest that any specific groups would benefit from an additional booster dose?

What does the evidence suggest will happen with COVID-19 as we move out of the pandemic?

What is the risk of developing myocarditis or pericarditis following a SARS-CoV-2 mRNA based vaccination?

Are there specific warning symptoms of COVID-19 infection for patients who have received a SARS-CoV-2 vaccination?

What do we know about the effect of long COVID and its impact on asthma or COPD patients?

What should we advise patients regarding fourth and subsequent SARS-CoV-2 vaccine doses?

What are the distinguishing features of COVID-19 vs other respiratory illnesses?

What medicines are available to treat an acutely unwell person with COVID-19 in the primary care setting to reduce the risk of hospital admission?

Are new oral anti-COVID-19 drugs effective?

How effective are the current SARS-CoV-2 vaccines against the Omicron variant?

What is the risk and impact of myocarditis for young adults aged 16 to 18 years following a COVID vaccination?

What should we advise people who have had a non-mRNA vaccine and who would like a different vaccine for their second dose?

How do we define long-COVID-19 disease/post-COVID syndrome?

What percentage of the population is needed to be immune to SARS-CoV-2 variants to achieve population level immunity?

How long will the COVID-19 vaccines provide protection from severe disease?

What are the benefits of doses of the SARS-CoV-2 vaccines beyond the initial vaccination course?

What are the potential benefits and risks for vaccination of children and adolescents against SARS-CoV-2?

What is the transmissibility of the Delta variant from and to people who are vaccinated against SARS-CoV-2?

Should flu vaccination be recommended alongside a COVID booster vaccine and can these be delivered together?

Where available, should a pulse oximeter be provided for patients with COVID-19 symptoms following assessment?

What is the optimal time for COVID-19 vaccinations for people with post- COVID disease and do they require one or two vaccine doses of dual- dose vaccines?

What are the safety concerns and what are the serious side effects reported with existing SARS-CoV-2 vaccines?

Should we give COVID-positive patients without asthma ICS as a preventer of respiratory distress syndrome?

Does Vitamin D levels and its supplementation affect the risk of mortality or ICU admission from COVID-19?

How dangerous are new mutations of the SARS-CoV-2 virus and what should we advise patients with regard to these mutations?

Can we safely use nebulisers during the COVID-19 pandemic in the primary care setting, and if so how?

Are patients with COPD at a higher risk of infection with SARS-CoV-2 and are they also more likely to experience a more severe course of COVID-19 illness?

Are patients with asthma at a higher risk of infection with SARS-CoV-2 and are they also more likely to experience a more severe course of COVID-19 illness?

How should post COVID tiredness and fatigue be managed?

Is lung function testing safe during COVID-19 in the primary care setting?

What evidence is available to support the recommended dosing intervals for the current SARS-CoV-2 vaccines?

How do we manage post-COVID respiratory symptoms?

After serious pathology has been excluded, how do we manage common post-COVID symptoms?

What is the duration of immunity from vaccination?

Should individuals who have been infected with SARS-CoV-2 still be vaccinated against COVID-19?

How can we prevent or minimise COVID-19 transmission in a clinical primary care setting?

For a person accessing primary care, how can I decide which symptoms are more likely to suggest a current COVID-19 infection in order to decide further which of them should be tested in preparation for a face to face consultation?

What is the most appropriate test to diagnose COVID-19 in an individual presenting with suggestive symptoms?

IPCRG Sentinel Network

Where we looked

IPCRG COVID-19 and Respiratory Q&A Answer Review Group

Tiago Maricoto

Jaime Correia de Sousa

Alan Kaplan

Ee Ming Khoo

Fiona Mosgrove

Karin Lisspers

Janwillem Kocks

IPCRG COVID-19 & Respiratory Q&A Team

Neil Fitch