AFP Clinical Answers

Postpartum Care, COVID-19, Augmentation Therapy, Vitamin D Supplementation


Am Fam Physician. 2020 Aug 15;102(4):209.

When should a mother receive follow-up care postpartum?

Initial follow-up should happen within three weeks after delivery, in person or by phone. Women with hypertensive disorders should have their blood pressure checked within seven days postpartum. A comprehensive visit should occur within 12 weeks postpartum and include a biopsychosocial assessment.

Which symptoms are common after hospitalization for COVID-19?

In an Italian study, patients who had been hospitalized for coronavirus disease 2019 (COVID-19) but then met criteria for discontinuing quarantine (afebrile for three days, symptoms improved, and two negative polymerase chain reaction tests 24 hours apart) were invited to attend a COVID-19 follow-up clinic. Of 179 eligible patients, 165 agreed to participate, but 22 had a positive polymerase chain reaction test result and were excluded. The mean age of patients was 57 years and 63% were men. Patients were a mean of 60 days past symptom onset, and 87% were still reporting symptoms, with 32% reporting one or two symptoms and 55% reporting three or more persistent symptoms.

Approximately 44% reported a clinically significant 10-point decline on a 100-point quality-of-life scale compared with their pre–COVID-19 state. The most common post–COVID-19 symptoms noted at follow-up were fatigue (53%), dyspnea (43%), joint pain (27%), chest pain (22%), cough (17%), and anosmia (16%). Strengths of the study included a standard protocol for data collection and a good response rate among invited patients. This is valuable prognostic information for patients who were sick enough to be hospitalized; longer-term follow-up in these patients and in those who were less symptomatic will be important. Comparison with patients who have survived other serious pulmonary infections such as community-acquired pneumonia and acute respiratory distress syndrome is also necessary to provide context.




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