Introduction COVID-19 is a new disease. As the first wave hit the UK, clinicians had to learn how to manage the condition acutely. We progressed from a priori approach to assimilation of acquired experience and evidence. After the acute phase, the longer term sequelae were entirely unknown. We developed a service to follow up survivors. The service had to accommodate a large volume of patients and operational infection prevention restriction. Whilst primarily respiratory, the disease is multisystem. Patient assessment had to be comprehensive at the outset; ‘Post-COVID syndrome’ was an unknown entity.

Methods At 3 months post admission, patients were screened initially via telephone questionnaire. Those with ongoing issues were seen in a one stop multi-disciplinary clinic comprising: Respiratory, ID and Intensivist physicians, Physiotherapists, Psychologists with full lung function testing, a broad battery of blood tests, thoracic radiology and questionnaires on fatigue, mental health and activity.

Results Results from 101 patients seen in a 7 week period from June to August 2020 are presented here.

Of those seen in the clinic, 58 (57%) were male and 43(43%) were female. The mean age was 60 and the mean BMI was 32. 32% of patients demonstrated moderately-severe to severe anxiety. 18% of patients were suffering moderately-severe to severe depression.

37% of follow up CXRs were still abnormal at 3 months. 48% of available CT scan demonstrated parenchymal or pulmonary vascular abnormality.

The vast majority of patients demonstrated significant fatigue and breathlessness. Almost all were sleeping poorly.

23% patients demonstrated evidence of PTSD using the Impact of events score. Based on the MDT assessments 45% patients were referred for additional follow up.

Conclusion We have demonstrated that a significant proportion of patients continue to have physical and psychological sequelae at 3 months post COVID-19 infection. In particular, almost half of patients with a follow up CT scan demonstrated radiological abnormality.

All patients benefited from a comprehensive psychosocial and clinical review with individualised, specialist advice on management. The MDT follow up approach has not only guided management of these patients but also allowed us to understand the multi-system complexity of the post-COVID condition.