Understanding the Impact of COVID-19: Now and for the Future

As I write this series introduction, our future with COVID-19 remains uncertain. Overall in the United States new cases had been declining, although rates in most states currently remain higher than during the initial surge of the pandemic in the first 6 months of 2020.¹  In addition, some states are seeing increasing numbers of cases caused by variant and more virulent strains²  and all regions of the world, other than Africa, are experiencing concerning new increases in cases.^3,4  Even when containment of the virus is achieved through herd immunity, it is likely that COVID-19 will not be completely eliminated, remaining endemic.⁵  And it is clear that some people who have recovered from the acute phase of COVID-19 will suffer from long-term sequelae. It therefore behooves us and those we care for to learn as much about this disease as we can to understand the disease trajectory and its effects on organ systems, convey innovative lessons learned in caring for those affected, and acknowledge and address the toll this pandemic has taken on frontline health care workers. This symposium series comprises content to help us do all that.

The COVID-19 pandemic has required health care workers to be creative in order to maintain quality of care for their patients. Miguel and colleagues describe development of an interdisciplinary proning team to reduce the workload of the intensive care team and provide needed care for patients experiencing COVID-19–related acute respiratory distress syndrome. This innovative project resulted in the ability to provide a necessary intervention that used safe techniques and led to no adverse events. Both the intensive care and proning team members reported positive outcomes from the experience.

It is well known that COVID-19 primarily affects the respiratory system, but it can have significant impact on the cardiovascular (CV) system as well. Cajanding provides an in-depth review of the mechanistic and pathophysiologic evidence underlying the CV changes seen with this viral disease. This information is essential because CV changes can affect the majority of patients hospitalized with COVID-19 in both those with and without underlying cardiac disease. Therefore, clinicians should be alert and monitoring for signs of CV involvement with all patients arriving in emergency departments or hospitalized with COVID-19.

As the pandemic has progressed over time, it has become clear that many patients suffer long-term symptoms after recovery from COVID-19; they are being termed “long-haulers.”⁶  Scordo and colleagues provide an overview of the symptoms and affected organs in post-COVID syndrome, the potential etiology for these sequelae, and considerations for management of patients who will require long-term management and support.

Finally, we are aware of the toll the pandemic has taken on nurses and other frontline health care workers in caring for seemingly never-ending waves of critically ill patients with supply, worker, and equipment shortages; unknown risks to self; and grim patient survival rates to date for those requiring intensive care unit stays. These circumstances only add to the ongoing potential for burnout in health care workers who work daily in this challenging environment. Howell describes the phenomenon of burnout, the consequences when it is not addressed, and potential strategies individuals and organizations can use to promote well-being and resilience.

Although these articles provide timely information for use in the midst of the pandemic, they also have implications for well after the pandemic is controlled. We will be addressing the consequences of the pandemic for years to come, whether for the patients who contracted the disease or the health care workers who cared for them. In addition, I hope that this content not only optimizes care for patients during the COVID-19 pandemic but also can be applied to optimize care for patient populations with similar conditions as well as future crisis situations.