Post-COVID condition is the presence of new, recurring, or ongoing signs and symptoms for greater than four weeks after a SARS-CoV-2 infection. Persistent headache as a neurologic sequalae of COVID-19 infection is a common prolonged symptom with limited characterization in the literature. This was a case of a 27-year-old female diagnosed with mild COVID-19 who presented with fever, colds, fatigue, headache, decreased hearing, sore throat, dry cough, pleuritic chest pain, anosmia, ageusia, myalgia, and severe low back pain. Headache was described as remitting, frontally located, squeezing and moderate to severe in pain intensity. She was admitted in a tertiary COVID referral hospital for 8 days and was managed supportively. On the 10th day of illness, symptoms had resolved except for an on and off headache. The residual recurrent headache lasted for more than 5 months after being tested negative for SARSCOV2 on repeat reverse transcriptase-polymerase chain reaction (RT-PCR). The possible pathophysiologic mechanisms for neurologic manifestations and prolonged headache were hypoxia, endothelial damage through angiotensin converting enzyme receptor, and cytokine reactions. The characteristics of the symptoms remained unclear despite the proposed mechanisms for prolonged headache among COVID-19 patients.
Headache ; COVID-19 ; Common Cold

BACKGROUND

In Family and Community Medicine (FCM) residency training, the biopsychosocial approach to care was translated to a teaching strategy and cognitive framework called patient-centered, family-focused, and communityoriented (PFC) lens. However, the PFC lens documented in a matrix has no evidence of its implementation acceptability and appropriateness for the users in the FCM training program.

To determine the acceptability and appropriateness of the integration of the PFC lens in the Ortho- Geriatrics Fracture Liaison Service (OG-FLS) in applying the family medicine principles and achieving family practice required competencies of the residents in a tertiary hospital FCM training program.

A cross-sectional survey was conducted using a 15-item self-administered pre-tested online questionnaire to gather feedback and experiences on the PFC lens integration. Answers to open-ended questions were coded and analyzed with MaxQDA and synthesized into themes while numerical rating scales were analyzed with Microsoft Excel into means and standard deviation.

Nineteen residents answered the questionnaire. There were 47 OG-FLS patients referred to the service. Overall, the acceptability of the approach among FCM residents had an average score of 9.26 (SD ± 0.99) while appropriateness was rated 9.26 (SD ± 1.09) with 10 points as the highest score. The competencies achieved reported by residents were communicating effectively, collaborating with interprofessional teams, demonstrating clinical competence, and practice of biopsychosocial approach.

The PFC lens integration in OG-FLS is acceptable and appropriate in the practice of multidisciplinary care in the in-patient setting among FCM residents. Its integration is aligned with the expected competencies of a family physician that trainees can apply in future practice.