Multidisciplinary Center Care for Long COVID Syndrome – a Retrospective Cohort Study

Link:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10200714/

Graphic:

Specialty Utilization Specialty utilization by a total of 1802 patients evaluated at the Comprehensive COVID Center (CCC) during the first 21 months in a total of 2361 initial visits in 12 specialty clinics. The mean number of specialty clinics visited by CCC patients was 1.3 (range 1-6) and multiple clinic consultations accounted for 405 visits.

Excerpt:

Background

Persistent multi-organ symptoms after COVID-19 have been termed “long COVID” or “post-acute sequelae of SARS-CoV-2 infection” (PASC). The complexity of these clinical manifestations posed challenges early in the pandemic as different ambulatory models formed out of necessity to manage the influx of patients. Little is known about the characteristics and outcomes of patients seeking care at multidisciplinary post-COVID centers.

Methods

We performed a retrospective cohort study of patients evaluated at our multidisciplinary Comprehensive COVID-19 Center (CCC) in Chicago, IL, between May 2020 and February 2022. We analyzed specialty clinic utilization and clinical test results according to severity of acute COVID-19.

Results

We evaluated 1802 patients a median of 8 months from acute COVID-19 onset, including 350 post-hospitalization and 1452 non-hospitalized patients. Patients were seen in 2361 initial visits in 12 specialty clinics, with 1151 (48.8%) in neurology, 591 (25%) in pulmonology, and 284 (12%) in cardiology. Among patients tested, 742/878(85%) reported decreased quality of life, 284/553(51%) had cognitive impairment, 195/434(44.9%) had alteration of lung function, 249/299(83.3%) had abnormal CT chest scans, and 14/116(12.1%) had elevated heart rate on rhythm monitoring. Frequency of cognitive impairment and pulmonary dysfunction was associated with severity of acute COVID-19. Non-hospitalized patients with positive SARS-CoV-2 testing had similar findings than those with negative or no test results.

Conclusions

The CCC experience shows common utilization of multiple specialists by long COVID patients, who harbor frequent neurologic, pulmonary, and cardiologic abnormalities. Differences in post-hospitalization and non-hospitalized groups suggest distinct pathogenic mechanisms of long COVID in these populations.

Keywords: Long COVID, Post-Acute Sequelae of SARS-CoV-2 Infection, PASC, Multidisciplinary Care, Health Service Delivery

doi: 10.1016/j.amjmed.2023.05.002 [Epub ahead of print]

Author(s): Joseph Bailey, M.D.,a,⁎ Bianca Lavelle, M.D.,b Janet Miller, B.S.,a Millenia Jimenez, B.S.,c Patrick H. Lim, M.S.,c Zachary S. Orban, B.S.,c Jeffrey R. Clark, B.A.,c Ria Tomar, B.S.,a Amy Ludwig, M.D.,a Sareen T. Ali, B.S.,c Grace K. Lank, B.S.,c Allison Zielinski, M.D.,d Ruben Mylvaganam, M.D.,a Ravi Kalhan, M.D.,a Malek El Muayed, M.D.,e R. Kannan Mutharasan, M.D.,d Eric M. Liotta, M.D. M.S.,c Jacob I Sznajder, M.D.,a Charles Davidson, M.D.,d Igor J. Koralnik, M.D.,c,1 and Marc A. Sala, M.D.a,1, for the Northwestern Medicine Comprehensive COVID Center Investigators

Publication Date: 2023 May 22

Publication Site: National Library of Medicine

Prolonged brain dysfunction in COVID-19 survivors: A pandemic in its own right?

Link: https://theconversation.com/prolonged-brain-dysfunction-in-covid-19-survivors-a-pandemic-in-its-own-right-158743

Excerpt:

One in three survivors of COVID-19, those more commonly referred to as COVID-19 long-haulers, suffered from neurologic or psychiatric disability six months after infection, a recent landmark study of more than 200,000 post-COVID-19 patients showed.

Researchers looked at 236,379 British patients diagnosed with COVID-19 over six months, analyzing neurologic and psychiatric complications during that time period. They compared those individuals to others who had experienced similar respiratory illnesses that were not COVID-19.

They found a significant increase in several medical conditions among the COVID-19 group, including memory loss, nerve disorders, anxiety, depression, substance abuse and insomnia. Additionally, the symptoms were present among all age groups and in patients who were asymptomatic, isolating in home quarantine, and those admitted to hospitals.

Author(s): Chris Robinson

Publication Date: 15 April 2021

Publication Site: The Conversation