COMPREHENSIVE COVID-19 ‘LONG-HAULER’ CLINIC OPENS AT U OF U HEALTH

The University of Utah post-COVID-19 care clinic is evaluating more than 80 Post-Acute Sequelae of SARS-CoV-2 (PASC) patients a week and has 300 others on a waiting list. The clinic offers medical services to self-described COVID-19 “Long Haulers” in the Mountain West who have one or more symptoms that have persisted for weeks or months after initial infection.

“I’ve heard from a lot of long-hauler patients that they want care from someone who will listen to them and take them seriously,” says Jeanette Brown, M.D., PhD, the medical director of the new clinic and a pulmonologist who is an assistant professor of Internal Medicine at U of U Health. “Our goal is to address their needs in the best and most effective ways we can in an environment where precision, patient-centered care is paramount.”

In the 623 days (as of November 18) since the first COVID-19 case was reported in Utah, more than 581,000 incidences of the disease have been confirmed in the state. In most of those cases, the viral infection ran its course without lingering symptoms. But for an unfortunate few, the effects of the disease have persisted. Overall, studies show up to 50% of COVID-19 patients experience post-infection symptoms, Brown says.

These symptoms, ranging from mild to debilitating, include:

• Fatigue
• Shortness of breath or difficulty breathing
• Cough
• Joint pain
• Chest pain
• Memory, concentration, or sleep problems
• Muscle pain or headache
• Fast or pounding heartbeat
• Loss of smell or taste
• Depression or anxiety
• Fever
• Dizziness when standing
• Worsened symptoms after physical or mental activities

To address these problems, clinic patients are evaluated by an advance practice clinician or a nurse who, in consultation with Brown, will coordinate care with physicians and practitioners in 10 specialties:

• Dermatology
• Cardiology
• Endocrinology
• Ear, Nose, & Throat (ENT)
• Infectious Disease
• Nephrology
• Neurology
• Psychiatry
• Pulmonary
• Social work

Coordinating through a single provider helps specialists concentrate on what they can specifically do for a patient as part of an overall care plan.

“I can stay focused on their shortness of breath or other pulmonary issues, knowing that they’re going to get the cardiovascular or neurological care they might need without me having to reach out to my colleagues in those departments,” says Mary Beth Scholand, M.D., an associate professor in Pulmonary Medicine at U of U Health who will be participating in the clinic. “It’s going to allow us to be really directed and efficient, hopefully leading to better care for these long-term COVID patients.”

In addition to patient care, the clinic will also conduct research on the long-term effects of COVID-19 in hopes that it will lead to better treatments.

“Right now, treating COVID-19 and its long-term effects is like jumping out of an airplane and trying to make the parachute as you go down,” Brown says. “We still have a lot to learn about it. By gathering evidence and developing clinical pathways that are based on collaborative learning, we can funnel this knowledge into improving all aspects of long-hauler care.”

The clinic also plans to have educational learning collaborative sessions to help providers learn more about post COVID-19 symptoms. This will provide support for care providers as well, Brown says.