For health care workers, one of the most troubling aspects of the COVID-19 pandemic is people who get and recover from the virus, only to have additional — often more severe — symptoms arise weeks or even months later. Known in medical journals by names like “post-acute sequelae of COVID-19 (PASC)” or “long-haul COVID,” the condition can have debilitating effects even among the previously young and healthy.
At the University of Colorado School of Medicine, a weekly post-COVID clinic brings together specialists in lung and heart health, as well as psychiatrists, physical therapists, and occupational therapists, to evaluate and treat patients with post-COVID symptoms.
“The clinic was established for patients who have had persistent symptoms following COVID infection, whether they were hospitalized and critically ill or whether they had relatively mild COVID infections and have noted persistent lingering symptoms,” says Natasha Altman, MD, an assistant professor of cardiology who sees patients at the clinic. “It's very interesting, because COVID seems to affect different people in different ways. Some people are more susceptible to having severe illness in the hospital, but it seems that other people are also susceptible for unclear reasons to having persistent symptoms post-COVID. Those can range from persistent loss of taste and smell to heart palpitations or high heart rates to ongoing shortness of breath.”
An undertreated issue
Nationwide, Altman says, people with post-COVID syndrome are connecting on Facebook or online support groups to talk about their symptoms and possible cures. For many, treatment options are limited. As soon as the CU post-COVID clinic was up and running, its providers were getting close to 20 referrals per week.
“Especially early on, when this was just starting to be recognized, people were coming in with symptoms that nobody else knew what to do with,” Altman says. “And a lot of people were not feeling heard despite experiencing very real symptoms. They were hearing, ‘Push through it. You can exercise your way out of it. You'll be OK.’ But it's not OK if you're feeling that way for six months. One of the major things we do is help people realize that this is a real thing, and there are ways to address the issues depending on what their symptoms are.”
Causes as well as cures
In addition to treating post-COVID symptoms with medication and physical therapy, members of the CU clinic also are looking at what it is about the virus that causes the persistent reactions to happen.
Clinic leader Sarah Jolley, MD, an assistant professor of pulmonary sciences and critical care, is conducting research on post-COVID patients who spent time in the intensive care unit, and the clinic as a whole is recruiting patients for the National Institutes of Health’s RECOVER initiative, a nationwide group of institutions looking at the effects of COVID long term.
“There’s a huge group of people out there who are really struggling from symptoms, and some of them are so debilitated,” Altman says. “They can’t work; they can’t exercise — we've seen elite athletes who were previously competing on a national or sometimes even international level pre-COVID, and post-COVID, they can barely walk around the block. That’s one of the things that's been very concerning.”
Power of teamwork
For providers, Altman says, the clinic presents a new and timely challenge, as well as a chance to work together in a way they don’t typically have the opportunity to do.
“It's really wonderful to have a group of multidisciplinary folks collaborating,” she says. “We had great support from the hospital and from our divisions to get this up and running, and it's been a really cool experience to work so closely with different experts.
“It’s also been really gratifying to hear how many patients are just grateful that we’re there and listening and getting to the bottom of their symptoms,” she adds. “I think we're serving a great purpose.”