Washington University Starts Clinic to Help Covid Long Haulers

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A recent report shows one out of three Covid-19 survivors continue to have symptoms after their initial infection resolves. Stories about "Covid long haulers" are popping up worldwide. Doctors at St. Louis Washington University have decided to do something about it.

Washington University School of Medicine announced a new clinic specifically targeting patients who recovered from Covid-19 but continue to suffer from a wide range of symptoms. Covid Long Haulers in St. Louis and the surrounding area will have access to top-notch care in this multispecialty service line.

The Care and Recovery After COVID-19 (CARE) Clinic recognize people with long Covid presents with diverse issues and complications. Patients often complain about problems in the heart, lungs, kidneys, brain, blood, insomnia, sleep, and mood disorders. To facilitate care coordination, the CARE clinic has access to specialists in Cardiology, Endocrinology, Gastroenterology, Hematology, Infectious Disease, Nephrology, Neurology, Occupational Therapy, Physical Therapy, and Pulmonology.

The team of specialists addresses each patient's needs by providing a comprehensive individual assessment. Referrals, testing, and recommendations are coordinate from the central hub of the CARE Clinic.

The St. Louis Washington University CARE Clinic will schedule patients with Long Covid symptoms who have had a confirmed positive case of COVID-19 by a nasal swab test, a saliva test, or a blood antibody tes.

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Washington University is not the only institute launching post-Covid care clinics. The National Institute of Health (NIH) announced a new initiative to study the causes of the post-Covid condition. The influx of a $1.15 billion investment in new medical research funding will hopefully open the doors to preventative steps and, ultimately, treatment options.

Scientists continue to learn more about persistent symptoms after a Covid-19 infection. Popular terms for the condition include "long Covid" or "Covid long haulers." The CDC uses the more descriptive term post-COVID condition to cover the set of post-infection signs and symptoms experienced more than four weeks after infection with SARS-CoV-2.

We know that SARS-CoV-2 enters the brain and causes inflammation. Scientists in Bethesda, Maryland, published a paper in the New England Journal of Medicine evaluating the brains of people who died from Covid-19. They noted inflammation and evidence of leaky blood vessels in the postmortem brain tissue.

Despite these findings, we do not know the specific reasons the virus causes persistent symptoms in some patients. Long Covid symptoms appear in some patients with severe Covid disease and those with mild or asymptomatic infections.

The CDC lists common symptoms of post-Covid complaints.

• Tiredness or fatigue
• Difficulty thinking or concentrating (sometimes referred to as "brain fog")
• Headache
• Loss of smell or taste
• Dizziness on standing
• Fast-beating or pounding heart (also known as heart palpitations)
• Chest pain
• Difficulty breathing or shortness of breath
• Cough
• Joint or muscle pain
• Depression or anxiety
• Fever
• Symptoms that get worse after physical or mental activities

FIGURE. Self-reported symptoms at the time of positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) testing results and unresolved symptoms 14–21 days later among outpatients (N = 274)* — 14 academic health care systems,† United States, March–June 2020

Figure: CDC.gov

A recent study published in the Lancet evaluated patients six months after hospital discharge. Approximately 75% of the 1,655 hospitalized COVID-19 patients in Wuhan, China, continued to have at least one symptom six months after discharge.

Another Lancet study evaluated the neurolgic and psychiatric outcomes in 236 379 Covid-19 survivors six months after infection. One third met criteria for a neurological or psychiatric diagnosis within six months of infection. Anxiety, depression, muscle pain, substance abuse and insomnia were the most common reported conditions.

Patients in St. Louis and the surrounding area with post-Covid condition symptoms can find more information here.

For more information on the local impact of Covid-19 in the St. Louis area, check out the online town hall "ask the doctor" event hosted by Washington University faculty.

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