One of the most frightening aspects of COVID-19 is the fact that some patients struggle with symptoms for months after their recovery from the disease. These patients, sometimes referred to as long-haulers, find themselves coping with a range of conditions such as neurological problems that can include brain fog, debilitating fatigue, and severe migraines. There can also be complications like inflammation of heart muscle, kidney injury, muscle pain, heart palpitations, lung function abnormalities, rashes or hair loss, which can incapacitate people for interminable period of time. Some of the worst cases of the infection have been linked to mental decline equivalent to the brain aging by 10 years
A study in the UK found that as many of 10 percent of COVID-19 patients are experiencing longer-term illness. As of December, that equates to potentially over 1,000,000 Americans and 20,000 people in Alabama.
In an effort to help these patients, UAB has started a Post COVID Treatment Program. It is open to everyone in Alabama, and is one of the few programs of this kind in the United States. "Early on in the pandemic, we established an ambulatory clinic for COVID patients," said Turner Overton, who is director of the Post COVID program. "But our acute COVID clinic is not set up to manage these types of chronic symptoms so we started working with some of our providers who could see these patients and we realized that we needed to develop a program for them. Rather than building a stand-alone clinic, we decided on a centralized management structure where we could identify these patients and get them triaged to the right provider based on their symptoms, using our existing infrastructure at Kirkland Clinic and our other specialty clinics."
In an effort to evaluate these patients and meet their medical needs, UAB's Post COVID Treatment Program will use an algorithm to direct patients to experts based on their symptoms. Patients can make an appointment in the program through three avenues: they can make an appointment for themselves by calling the UAB COVID-19 Call Center at 205-975-1881; both UAB physicians and community physicians can refer patients; and the program has a dedicated clinical care coordinator who will reach out to patients discharged from UAB four to six weeks after their diagnosis/care to assess their symptoms and care needs.
The four week time frame was decided on because patients should no longer be infectious at that point. "Most people are no longer infectious after 10 days," Overton said. "If someone is immunosuppressed or has a more severe illness, the CDC recommends that they could be infectious up to 20 days so, in general, we are not referring people before three weeks and from a practical standpoint four weeks out from their symptom onset. That allows us to be sure we're seeing people with chronic post COVID symptoms."
It is possible that this program may also help UAB providers and researchers gain a better understanding of the disease and help to recognize disease patterns, as well as potentially gaining an understanding of how the disease manifests itself in specific organs.
Patients may see UAB providers from a number of areas depending on their symptoms, including but not limited to the departments of Psychiatry and Neurology, and divisions of Cardiovascular Disease, Clinical Immunology and Rheumatology, Infectious Diseases, and Pulmonary, Allergy and Critical Care Medicine.
"This approach allows the patient to be heard and helps us get them to the right provider," said Donna Dye, MSN, director of Ambulatory Services at UAB Medicine. "We want to be considerate and sensitive to their needs. It's important that these patients don't feel alone because these unending symptoms are frightening."