E-consult innovation helping OSF support COVID-19 long-haulers
The novel coronavirus that causes COVID-19 carries many medical mysteries that might take years for researchers to understand. But right now, it’s important to find support for possibly millions of people globally who, weeks and months after seemingly recovering from even mild cases of COVID-19, are battling a wide range of health problems.
Symptoms lasting more than six weeks have what is now being called long COVID. People in that category have also been referred to as long-haulers. Congress has approved legislation for the National Institutes of Health (NIH) to support continued study of these prolonged health consequences.
Mark Meeker, DO, vice president of physician services for OSF HealthCare, says research will look at what damage is caused by the virus itself and the impacts of the body’s immune system response to the virus. Until research produces more answers, Dr. Meeker says, OSF quickly innovated to support long-haulers.
Leaders at OSF HealthCare reached out to colleagues at other health systems, particularly at Mount Sinai Hospital in East Harlem in New York, one of the oldest and largest teaching hospitals in the United States. Mount Sinai has treated a large volume of people diagnosed with COVID-19. Ultimately, OSF HealthCare clinical experts determined the best approach was to begin with primary care providers to oversee people who have lingering symptoms due to COVID-19.
“This touches so many different organ systems and the severity can be so different and the consequences so different that it’s really best to have your primary care team navigate you through the system. So we have set up a long hauler clinic, so to speak, that’s virtual.”
With the creation of the COVID Recovery Clinic, OSF HealthCare expanded the ability of primary care providers (PCPs) to consult with specialists and collaborate on care. The e-consult approach uses medical record software to request an opinion of medical specialists who can weigh in within 24 hours.
Dr. Meeker says this strategy prevents patients who have multiple symptoms from having to travel for treatment from several specialists. However, in some cases, a patient with severe symptoms might require an in-person visit for evaluation and specialized care.
“The consultant can review the record, review the test results, review the symptoms primary care is reporting and give advice on how to address that situation. Or they (the specialist) may see that person virtually and do a virtual consult. Or, if we feel it’s appropriate, we may say, ‘You need to go see doctor X, who is in this specialty to help us manage this.’”
The primary care provider can fast-track a patient who might need in-person specialty care and ensure they are going to the proper specialist for their particular problem. The most common symptoms reported among OSF HealthCare patients are fatigue, shortness of breath and cough that lingers, along with muscle, joint and other body aches. The more serious symptoms among long-haulers are chest pain and brain fog, where they just can’t think clearly. Some also have memory issues and headaches.
In all, at least 200 symptoms have been traced to COVID-19. In some cases, patients will need medication to manage their symptoms. That is the case with some patients who are at risk of blood clots.
“We’ve had some young people, for example, with significant blood clot issues that appear to be induced by circulation problems triggered by COVID because we had no other explanation for that person to have that problem,” according to Dr. Meeker.
Researchers have estimated at least a third of people diagnosed with COVID-19 end up with one or more lasting or emerging symptoms. Dr. Meeker says rehabilitation is often a key pillar in their treatment plan.
“Physical rehab, pulmonary rehab, cardiac rehab and now we’re starting to talk about brain rehab, which is really more along the lines of cognitive rehab. How do we get the brain rehabbed to clear up (the brain fog) and to be able to think more clearly? Those are all emerging issues that our therapists are working on.”
The uncertainty and the roller coaster of sometimes fleeting and reoccurring symptoms some long haulers experience can take a psychological toll. Our next story will take a closer look at the mental health of people experiencing long-haul COVID symptoms.
If you are recovering from COVID-19, make sure to find a primary care provider if you don’t already have one. That can be the first step to getting the proper support you might need to manage ongoing symptoms.