Ask the Expert: Addressing Long-Term Post-COVID Needs

Rachel Houseal, PA-C, on managing Aspen Valley Hospital’s COVID-19 Respiratory Evaluation Clinic, caring for patients with lingering side effects and planning for the future of COVID-19 care in our community.

As clinicians and researchers learn more about COVID, what trends are emerging about long-term effects of infection?

Anecdotally and in scientific literature, persistent symptoms are being documented in COVID-19 patients. The most common symptoms are fatigue, shortness of breath, cough, joint or muscle pain, chest pain, brain fog, and anxiety or depression. Severity and duration of symptoms vary greatly among individuals, regardless of demographic. Male or female, young or old, healthy or sick, hospitalized or not: anybody is susceptible to the long-term effects of COVID-19.

Based on current information, what kinds of care are likely to be beneficial for patients with long-term effects of COVID infection?

Post-COVID recovery clinics are being developed across the nation, taking a multidisciplinary approach to deliver comprehensive care. Early research indicates benefits from multimodal intervention, including rehabilitative and behavioral health services, with potential referral on to additional specialties such as pulmonology, cardiology, physiatry or neurology. Numerous ongoing studies will play a critical role in understanding the long-term effects of COVID and how to best treat patients.

How is AVH preparing to address the needs of patients with long-term COVID effects?

AVH has been addressing the needs of patients with COVID-like symptoms since the beginning of the pandemic. What began as a pop-up tent in the parking lot has evolved into the Respiratory Evaluation Center ― a separate, dedicated space within the hospital in which providers can evaluate patients. As the need for post-COVID care became apparent, we reached out to multiple subspecialties to establish a network of experts who are available, either in-person or via telemedicine, to ensure comprehensive care for each patient.

What will be some challenges to putting these plans into action?

The biggest challenge, for both patients and providers, is the deficit in knowledge of the mechanisms contributing to persistent COVID symptoms. Without a fundamental understanding of why something is happening, it is difficult to fully address and resolve the issue. Although we have much to learn about long-term COVID effects, the promising news is that many studies are underway and current treatment modalities are beneficial to patients.

Will AVH bring in additional clinical specialists or create a dedicated clinic space for these services?

We are looking to formalize this network of experts into a Post-COVID Clinic, which will operate under Aspen Valley Primary Care at AVH. Since those suffering from post-COVID symptoms have completed their self-isolation, we don’t need a dedicated space for this clinic. All of our hospital’s specialties are willing to care for this population in-person or via telemedicine, including rehabilitative services, behavioral health, pulmonology, cardiology and physiatry. Other services available in and outside of the valley include neurology and nephrology.

How much demand do you anticipate for these services?

A large percentage of patients who have recovered from acute COVID illness continue to experience persistent symptoms for two to six months. This means potentially thousands of individuals in our valley (Aspen to Glenwood Springs) could struggle with post-COVID effects. While our clinic will start off small, as the knowledge base and provider network grow, we will have the capability to accommodate more patients.

Check out this interview in the full Spring 2021 issue of Health Matters magazine, here.