Some health care providers in Arkansas are beginning to offer services tailored to patients who are struggling to recover weeks or months after being diagnosed with covid-19.
According to a study released this year by the federal Centers for Disease Control and Prevention, an estimated one in five covid-19 survivors aged 18 to 64 and one in four survivors aged 65 and over have a problem. health related to their disease. included 63.4 million individuals.
Another 2022 study published in the Journal of Infectious Diseases estimated that millions of Americans – about 1.7% to 3.8% of the US population – experienced new long-term symptoms that limited daily activities. a month or more after infection with covid-19.
“Because the coronavirus can attack the lungs, heart, brain, and other organs, there can be lasting internal damage,” said Sheena CarlLee, director of the University of Arkansas’ Long Covid Clinic. for Medical Sciences, which opened Aug. 25 in Fayetteville.
Damage to vital organs can exacerbate long-term health problems such as heart disease, diabetes, kidney disease, blood disorders, neurological disorders, and mental health disorders.
The new UAMS clinic brings together specialists to treat patients across the spectrum of symptoms.
“We see patients with a wide variety of symptoms that require a unique treatment regimen,” CarlLee said. “Our longstanding covid clinic offers in-depth assessment by a team of students and health care providers trained in the disciplines of medicine, pharmacy, nursing, physiotherapy, occupational therapy and life sciences. radiation therapy.”
Some of the most successful long-term clinics in the country are team clinics, which can dive into a variety of symptoms and design a detailed plan, according to CarlLee.
The clinic team also works closely with researchers at the UAMS campus in Little Rock, and patients can choose to participate in this research, she said.
UAMS bills through insurance, and the cost for patients in the long covid clinic will be the same as a visit to the primary care clinic, according to CarlLee.
UAMS internal medicine physician CarlLee and other physicians from various UAMS campuses have seen former covid-19 patients with prolonged symptoms related to the infection, she said. .
Sometimes long covid symptoms develop in people who had few or no symptoms when they initially tested positive, but long covid tends to affect those who had a more complicated initial infection, he said. she declared.
Based on recent research, people who have stayed in intensive care, been put on a ventilator, not vaccinated, or have underlying medical conditions all appear more likely to develop long covid, according to CarlLee. Women may also be disproportionately affected, she said.
Long covid is still defined by the scientific community, health officials say, but it usually means new or persistent symptoms of the virus occurring at least three or four weeks after a positive covid-19 test.
Because the term has not yet been precisely defined, the data varies depending on the prevalence of the disease, said Jennifer Dillaha, director of the Arkansas Department of Health.
Symptoms and conditions associated with long covid, which will likely affect many people for years to come, are consistent throughout the scientific literature, Rachel Levine, U.S. Assistant Secretary for Health, wrote last month in the Journal of the ‘American Medical Association.
Symptoms such as shortness of breath, muscle aches, cough, fatigue, loss of taste or smell, and memory and concentration problems are some of the most common symptoms. Heart palpitations, dizziness, diarrhea, stomach pain, rash, and joint or muscle pain have also been experienced after covid, according to the federal Centers for Disease Control and Prevention.
Long covid is not a singular case of long-term symptoms developing from viral infections, according to Fayetteville City Health Officer Dr. Marti Sharkey. The Epstein-Barr virus is the cause of infectious mononucleosis, more commonly known as mono, she noted.
“It’s not uncommon to see prolonged systems. It’s not surprising with a virus that has infected so many people,” she said.
YOUNG AND OLD PATIENTS
In central Arkansas, the Strong Hearts Rehabilitation Center at Arkansas Heart Hospital offers a rehabilitation program for long-term patients at facilities in Little Rock, Russellville, Conway, and Bryant.
The center enrolled its first post-covid patients in January, shortly after the US Centers for Medicare and Medicaid Services issued guidelines for programs to treat persistent symptoms of the disease, said Amanda Xaysuda, director of the center.
“We had it all planned out before, but once Medicare paid for it and more research showed it was beneficial for this patient population, that’s when we decided to go for it.” , she said.
The Strong Hearts Rehabilitation Center program focuses on pulmonary rehabilitation. The center’s health care providers help patients build exercise tolerance and work on breathing exercises.
“Everything else we do is focused on the patient and their symptoms,” Xaysuda said.
The program has helped post-covid patients with postural orthostatic tachycardia syndrome, an abnormal spike in heart rate that occurs after sitting or standing.
While the oldest patients in the program were in their 90s, the youngest was 16. Many patients are in their 30s and 40s, a demographic the Strong Hearts Rehabilitation Center isn’t used to seeing.
“What we’ve always done is traditional cardiac rehab. Typically, our patients are of Medicare age. They’re 65 and older,” Xaysuda said. “It’s a whole new population of people.”
Although Medicare and some private insurance companies cover pulmonary rehabilitation for post-covid diagnoses, Xaysuda said the Arkansas Blue Cross Blue Shield does not.
Other major healthcare providers in Arkansas do not offer specialty clinics like those provided by UAMS and Arkansas Heart Hospital.
In a statement Thursday, spokesperson Joshua Cook said CHI St. Vincent does not have a dedicated clinic for long-term treatment.
At Baptist Health, the prevalence of long covid is not high enough to warrant a specialty clinic, Dr. Amanda Novack, medical director of infectious diseases, said in a statement Friday. However, Baptist Health primary care physicians work with long-time patients to create personal care plans.
“These treatments could include specialized treatments such as physiotherapy, nutritional support, cardiac or pulmonary rehabilitation,” Novack said in the statement.
Sharkey, the Fayetteville city health worker, said preventing transmission should always be a community goal.
“Every time we get infected with this virus there is another risk of long term covid. Just because you haven’t had long term covid doesn’t mean you won’t,” said she declared. “We have people who caught covid during the first wave of winter 2020 and are still suffering.
“We’re definitely a lot better than where we were a year ago, but we’re not at the end yet,” she said.
Sharkey recommends people with long-term covid symptoms visit a clinic with a multidisciplinary team approach, such as the UAMS clinic.
“You need a team approach to assessing multiple organ systems and to have a very tailored approach to the person’s symptoms,” she said.
Getting vaccinated will help fight transmission of the virus, Dillaha said.
“I would encourage people to receive primary vaccination doses, followed by at least one booster dose. Take reasonable steps to avoid becoming infected. Especially if you are at high risk of serious illness,” Dillaha said. .
Dillaha worries that people, especially parents, are not being informed about the long covid and not considering the risks of infection when deciding whether to get vaccinated or have their children vaccinated.
Even with mild symptoms, people should still get tested for covid-19 because they may be eligible for treatment with Pfizer’s antiviral drug Paxlovid and be able to minimize the risk of infection, according to Dillaha.
The death toll from Covid-19 in Arkansas topped 12,000 on Tuesday. Nationwide, more than one million people have died from covid-19 infection, according to the centers.
Residents can make an appointment at the UAMS Clinic at 1125 N. College Avenue in Fayetteville by calling (479) 713-8701.
Source: University of Arkansas for Medical Sciences