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The new long-distance COVID clinic treats mysterious and ongoing symptoms

After a positive COVID test on December 10, 2020, 47-year-old Sheriflin in Goldsboro, North Carolina, suffered from severe fatigue, blood clots, chronic headaches, increased heart rate, and general pain. I have been suffering from illness. , Thinking and memory problems, and type 2 diabetes. And she accumulated a shelf full of prescription drugs. Approximately two months after the diagnosis, Flynn’s GP introduced her to a recently opened facility. COVID Recovery Clinic At the University of North Carolina at Chapel Hill (UNC) School of Medicine. “She said,” I can treat all your symptoms, but you can not only take all these medications, but also find other ways to help you rehabilitate yourself. I believe, “says Flynn.

The clinic examines many such patients, commonly known as long-haul carriers. On Tuesday afternoon, May, eight people arrived at the facility and met with a team of therapists and doctors. Like Flynn, each patient wanted to be at least free from the myriad of symptoms that had been suffering for months after being diagnosed with COVID, if not a cure. These people underwent a thorough medical examination by various specialists over a period of 3-4 hours. Physiatrist, physician, psychiatrist, neuropsychologist, physiotherapist, and occupational therapist visited each patient’s office to evaluate the patient’s condition. “It’s a lot of work for them to come half a day, and we want to make sure they’re worth it,” says John Baratta, co-director of the clinic who developed this interdisciplinary approach.

Baratta believes that coordinated care between these professionals provides the best opportunity to guide the patient on the path to recovery. Such adjustments treat the entire patient, rather than treating each symptom as its own illness. Similar clinics are open nationwide as doctors are looking for the best way to treat new, embarrassing and multifaceted illnesses without proven treatments. However, clinic managers are concerned that few people of color have been referred to these facilities.

Long-term effects have proven to be common. A study published in the journal in June Nature medicine We examined about 300 patients in Bergen, Norway. Almost all patients diagnosed in the city in the months of 2020. 6 months from the first diagnosis, 61% of the group had persistent symptoms. The most common problem was malaise, followed by poor concentration, sensory and taste disturbances, memory loss, and dyspnea. Many of these patients were young, 16 to 30 years old, and initially had only mild or moderate COVID cases. Another study published in the journal in February JAMA network open About 30 percent of COVID patients, according to researchers at the University of Washington Experience ongoing problems The range of severity, such as malaise, loss of taste and smell, and dyspnea, is at least 4 weeks after the infection test is not positive. Some people reported symptoms after a few months. Centers for Disease Control and Prevention in April Weekly morbidity and mortality reports 69% of non-hospitalized adult COVID patients in Georgia One or more outpatient visits 28 to 180 days after diagnosis, And many of these people had symptoms that could be associated with the original illness.

The entire cluster of long-term COVID symptoms (like Flynn, many have some) has been named by the National Institutes of Health as the acute sequelae of SARS-CoV-2 infection (PASC). Over the next four years to study these effects.

The new clinic is also studying the condition when they are trying to treat it. Many, like UNC, combine patient care with ongoing research to better understand the causes of these persistent problems, predict who is most vulnerable, and devise the best treatments. It is based in the Academic Medical Center. Last year, Balatta realized that some patients in physiotherapy and rehabilitation practices took longer than expected to recover from COVID and began thinking about starting a UNC clinic. “Most people recover in just a few weeks, but we’ve begun to see people with long-lasting, really significant debilitating effects that lasted months,” he says. “We recognized the need for professional care.”

The UNC facility, which opened in February, was opened to treat patients over the age of 18 who were referred by a doctor, diagnosed with coronavirus, and had post-COVID symptoms for more than 4 weeks. “It’s really impressive to me that many people with milder illnesses have these persistent symptoms,” says Baratta, reflecting the results of a Norwegian study. “Probably more than three-quarters of the patients we see have never been hospitalized with COVID.”

The UNC facility is the only long COVID clinic in the long and populous area between Atlanta and Washington in the southeastern United States, and DC Balata is diminished by the number of patients in need of help. It states that it is. To date, the clinic team has evaluated more than 300 people. Some people have damage to the lungs, heart, kidneys, brain, and other organs. Others experience fatigue, headaches, cognitive deficits commonly referred to as “brain fog,” and dyspnea, but no recognizable organ damage.

Due to the lack of established treatments for particularly long COVID symptoms, physicians are well on their way to treatment protocols and rely primarily on approaches that have been successfully used for other illnesses with similar symptoms. Patients diagnosed with post-exercise fatigue, a type of fatigue caused by mental or physical activity, undergo a series of heart and lung tests and blood to assess electrolyte, vitamin, and thyroid levels. Get a panel analysis. The idea is to rule out other causative conditions before giving the patient rehabilitation exercise therapy. Neurostimulants such as Adderall, dextroamphetamine, and Ritalin have proven effective in improving energy and concentration. Albutamol (a commonly used inhaler to treat asthma) improved breathing with steroid inhalation and breathing exercises.

Finding the right treatment is a learning process and resources are still scarce. “We are focusing on people with a known history of COVID, making better use of our resources within the clinic, and better targeting the people we see. We’ve changed the criteria to make it happen, “says Baratta.

However, the people the clinic sees may not represent many of the people in question. Eighty-one percent of patients referred to UNC are white and 17% are black. (The remaining 2% of patients are made up of several different groups.) This combination is similar to the patients found at other COVID clinics across the country. The relatively small number of black patients raises concerns among public health authorities and clinic managers, as the disease itself is disproportionately damaging colored races. They are worried that, along with other social and economic barriers, lack of access and lack of proper health insurance keeps many people with color illness from the care they need terribly.

John Brooks, CDC’s Chief Medical Officer for COVID, spoke at the House of Representatives Energy and Commerce Commission’s April 28 hearing with racial and ethnic minority populations and other disadvantaged communities. He said he was almost certainly having a big long-term impact. sick. “We believe that these conditions are likely to be disproportionately affected because they are … few. lYou are likely to have access to health care services. “

This disparity is also worrisome to Monika Lipson, co-director of the COVID-19 Recovery Clinic at George Washington University’s Medical Faculty Associates in Washington, DC until recently. But if you look at the long COVID, you don’t see the same demographic data, “says Lipson, who just moved to Columbia University. She states that in addition to the access barriers faced by underprivileged people, members of such groups may not seek help due to previous negative experiences with the health care system. “I know they are there, so I want to see more diversity in our clinic,” she says.

Flynn has a positive experience at UNC. Her treatments include physiotherapy and speech therapy. She is also considering mental health counseling for depression caused by months of illness. Her progress is slow, but Flynn says she is grateful to have a doctor who knows what it means to be a long-haul carrier.

https://www.scientificamerican.com/article/new-long-haul-covid-clinics-treat-mysterious-and-ongoing-symptoms/ The new long-distance COVID clinic treats mysterious and ongoing symptoms

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