Even long after having had COVID-19, 1 in 13 adults are still feeling the effects, according to Data from the Centers for Disease Control and Prevention.
The Adult Post-Acute COVID Clinic at Vanderbilt University Medical Center remains busy, with more than 300 patients and 1,500 encounters per quarter in its multidisciplinary outpatient departments. VUMC also participates in long-running COVID research studies, including the National Institutes of Health recovery initiative and one $1 million study on the effects of COVID on the heart.
Sara Martin, an assistant professor of medicine and one of the clinic’s founders, said vaccination is the best protection to prevent more long-standing COVID cases — and the CDC last week approved a new vaccine formulated to protect against the BA.5 variant.
Martin sat down with the Nashville Post to discuss the symptoms, treatment and prevention of long COVID.
What are the most common symptoms of long COVID?
Right now, in our particular clinical population, our most common diagnoses are shortness of breath, #1. #2 is fatigue. Three is acid reflux. Four tend to be cognitive impairment – brain fog, memory impairment – and #5 is anxiety.
How do I know if it’s long COVID or something else?
Currently, long COVID is a diagnosis of exclusion. So part of what we do, at least when seen in a consultation with an internal medicine specialist, is to make sure we’re working to make sure we haven’t missed another condition that could be the cause. of their current symptoms. We do our due diligence to make sure, before labeling someone as long-standing COVID, that they don’t have another diagnosis that could be contributing to their current symptoms.
Are you finding effective treatments?
Each specialty treats everything differently. Specifically for cognitive impairments and fatigue, we have unique interventions available at Vanderbilt. We worked with our physiotherapists throughout the [Vanderbilt Dayani Center for Health and Wellness] here to develop physical therapy specifically for patients with long COVID. They offer different types of therapy, depending on the primary issues. Whether it’s shortness of breath when they try to walk, or they walk very well and after walking they feel really, really tired. … We have different exercise programs to help people rebuild that strength.
For cognitive impairments, we have several different options, including a cognitive support group. Through our disease survivor clinic or [Critical Illness, Brain Dysfunction, and Survivorship Center] here is the work they have been doing for years now [on] post-ICU syndrome, we have access to their psychologists, who run a support group for patients and families.
We also offer dedicated cognitive therapy with speech therapists across [Pi Beta Phi Rehabilitation Institute] at Vanderbilt, as well as counseling with other board-certified psychologists to help people rebuild their life skills. …brain exercises to help them regain confidence and re-enter the workforce. For many of these patients, if you’ve met them, you might not know that they have brain fog or cognitive impairment, but they find it very difficult to do things that they previously could do without a problem. . It really helps them rebuild mental plasticity so they can start over.
Can the therapy reverse some of the brain fog or is it more about dealing with the current state of the patient’s brain?
I don’t know if we know the exact answer to this, if it reverses it or helps you cope, then it gets better over time. We find that people, over time, tend to improve. Now, this can vary from a few weeks to several months or even a year or more for some patients. It is not uncommon, and well confirmed in the literature, for patients to have setbacks. Even something like you catch COVID again, or you have more stress in your life, or you drink too much alcohol can set you back and cause a major flare-up of all the symptoms you had before. We think it’s helpful for patients to start these brain exercises – that it helps over time. But whether it’s just the weather or a combination of it all, we’re not sure.
Will we see long COVID rates change in the future?
The most recent data available on vaccination shows that in terms of preventing long COVID, it is the most effective thing you can do. Even if you were to catch COVID, if you were vaccinated, your risk of developing a long post-acute COVID infection is down. I would say that a significant proportion of the patients we see are vaccinated, and there is still a significant proportion of the patient population that is unvaccinated.