With over 10M COVID-19 cases in the United States since January and an imminent second wave, it’s more important than ever to understand the lasting impact this virus will have on patients’ health.
Last month, Infectious Disease Specialist Dr. Megan Coffee joined us for a live webinar to share updates on COVID-19 and provide advice on treating patients with Long COVID. Dr. Coffee is a clinical professor at NYU Grossman School of Medicine and an Infectious Disease Attending Physician at Bellevue hospital, where she has been involved in the coronavirus clinical response. She is also an adjunct professor at Columbia University and the communicable disease advisor for the International Rescue Committee, working on the coronavirus response.
In the last few weeks, exciting news has come out about apotential vaccine andnew treatment options. Despite these promising steps, new cases are still on the rise and primary care physicians need to understand how to help their patients manage the initial and long-term symptoms.
“It’s going to be an incredibly important time for primary care to be learning from Long COVID as we begin to understand this disease better,” Dr. Coffee said.
What is Long COVID and what are the symptoms?
Dr. Coffee shared that Long COVID is the persistence of symptoms 3 weeks after the initial onset of symptoms. This can occur with both mild and severe illness and affects at least 10% of patients but seems to be more prevalent in those who have been hospitalized, with 2/3 of patients reporting symptoms after 3 months.
According to Dr. Coffee, these symptoms include:
Main: cough, fever, fatigue
Others: shortness of breath, chest pain, headaches, mental fog, neurocognitive difficulties, muscle pain and weakness, GI issues, rashes, worsened diabetes, thromboembolisms
Post-ICU syndrome, PTSD
Dr. Coffee also mentioned some patients have experienced prolonged loss of taste and smell. Most regain these senses within 10-14 days, but she said there has been a lot of plateauing and this can persist for months.
How can you treat Long COVID?
When thinking about how to help patients with ongoing symptoms, Dr. Coffee recommended considering the following depending on the clinical presentation:
Home pulse oximetry
CBC, BMP, LFTs, Troponin, CRP, Ferritin, D-dimer
Potential referrals to pulmonology, pulmonary rehab, cardiology, neurology
Management for PTSD or depression as appropriate
Above all else, Dr. Coffee said the most important thing is preventing future cases. “We really need to reduce the chance of anyone being infected because we’re still learning so much about Long COVID,” she said. “I think it’s especially important for primary care doctors. We don’t even yet have a great definition of the disease.”