How Physicians Can Support Patients with Long COVID-19

Post-COVID Conditions (commonly known as “long COVID-19”) is an umbrella term that encompasses the wide range of physical and mental effects that remain after SARS-CoV-2 infection.

According to the Centers for Disease Control and Prevention (CDC), much is still unknown about long COVID-19. The broad spectrum of symptoms, signs and severity associated with the condition make it difficult to accurately evaluate. In a report on interim guidance for evaluating and caring for patients with long COVID-19, the CDC states that “At present, robust longitudinal surveillance data on post-COVID conditions are lacking and the prevalence is challenging to estimate.” Although the true frequency and severity of the condition is largely unknown, evidence suggests that post-COVID conditions occur in patients of all ages, from children and adolescents to older patients. One study, published by the journal BMJ, estimates that 32% of older adults who survived COVID infections had symptoms of long COVID-19.

The effects of the condition can range from minor (such as a loss of smell) to major, impacting individuals’ quality of life and ability to attend work or school.  

The CDC recommends that physicians take the following actions, in addition to standard care recommendations, to support long COVID-19 patients.

• During patient conversations, maintain an attitude of empathy and understanding. Be sure to validate patient experiences.
• Focus on holistic, patient-centered care that aims to improve quality of life.
• Discuss and set treatment goals and clarify recovery expectations.
• Evaluate the patient’s social history, including their finances, employment, housing, substance use and access to food.
• Establish partnerships with specialists, such as mental healthcare professionals and consider referral to multidisciplinary post-COVID care centers.
• Connect patients to social services, such as support groups and financial assistance.
• Develop a physical rehabilitation plan.
• Offer guidance to manage nutrition, sleep and stress.
• Encourage use of patient health diaries that record physical and mental wellness.
• Inquire about patient use of additional supplements, such as herbal remedies.
• Follow up with the patient throughout the illness and reconsider treatment approaches, if necessary. Using telemedicine (phone calls and virtual visits) for appointments, when possible, may help reduce patient stress.

The CDC also notes that it is important to consider the role that health disparities may play in certain populations, such as racial and ethnic minorities or aging patients. For example, according to STAT’s Elizabeth Cooney, it’s well established that COVID-19 disproportionately affected people of color and experts predict long COVID-19 will have a similar effect. Cooney cites the following statement from John Brooks, chief medical officer on the Covid-19 response at the CDC: “While we do not yet have clear data on the impact of post-Covid conditions on racial and ethnic minority populations and other disadvantaged communities, we do believe that they are likely to be disproportionately impacted by these conditions as they are more likely to acquire SARS-CoV-2 and less likely to be able to access health care services.”

Additionally, Kaiser Health Network (KHN) reports that long COVID-19 symptoms are often confused with common signs of aging, although these issues are distinctly different. KHN explains that the higher occurrence of long COVID-19 in this population could be due to the higher incidences of chronic disease and physical vulnerability.

MLMIC has assembled several COVID-19 resources on our website and will continue to keep policyholders informed of pandemic-related developments.