Although the long-term effects of COVID-19 are still unknown, the presumed sequelae of the disease would likely resemble those of recent coronavirus-related disease outbreaks, like Middle Eastern Respiratory Syndrome (MERS).
Recovery After COVID-19
Reports suggest that following infection, many novel coronavirus patients will experience lingering deficits in pulmonary and cognitive functioning, as well as multifaceted health issues and worsened quality of life. From records in Italy and France, it's also likely that the post-COVID experience will include the return of symptoms — fever, fatigue and breathlessness — as well as more severe sequelae, including impairment of renal and cardiovascular function, ongoing hypercoagulability, myalgia, depression, and other persistent physical and psychological effects.
What Does Post-COVID Care Look Like?
In the months since the first COVID-19 patient in the Philadelphia region appeared at the Hospital of the University of Pennsylvania, the prolonged effects of COVID-19 have become familiar to the faculty at Penn Clinical Physical Medicine and Rehabilitation.
"We've come to realize that COVID-19 recovery doesn't end as soon as someone is stable and leaves the hospital," says Benjamin Abramoff, MD, MS. "A wide range of medical issues can persist and impair function and overall quality of life in these patients."
The Post-COVID Assessment and Recovery Clinic at Penn Medicine
To address issues as they emerge, Penn Medicine has created the Post-COVID Assessment and Recovery Clinic to provide multidisciplinary assessment and resources for patients recovering from COVID-19 disease.
Among the Center's principal objectives for post-COVID patients re-entering the community is to ensure continuity of care, a known critical factor in the prevention of mortality and morbidity in long-term disease. Given the novelty of the disease, the exact nature of ongoing deficits is uncertain, and needs to be established and tracked over time. Penn's clinic will also serve to create a registry to accurately track important clinical patient data for a disease about which little is known.
In addition to Dr. Abramoff, the Penn faculty at the Post-COVID Assessment and Recovery Clinic includes fellow rehabilitation specialist Franklin Caldera, DO, and pulmonologist Robert M. Kotloff, MD, and a number of other colleagues specializing in Physical Medicine and Rehabilitation, and Pulmonary and Critical Care Medicine.
Post-COVID Assessment Process
On entry, patients are evaluated to determine their personal, health and rehabilitation needs. Patients can expect an initial one-hour virtual visit via telemedicine to begin this screening.
Our screening methods include:
- Medication reconciliation
- Rehabilitation Needs Screen: Bowel, bladder, pain, ADL/iADL performance, cognition, equipment needs, mobility, sleep, skin
- Pulmonary Functioning Screen
- Criteria established to automatically refer back to Pulmonary
- Montreal Cognitive Assessment (MoCA)
- Hospital Anxiety and Depression Scale (HADS)
- Impact of Event Scale-6 (IES-6)
- General Health Slider
- Will be logged in redcap to allow for future research efforts
Upon completion of assessment, the patient's individual clinical needs will be identified. Penn Physical Medicine & Rehabilitation colleagues will recommend and/or provide rehab management, and triage patients to specialist colleagues as needed.
Every phase of care is communicated to, and coordinated with, the patient's primary care provider and caregivers.
Is My Patient a Candidate?
The Penn Post-COVID Assessment and Recovery Clinic is open to all patients post-COVID. Referrals are welcome for all patients who have recovered from COVID and are experiencing lingering health issues including, but not limited to, these frequently reported issues:
- Autonomic function: Pain, Hypercoagulability
- Poor endurance
- Impaired renal function
- CI Myopathy/Polyneuropathy
- Residual pulmonary manifestations
- Psychological issues: PTSD, Insomnia, Cognitive impairment
- Myocardial Injury
- Progression of chronic issues
For More Information
In addition to virtual visits via telemedicine, the Post-COVID Assessment and Recovery Clinic has three locations across the Philadelphia region: Penn Institute for Rehabilitation Medicine at Penn Medicine Rittenhouse, Penn Medicine Cherry Hill and Penn Medicine Radnor.