Danielle Sandsmark, MD, PhD
Brain fog, fatigue, headache, and cognitive dysfunction are all symptoms seen in "long-haulers," people who have recovered from COVID-19 but who are experiencing residual health problems. Now termed "post-acute sequelae of SARS CoV2 infection" or PASC, these problems are familiar to Penn neurointensivist Danielle Sandsmark, MD, PhD, through her work with traumatic brain injuries.
"I became interested in PASC because it sounded so similar to what my patients with concussions or more severe traumatic brain injuries experience," she says.
In 2021, at the height of the pandemic, Dr. Sandsmark, along with colleagues Dennis Kolson, MD, PhD, a neuroinfectious disease specialist; Matthew Schindler, MD, PhD, a neuroinflammation and neuroimaging expert; and Sara Manning Peskin, MD, a cognitive neurology specialist, launched Penn Neurology's clinic for patients dealing with post-COVID complications to provide them with specialized neurological care.
A Multidisciplinary Effort to Provide Post-COVID Neurological Care
Today, the Penn Post-COVID Assessment and Recovery Clinic remains a valuable resource for the region as the population continues to grapple with COVID-19 and its many variants. According to Dr. Sandsmark, to date, the clinic has evaluated over 160 patients, and with the recent uptick in cases (not related to surges in infection rates), is having to schedule patients out more than six weeks.
"We are continuing to see a great demand for these services as people realize that their symptoms are not always getting better over weeks, or even months." she shares. "As the prolonged symptoms of COVID can fall into many different subspecialities of neurology we are trying to serve as many people as we can, particularly those who do not already have established care with a neurologist."
Given the relative newness of SARS CoV2, the clinic's physicians spend a fair bit of time discussing what patients are reporting and sharing strategies for patient management. They work closely with colleagues in physical medicine and rehabilitation, physical and occupational therapy, and speech therapy. "We collaborate both across departments at Penn and with other programs across the country," says Dr. Sandsmark. "We are all trying to work to develop best practices for helping these patients.
Finding What Works for Long-Haul Neurologic Symptoms
"We still have a lot to learn and are honest with patients about what we don't know yet, but we have found that certain therapies are helpful for many patients" Dr. Sandsmark adds.
She explains that graduated exercise therapy and cognitive therapy have been particularly helpful for many patients experiencing fatigue and brain fog. Medications are generally targeted at symptoms such as headaches, insomnia, and fatigue, but these need to be tailored to each patient's unique symptoms.
"Although we cannot explain why the symptoms are happening, the patients appreciate that their symptoms and concerns are being taken seriously," says Dr. Sandsmark. "We hope that our efforts, and the understanding of this syndrome that we are gaining through our clinic, will help to inform our understanding of PASC and how to both prevent and treat it in the future."
Referrals and Information
The Penn Neuro COVID Clinic is conducting visits both in-person and virtually. All neurological patients are currently being referred through the Penn Post-COVID Assessment and Recovery Clinic. Download the Clinic's Information Sheet.
- Questions about referrals, scheduling information and other issues for the Post-COVID Assessment and Recovery Clinic are available at 215-893-2668.
- Records may be faxed to 215-893-2686.