For some COVID-19 survivors, the nightmare does not end when they test negative. Fatigue, cardiac and respiratory complications, and mental health issues can persist.
University of Maryland Baltimore Washington Medical Center (UM BWMC) has launched a program to help patients suffering from long-term effects of COVID-19 after receiving treatment in the intensive care unit.
“A lot of our patients spend over a week on a ventilator in a medically induced coma, and when they wake up, they have lost muscle mass,” said Dr. Sara Viola, a critical care and pulmonology expert who helps oversee the program. “They sometimes still require mechanical ventilation through a tracheostomy tube. A lot of them suffer psychological effects from essentially going through what I think is accurately described as a near-death experience.”
As a part of the COVID-19 Recovery Program, patients are evaluated for ongoing oxygen needs, lung function, new or ongoing chronic health conditions, mental health concerns and socioeconomic needs. The care team then develops a customized treatment plan to address each health factor. Appointments consist of a private, one-hour visit with specialists and regular follow-up appointments as needed.
Patients are assessed for lung function, and a pharmacist helps them understand their medications. Viola’s team also works closely with UM BWMC primary care providers to coordinate subspecialty care for patients.
“Some patients need wound care, ongoing physical therapy or occupational therapy, and then we also have a community health advocate who is able to make referrals for patients who have any severe mental health needs, who may need to see a psychiatrist or other mental health specialist,” Viola said. “In addition to that, we have a nurse practitioner and medical assistant and nurses who facilitate all of the other aspects of their visit.”
Since October, the program has helped more than 30 people.
“Most often, I am following closely patients who have a lot of lung function issues on their initial visit that they seem to be not back to their baseline exercise capacity, meaning they could previously walk two flights of stairs and now can barely get up one flight of stairs,” Viola said. “That’s the first [group] I’m following closely and getting them engaged in other subspecialty services and wanting to follow up to make sure all of that gets coordinated. Patients who are back on their feet, back to their work, and back to their normal family lives and community lives, those are the patients I feel more comfortable graduating out to the primary care world, where they will continue to have routine medical care but may not need to follow up with the program.”
Viola wants people to know that they don’t have to feel isolated. They don’t have to feel hopeless.
“Some patients spent weeks in a hospital without even a single visitor and only spent time with the nurses or doctors or respiratory therapists who came into their room, and then some have expressed to me that a lot of their family members don’t want to be around them, even after they have been cleared from a contagious standpoint,” Viola said. “So it’s a very devastating and isolating situation, and one of the things that I can provide for them is an understanding that they are not alone, that there are other people who have been through what they have been through, and that we know with engaging in physical therapy and mental health services that things do get better.”
Viola relayed one example of a man who spent more than two months in the hospital, losing muscle mass in the process.
“When I saw him a couple months after his discharge, he was back on his feet and can even ride a bike now and is having a great time with his family,” Viola said, “so I want people to know if they really persevere and follow up with their medical care after their hospital stay that they can get back on their feet and things can get better. They may not be 100 percent back to where they were or they might be forever changed in terms of their mental health, but there is help out there for sure.”
For more information about the COVID-19 Recovery Program, call 410-787-4291.