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While many COVID patients recover after a few weeks, some have lingering symptoms for months, or longer, and may even get new symptoms.
While fatigue is the most common symptom, long haulers may also have chest pain, cognitive changes, lightheadedness, skin numbness, and tingling.
One goal of the post-COVID recovery programs is to provide a central source for all needed health care providers.
The program, like many, starts with a comprehensive in-person evaluation by either an infectious disease or pulmonary medicine specialist.
Depending on the patient needs, referrals are made to other specialists. Those specialists vary by program, and they include:
- Infectious disease specialists
- Pulmonary medicine doctors
- Primary care doctors
- Kidney specialists
- Physical and occupational therapists
- Therapists and social workers
Borrowing from Other Treatments
Because COVID’s “long-haul” condition is so new, health care providers are writing the script, as they go, for how best to treat people who have it. They often borrow from other treatment plans known to work for similar conditions, such as the lung condition COPD (chronic obstructive pulmonary disease) and other heart issues, concussion clinics, and transplant patients.
Likewise, established programs for rehabilitation of lung conditions, focused on exercise training, can help long haulers overcome fatigue and gain muscle strength, other experts have found.
The outlook for returning to normal varies from person to person. “I’m very hopeful,” says Zabner of Cedars-Sinai. “I’ve seen other viral illnesses that people eventually recover from.” She expects issues like memory and brain fog to eventually decrease, while the lack of smell is sometimes a lengthy symptom.
Patients with lingering heart issues can also probably improve with treatment, she says. She recalls a middle-age patient who had a very rapid heartbeat who got help from a cardiologist who prescribed medications to manage it and did much better.
Putrino, of Mount Sinai, says the longest one of their patients has been in rehabilitation is about 6 months. Even when patients make good progress, he says, “We have yet to see someone who has said, ‘I feel like I did before.”’ Even so, he says, ”they are getting a lot of their autonomy back.”
Gut of Staten Island University Hospital is more optimistic. “It’s not a question of if they are going to recover, but when,” he says. “They do improve slowly, over time.” While the risk for lingering symptoms is generally higher for those with more severe disease, not always, he says. He has cared for older people with severe COVID, ”and they bounced back within a month.” He has had younger people who didn’t need to be hospitalized who have had persistent symptoms for 6 months.