To help physicians meet the growing health care needs of the estimated 16 million-plus Americans who have long COVID-19, Oregon Health & Science University has compiled an easy-to-read diagnosis and care guide, and has organized an interactive, educational video series for clinicians across the state.
Published in the November 2022 print issue of the journal American Family Physician, the guide offers a quick, approachable summary of what is known about long COVID to date, and recommends specific ways primary care providers can apply that knowledge while diagnosing and treating the condition. The guide also features a lay-friendly informational flier that providers can share with their patients.
“As the number of people affected by long COVID keeps growing, more and more primary care providers are finding themselves caring for patients with this chronic and complex condition,” said one of the guide’s authors, Eric Herman, M.D., an assistant professor of family medicine in the OHSU School of Medicine who led the OHSU Long COVID Program’s creation in 2021.
“Long COVID can be overwhelming for patients and providers alike,” Herman continued. “This guide aims to make long COVID diagnosis and care easier for primary care providers — whose help patients typically seek first when they’re struggling with a health issue.”
Long COVID patients experience a variety of symptoms for months or, in some cases, more than a year after initially getting sick with COVID. The condition varies from patient to patient, with symptoms that can include difficulty concentrating or breathing, brain fog, fatigue and anxiety, as well as with patients exhibiting a range of severity levels. While most patients can expect gradual improvement over time, a small portion have symptoms so debilitating that they are at least temporarily unable to work.
Herman and two other OHSU family medicine physicians drew on their experiences caring for long COVID patients to create the guide. They also pored through the vast volumes of published research about long COVID, as well as interim guidance from the CDC and a national initiative organized by the American Academy of Physical Medicine and Rehabilitation; Herman is co-chair of the initiative.
While specialized clinics are better suited to manage the most severe or complex cases, Herman said there aren’t enough such clinics to care for everyone experiencing chronic COVID-19 symptoms. The multidisciplinary specialists involved in the OHSU Long COVID Program — which has served about 1,300 patients since launching in March 2021 — help establish comprehensive, individualized care plans for each patient. At the same time, patients served by the OHSU program also rely on their primary care providers to manage their overall care.
Interactive education
In another effort to better equip primary care providers for long COVID care, OHSU since September has offered a virtual education series geared toward Oregon clinicians who serve rural, Latino/a/x and other underserved communities.
Organized by OHSU long COVID specialists and staff from OHSU’s Oregon ECHO Network, each of the weekly virtual sessions start with a brief presentation by experts who specialize in various aspects of long COVID care such as brain recovery, mental health and social services. After, participating providers discuss de-identified patient cases or situations they’ve encountered in their clinics and how they could apply what they’re learning to similar situations moving forward.
“I’m really excited to see participating clinicians, who are hungry for information, start to become experts in long Covid,” said Anthony Cheng, M.D., an associate professor of family medicine in the OHSU School of Medicine who led the series’ development and also co-wrote the guide. “Given the magnitude and impact of long COVID, this type of robust knowledge dissemination is sorely needed among all health care providers.”
Supported by the U.S. Health Resources and Services Administration, the series will wrap in mid-December after holding 13 online sessions. About 40 clinicians from throughout Oregon have participated to date. Another 50 providers expressed interest, but organizers needed to keep attendee numbers low to increase participation and facilitate impactful conversations.
Because of widespread interest, it will be offered at least one more time in fall 2023. When details are finalized, information will be shared through the Oregon ECHO Network digital newsletter.