Growing research shows how patients who suffer from long COVID are developing cardiovascular conditions. One group of physicians raised a call to action in sharing new guidance on diagnosing and treating these mystery post-COVID complications.
Long COVID is a condition where patients who recover from the acute COVID infection experience lingering symptoms or an onset of new long-term symptoms months after initial recovery.
Post-COVID illnesses can impact almost every organ system and include fatigue, brain fog, depression, joint or muscle pain and heart palpitations. Some symptoms are more difficult to explain and manage than others, leaving unanswered questions for long-haulers and healthcare providers.
An estimated 1 in 5 adults may develop a post-COVID condition related to a previous infection with COVID survivors having twice the risk of suffering from pulmonary embolism, according to a recent study by the Centers for Disease Control and Prevention.
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A multidisciplinary collaboration of physicians, clinicians and patient advocates joined together by the American Academy of Physical Medicine and Rehabilitation (AAPM&R) to address the urgency in spreading awareness on how to care specifically for these long COVID patients.
Dr. Steven Flanagan is the president-elect of the AAPM&R Board of Governors and rehabilitation medicine department chair at New York University Langone Health.
He believes physiatrists, doctors who specialize in physical medicine and rehabilitation, "own disability more than any other specialty" and are ideal to see the whole picture when guiding an interdisciplinary approach to managing long haul care.
Based on an AAPM&R guide released Tuesday, individuals moving beyond the first 30 days after a COVID-19 infection are at a higher risk of cardiovascular disease, including cerebrovascular disorders, dysrhythmias, heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease.
This risk is prevalent for those who were not hospitalized during acute COVID infection and increased according to the intensity of illness -- regardless of age, race, sex, and other medical factors, like obesity, hypertension, diabetes and previous history of cardiovascular disease.
Dr. Jonathan Whiteson, vice chair for Rusk Rehabilitation clinical operations and medical director of cardiac rehabilitation at New York University Langone Health, was one of the doctors who led a private roundtable discussion with reporters on Monday.
"Myocardial injury had been reported in up to 40% of individuals, acute heart failure in a third of patients who have been hospitalized with COVID, heart rhythm disturbances persist in up to 20% of individuals and ongoing inflammation has been reported up to three months after acute infection of up to 60%," Dr. Jonathan Whiteson said during the call.
Dr. Whiteson says these projections should be a wake-up call for the healthcare system and government to get ahead of the game and highlight health inequities. In his view, physicians must be properly educated on evaluating post-COVID conditions and individualize patient approaches.
For example, activity and exercise are common recommendations for those suffering from cardiovascular disease, but Dr. Whiteson warns physicians to proceed with caution when dealing with long haulers who may undergo symptom exacerbation.
The AAPM&R consensus guide is comprised of over 30 post-COVID clinics giving unique expertise in the assessment and treatment of long COVID.
This study provides in-depth instruction and direction for healthcare workers and patients navigating long COVID from the initial evaluation, laboratory work-ups, cardiac monitoring and exercise considerations.