Becker's Hospital Review

78 CMO / CARE DELIVERY Emerging trends among COVID-19 long-haulers: 6 physicians weigh in By Erica Carbajal E arly research estimates have shown anywhere between 10 per- cent to 30 percent of people with COVID-19 go on to become long-haulers, or those who experience persistent symptoms weeks or months aer the infection has cleared. With more than 32 million COVID-19 cases reported in the U.S. as of April 30, the num- ber of people who are experiencing or will experience long-term ef- fects presents a profound challenge to health systems. In response to the growing problem, many hospitals and health sys- tems have launched COVID-19 recovery programs, or post-COVID clinics, to support patients experiencing lasting effects. However, there are plenty of perplexities surrounding long COVID-19. In February, the National Institutes of Health announced it is leading a major research program aimed at identifying what caus- es prolonged symptoms and developing methods to treat or prevent the lasting problems. In the meantime, Becker's spoke to and collected responses from the following clinical leaders about early trends they've noticed at their organization's post-COVID-19 programs: • Fred Cerrone, MD, co-director of Morristown, N.J.-based Atlantic Health System's COVID-19 recovery center • Rasika Karnik, MD, internist at UChicago Medicine's clinic • Maureen Lyons, MD, director of St. Louis-based Washington Uni- versity School of Medicine's clinic • Jillian O, MD, infectious disease specialist at Los Angeles-based Cedars Sinai's program • Turner Overton, MD, director of Birmingham, Ala.-based UAB Medicine's program • Monnie Wasse, MD, director of Chicago-based Rush University Medical Center's clinic Four emerging trends: 1. Most patients did not require hospitalization. "Over two- thirds of our patients did not require hospitalization, indicating that they had relatively mild acute illness, but despite that, may have severe post-COVID-19 symptoms," Dr. Oft said of what she's noticed about the patients coming through Cedars-Sinai's COVID-19 recovery program. Drs. Wasse, Cerrone and Lyons noted the same. "ey weren't super sick, but they've had residual symptoms that have lasted for months and aren't able to get rid of them," Dr. Wasse said. e observation has also been reported in other research. A study published March 5 in the preprint server medRxiv found that of 1,407 COVID-19 patients who did not require hospitalization, 27 percent were experiencing lingering symptoms more than 60 days aer their initial infection. Of those experiencing lingering symptoms, nearly a third were asymptomatic through the 10 days aer a COVID-19 di- agnosis. A separate study published Feb. 19 in JAMA Network Open reported that out of 150 outpatients who initially had a mild COVID-19 infec- tion, about one-third reported persistent symptoms as long as nine months aer the illness. 2. e majority of patients are women. At UAB's post-COVID-19 program, about 70 percent of patients have been women, Dr. Overton told Becker's. "ere's some data in the literature [that shows] wom- en are disproportionately affected by these longer [term] symptoms than men, but women are also more likely to seek care," he added. "So 1 in 6 healthcare employees would rather quit than get vaccinated By Hannah Mitchell A s COVID-19 vaccines become more readily avail- able, healthcare companies are debating to what extent they should pressure their employees to be immunized, according to an April 5 article published by The Washington Post. Some healthcare companies have already mandated that employees at least have an appointment for a vaccine to protect their patients. At Silverado's 22 assisted living communities, not one lo- cation had more than 80 percent of the staff vaccinated after the first round of a companywide vaccination clinic. Some sites were barely at half of the staff. In response, Silverado mandated that staff must have at least an appointment for a shot as a condition of their job. With about 1,300 employees at memory-care facilities, Sil- verado has said 137 employees asked for an exemption of the mandate, 10 employees have resigned, and more than two dozen are on leave while they decide what to do. The other 1,000 have gotten their COVID-19 shots. According to a Washington Post and Kaiser Family Foun- dation poll, nearly 6 in 10 healthcare employees said they would support a COVID-19 vaccination mandate. More than 3 in 10 said they did not intend to get vaccinated or were undecided. Within that group, more than 8 in 10 said they would op- pose a vaccine mandate, and nearly two-thirds said they would leave their job if it was required. The poll found that 1 in 6 healthcare workers said they would leave their job rather than get the COVID-19 vaccine. n

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