Post-acute sequelae of COVID-19 in adults referred to COVID recovery clinic services in an integrated health system in Texas

Valerie Danesh; Alejandro C Arroliga; James A Bourgeois; Andrew J Widmer; Michael J McNeal; Tresa M McNeal

doi:10.1080/08998280.2021.1972688

Post-acute sequelae of COVID-19 in adults referred to COVID recovery clinic services in an integrated health system in Texas

Proc (Bayl Univ Med Cent). 2021 Sep 22;34(6):645-648. doi: 10.1080/08998280.2021.1972688. eCollection 2021.

Authors

Valerie Danesh^{1

2}, Alejandro C Arroliga^{3

4}, James A Bourgeois^{4

5}, Andrew J Widmer^{4

6}, Michael J McNeal^{4

6}, Tresa M McNeal^{4

6}

Affiliations

¹ Center for Applied Health Research, Baylor Scott & White Research Institute, Dallas, Texas.
² School of Nursing, University of Texas at Austin, Austin, Texas.
³ Division of Pulmonary and Critical Care Medicine, Baylor Scott & White Health, Dallas, Texas.
⁴ College of Medicine, Texas A&M University, College Station, Texas.
⁵ Department of Psychiatry, Baylor Scott & White Medical Center-Temple, Temple, Texas.
⁶ Department of Internal Medicine, Baylor Scott & White Medical Center-Temple, Temple, Texas.

Abstract

The epidemiology and organ-specific sequelae following acute illness due to COVID-19 and prompting patients to seek COVID recovery care are not yet well characterized. This cross-sectional study reviewed data on 200 adult patients with prolonged symptoms of COVID-19 (>14 days after symptom onset) not resolved by usual primary care or specialist care who were referred for COVID-specific follow-up. Most patients sought COVID recovery clinic visits within the first 2 months of initial onset of symptoms (median 37 days), with some seeking care for sequelae persisting up to 10 months (median 82 days). At the time of telehealth evaluation, 13% of patients were using home oxygen, and 10% of patients had been unable to return to work due to persistent fatigue and/or subjective cognitive dysfunction ("brain fog"). The prominent specific symptom sequelae prompting patients to seek COVID-specific evaluation beyond usual primary care and specialist referrals were dyspnea, fatigue/weakness, and subjective cognitive dysfunction, irrespective of whether patients had required hospitalization or time since COVID-19 symptom onset.

Keywords: Care coordination; PASC; neuropsychiatric symptoms; post-acute sequelae of COVID-19; primary care.