Patient Experiences with a Tertiary Care Post-COVID-19 Clinic

Garg, Alpana; Subramain, Maran; Barlow, Patrick B.; Garvin, Lauren; Hoth, Karin F.; Dukes, Kimberly; Hoffman, Richard M.; Comellas, A.P.

doi:10.1177/23743735231151539

Cited by 6 publications

(7 citation statements)

References 38 publications

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“…A recent study found that of people accessing Long COVID clinics, 40% traveled over one hour to access care, and more than 50% waited between one and three months for an appointment [ 43 ]. Our participants affirm the lived experience of these findings, expressing frustration about a lack of available, quality services.…”

Section: Discussionmentioning

confidence: 99%

“It was almost like it’s set up for people to fail” A qualitative analysis of experiences and unmet supportive needs of people with Long COVID

McNabb,

Bergman,

Smith-Wright

et al. 2023

BMC Public Health

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Background Almost twenty percent of adults with COVID-19 develop Long COVID, leading to prolonged symptoms and disability. Understanding the supportive needs of people with Long COVID is vital to enacting effective models of care and policies. Design/methods This qualitative sub-study explored the experiences of people with Long COVID and their unmet needs. Participants enrolled in a larger study to evaluate the post-acute cardiovascular impacts of COVID-19 were invited to participate in subsequent in-depth interviews. Participants were enrolled purposively until saturation at 24 participants. Data were analyzed using thematic content analysis. Results Participants focused on adaptations to life with Long COVID and their unmet needs in different life spheres. Three domains, 1) occupational and financial; 2) healthcare-related; and 3) social and emotional support, emerged as areas affecting quality of life. Although participants were motivated to return to work for financial and personal reasons, Long COVID symptoms often resulted in the inability to perform tasks required by their existing jobs, and unemployment. Those who maintained employment through employer accommodations still needed additional support. Participants encountered diagnostic challenges, challenges in accessing specialty appointments, insurance loopholes, high healthcare costs, and medical skepticism. Existing social networks provided support for completing daily tasks; however, those with Long COVID typically turned to others with similar lived experiences for emotional support. Participants found government support programs inadequate and difficult to access in all three domains. Discussion We propose a five-pronged policy approach to support persons with Long COVID. These overarching recommendations are (1) improve public awareness of Long COVID; (2) improve clinical care quality and access; (3) implement additional school and workplace accommodations; (4) strengthen socioeconomic benefits and social services; and (5) improve research on Long COVID.

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Section: Discussionmentioning

confidence: 99%

“It was almost like it’s set up for people to fail” A qualitative analysis of experiences and unmet supportive needs of people with Long COVID

McNabb,

Bergman,

Smith-Wright

et al. 2023

BMC Public Health

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“…One possible reason is the nature of these patient's symptoms, many of which would have benefited from physical examination that could not take place. Data from a study by Garg [33] showed that 63%-91% of patients surveyed that attended an in-person post-COVID clinic were satisfied with clinical services, which is quite a broad range, with 71% answering they were satisfied or very satisfied with the physician interaction in the clinic, comparable to the 75% satisfaction rate with the medical care in our VPCC.…”

Section: Discussionmentioning

confidence: 59%

Use of a Virtual Multi-Disciplinary Clinic for the Treatment of Post-COVID-19 Patients

Rahamim-Cohen,

Kertes,

Feldblum

et al. 2024

Healthcare

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Post-COVID-19 has been recognized as possibly affecting millions of people worldwide. In order to optimize care and ensure equality, we established a multidisciplinary virtual Post-COVID-19 clinic (VPCC) within Maccabi Healthcare Services, the second largest HMO in Israel. This study aims to describe the structure, process and patient satisfaction with this clinic. The multidisciplinary team consisted of physicians, physiotherapists, social workers, occupational therapists and dieticians. Patient entry was to be at least four weeks after COVID-19 infection. A patient satisfaction survey was carried out 7–8 months after the clinic was closed. Demographic data were collected and compared to the general Maccabi COVID-19 population. The clinic treated 1614 patients, aged 16–91, over a period of 18 months. In total, 679 family physicians referred patients. In comparison to the general COVID-19 population, a higher percentage of the VPCC patients lived in the periphery of Israel, South (14.9% compared to 17.8%) and North (17.1% compared to 18.2%). In total, 249 patients answered the survey, and of them, 75% were highly satisfied with the medical care of the physician in the VPCC. A total of 54% of respondents would have preferred a face-to-face consultation, but 50% felt that communication was good in the virtual mode. In conclusion, the VPCC provided a dedicated service for patients, and the virtual format made it equally accessible to all parts of the country.

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“…For example, more Post COVID-19 care clinics may improve the well-being, function, and quality of life of this population while reducing burden on the mainstream health system [55][56][57][58][59][60][61].…”

Section: Clinical Predictors and Complex Medical Needs Of Casesmentioning

confidence: 99%

Clinical and Serological Predictors of Post Covid-19 Condition – Findings From a Canadian Prospective Cohort Study

Collins,

Galipeau,

Arnold

et al. 2023

Preprint

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Introduction: More than three years into the pandemic, there is persisting uncertainty as to the etiology, biomarkers, and risk factors of Post COVID-19 Condition (PCC). Serological research data remain a largely untapped resource. Few studies have investigated the potential relationships between post-acute serology and PCC, while accounting for clinical covariates. Methods: We compared clinical and serological predictors among COVID-19 survivors with (n=102 cases) and without (n=122 controls) persistent symptoms ≥ 12 weeks post-infection. We selected four primary serological predictors (anti-nucleocapsid (N), anti-Spike, and anti-receptor binding domain (RBD) IgG titres, and neutralization efficiency), and specified clinical covariates a priori. Results: Similar proportions of PCC-cases (66.7%, n=68) and infected-controls (71.3%, n=87) tested positive for anti-N IgG. More cases tested positive for anti-Spike (94.1%, n=96) and anti-RBD (95.1%, n=97) IgG, as compared with controls (anti-Spike: 89.3%, n=109; anti-RBD: 84.4%, n=103). Similar trends were observed among unvaccinated participants. Effects of IgG titres on PCC status were non-significant in univariate and multivariate analyses. Adjusting for age and sex, PCC-cases were more likely to be efficient neutralizers (OR 2.2, 95% CI 1.11 - 4.49), and odds was further increased among cases to report deterioration in quality of life (OR 3.4, 95% CI 1.64 - 7.31). Clinical covariates found to be significantly related to PCC included obesity (OR 2.3, p=0.02), number of months post COVID-19 (OR 1.1, p<0.01), allergies (OR 1.8, p=0.04), and need for medical support (OR 4.1, p<0.01). Conclusion: Despite past COVID-19 infection, approximately one third of PCC-cases and infected-controls were seronegative for anti-N IgG. Findings suggest higher neutralization efficiency among cases as compared with controls, and that this relationship is stronger among cases with more severe PCC. Cases also required more medical support for COVID-19 symptoms, and described complex, ongoing health sequelae. More data from larger cohorts are needed to substantiate results, permit subgroup analyses of IgG titres, and explore for differences between clusters of PCC symptoms. Future assessment of IgG subtypes may also elucidate new findings.

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Patient Experiences with a Tertiary Care Post-COVID-19 Clinic

Cited by 6 publications

References 38 publications

“It was almost like it’s set up for people to fail” A qualitative analysis of experiences and unmet supportive needs of people with Long COVID

“It was almost like it’s set up for people to fail” A qualitative analysis of experiences and unmet supportive needs of people with Long COVID

Use of a Virtual Multi-Disciplinary Clinic for the Treatment of Post-COVID-19 Patients

Clinical and Serological Predictors of Post Covid-19 Condition – Findings From a Canadian Prospective Cohort Study

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