COVID Long Haulers & Digital Health

It’s been just over 2 years since we were first introduced to COVID. And as we’ve become better at tracking variants, making diagnostic testing more available, and providing treatment options for those who are acutely sick, we’ve come to appreciate that there is an unfortunate subset of patients who experience prolonged effects of the disease long after the infection has passed. Some know these patients as the COVID long-haulers.

Officially, the disease is known as post-acute sequelae of SARS-CoV-2 infection or PASC, for short. As of July 2021, this condition is recognized as a cause of disability under the Americans with Disabilities Act (ADA). Researchers estimate anywhere from 10 – 50% of patients with COVID-19 go on to become long-haulers. It affects both men and women from adolescence to adulthood.

The symptoms of PASC (also called long-COVID) vary from person to person, but universally, patients experience an overall decline in their general health. For some, this can take the form of physical symptoms such as fatigue, problems breathing, stomach distress, or a racing-heart sensation. In others, there are neurological, psychological, and behavioral effects such as difficulty thinking or concentrating (often referred to as “brain fog”), headaches, and mood changes. For a comprehensive list of symptoms, please refer to this resource provided by the CDC: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html.

COVID long-haulers can develop their symptoms immediately following their infection or sometimes even as far out as 4-8 weeks afterwards. There is no specific time course for recovery, as some experience prolonged symptoms for 3-6 months before resolution, while others can be affected for greater than one year with no readily identifiable end point. At this time, it is still unknown why some patients go on to develop these long-term effects of COVID and why there are various time courses of recovery. It is hypothesized, though, that it relates to the interplay between the immune response to the virus and the inflammatory cascade that develops within the body and affects each organ system.

With no specific treatment yet available for COVID long-haulers, medical care is currently tailored to the individual based on their specific symptoms. Throughout the country, there are facilities opening up that specialize in the evaluation and treatment for long-COVID. Oftentimes, this is performed through a multidisciplinary approach that utilizes different healthcare providers from physicians, advanced practice providers, and nurses, to social workers, psychologists, and physical therapists.

With the increased adoption of digital health technologies that has occurred during this pandemic, the ability to access care is now greater than ever. Patients are now able to receive this specialized care without being limited by time or space. For example, people in rural communities can now consult with long-COVID specialists in academic institutions located in larger cities by utilizing telemedicine platforms. In addition, by receiving care directly within their own homes, patients are able to provide their healthcare team a more comprehensive look into their home environment. This allows for recommendations regarding home modifications that, in turn, influence their overall care and aid on the road to recovery.

At CareHive, we are advancing digital health through an asynchronous-first approach to care. By utilizing a sophisticated healthcare technology stack and incorporating numerous data elements through interconnected networks, we are able to create individualized curated content for patients. This information is then transferred to patients for review and completion within a secure digital platform. Based on robust escalation pathways that are triggered via responses to the curated content, patients can be seamlessly escalated to a real-time virtual telemedicine visit when needed. So whether we are treating patients for long-COVID, other chronic conditions, or acute ailments, CareHive is a full-service solution that uses data and technology at the front door with our multidisciplinary healthcare team directly behind it.

For more information about COVID long-haulers, please visit the CDC link posted above or check out this review article posted by the Journal of the American Medical Association: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780376.

Suneet Singh, MD, FACEP // Medical Director, CareHive // Assistant Professor of Surgery & Perioperative Care, University of Texas at Austin Dell Medical School