Now more than a year into the global pandemic, it’s become clear that not all of the patients recovering from acute COVID-19 infection are following the same journey.
A growing body of academic literature is describing the long-term impacts of COVID-19 on patients’ health, whether that be a lingering cough and fatigue or a broader range of issues including brain fog and joint pain.
“We are all continuing to learn about COVID-19, PASC (long COVID) and their treatments,” Vanessa Trespalacios, M.D., an internal medicine physician at New Jersey-based RWJBarnabas Health Medical Group, told Fierce Healthcare. “COVID-19 and its sequelae can affect any and all organ systems, therefore a comprehensive, multidisciplinary approach is necessary. This disease causes a ripple effect that extends beyond the individual and consideration must be given to the varying degrees of impact on the individual’s home and work life.”
To this end, RWJBarnabas Health launched an integrated, multidisciplinary program focused on treating persistent COVID-19 symptoms at its flagship Saint Barnabas Medical Center (SBMC) in October.
“Earlier [last] year when the pandemic descended upon the New Jersey area, [SBMC] was hit pretty significantly,” Stephen Zieniewicz, president and CEO of SBMC, said in a video on the center’s website. “We had over 1,500 patients that were inpatients here, and that affected not only the patients but their family members. We right away recognized that … many of them would require follow-up and a variety of different specialty services. We reached out to physician leadership here at SBMD as well as with our medical group to design a program that recently launched in order to support these post-COVID patients and their needs.”
The Post-COVID CARE (Comprehensive Assessment, Recovery and Evaluation) program incorporates 17 different specialties supported by the health system, ranging from infectious diseases to neurology to behavioral health. It’s recommended for patients who are still experiencing lingering symptoms four weeks after a COVID-19 diagnosis and does not require a referral to participate.
Those enrolled in the program are guided by the process by a designated nurse navigator, who connects them to the appropriate specialist, schedules their care and corresponds with the patient and their primary care physician.
“Unlike other diseases, Post-Acute Sequelae of COVID-19 (PASC) impacts each patient differently resulting in a very individualized treatment plan,” Trespalacios, who serves as director of the program, said. “On average, each patient may have three to four specialty referrals in addition to diagnostic testing. The nurse navigator is critical to facilitating patient appointments in order to minimize treatment delays.”
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Trespalacios said adopting this personalized, adaptive approach has helped the organization better tackle the wide range of issues that follow a COVID-19 infection. Among the 120 patients treated through the program to date, outcomes have varied from an improvement in symptoms or daily function to “a complete resolution of symptoms,” she said.
Also of note, she said the medical center has been logging relevant data points over time to flesh out its COVID-19 care pathways and inform future efforts.
While RWJBarnabas Health initially took a “measured” approach to ensure it had the capacity to treat those who were enrolled, in late 2020 it decided to move forward with a pediatric version of the program that hosts the same full range of specialty services, which officially launched in February.
The system said in a statement that it has also rolled out multidisciplinary programs and clinics focused on post-COVID-19 recovery at a handful of other facilities, including the Robert Wood Johnson University Hospital in New Brunswick, Newark Beth Israel Medical Center and Community Medical Center and Monmouth Medical Center’s Southern Campus. It also is planning another clinic at Jersey City Medical Center.
RWJBarnabas’ programs are among the growing number of post-COVID-19 care initiatives hospitals and health systems have been developing over the past several months.
Mount Sinai Health System, for instance, launched a center as far back as May that aimed to support recovering COVID-19 patients and collect early data at a time when much of the U.S. health system was still working in the dark. Similar to RWJBarnabas, the Mount Sinai Center for Post-COVID Care’s approach focuses on delivering support from a broad range of medical specialties.
Cleveland Clinic, Penn Medicine, UCSF Health, Cedars-Sinai and UAB Medicine are among other major names with dedicated programs or clinics in place.
Survivor Corps, a nonprofit organization founded to support COVID-19 patients and support data-driven research efforts, hosts an interactive map of post-COVID-19 care centers located in the U.S.