As the first wave of people suffering from COVID-19 streamed into the University of Iowa Hospitals and Clinics in March and April, it became clear to clinicians that many of these patients wouldn’t simply get over the virus as if it were a bad case of the flu. Some patients would continue suffering effects of the disease — such as respiratory ailments — for weeks and even months.
One of the ways COVID-19 is different from the flu is how long its symptoms can last. People who contract the flu typically get over their symptoms in a few days to a week. Some COVID-19 patients continue experiencing complications a month or more after their recovery.
Back in Iowa, doctors saw a need to continue caring for this specific group of COVID-19 survivors. Officials at the Iowa City hospital agreed, and in late June established the Respiratory Illness Clinic, which is dedicated to treating people struggling with long-term complications of COVID-19.
The novel coronavirus — which causes COVID-19 — can compromise not just the lungs but the heart, kidneys and the brain. The virus is probably best known for attacking the lungs. With COVID-19 patients, “we saw that (some of them) might potentially have chronic lung disease,” says Dr. Alejandro Comellas, a pulmonary and critical care physician who is director of the Iowa clinic.
Comellas, 49, says he and his colleagues agreed it was important to continue meeting the medical needs of people who are grappling with the fallout of COVID-19 infection. He noted that researchers aren’t certain that having contracted COVID-19 confers immunity on patients.
Because the virus is new, potentially fatal and highly transmissible, there’s often a stigma attached to patients with COVID-19, which provided another reason to establish a dedicated clinic to helping survivors. “We wanted to create a clinic where people would feel comfortable coming in for treatment and not feel stigmatized,” he says.
There’s no typical profile of the patients coming to the clinic for treatment.
“We’re seeing people who range in age from their mid-20s to their 70s. Some of our patients did not have any underlying health problems (before contracting COVID-19),” he says. The clinic has also treated patients who had underlying health issues, such as heart disease and chronic obstructive pulmonary disease, or COPD.
Most of the clinic’s patients are suffering respiratory distress, like shortness of breath. Many also suffer from fatigue and brain fog. Some had spent time in the intensive care unit and had developed scars on their lungs. “That’s not unexpected with a lung injury,” he says.
One thing that’s surprised Comellas is the number of patients coming to the clinic who were never admitted to a hospital and did not have any underlying health conditions. Comellas says he expected most of the clinic’s patients would be people who had been sick enough to have been hospitalized.
The clinic has also seen a number of Spanish-speaking Latino immigrants who became ill during an outbreak at a nearby meatpacking plant. A number of outbreaks have occurred at meatpacking plants, where workers labor in close quarters.
The clinic is well-prepared for treating these patients; Comellas, who is originally from Venezuela, is one of four clinic physicians who are fluent in English and Spanish.
Being able to communicate with patients directly, without the aid of an interpreter, is extremely useful, Comellas says.
“You want to be able to meet the clinical and some of the social and cultural needs of the patient,” he says. “We need to recognize the predicament of each patient, where emotions, loss and chronic illness play a fundamental role in healing.”
The clinic and its patients may also help researchers across the country better understand COVID-19.
Patients at the Iowa clinic are asked if they wish to be part of a national registry of people who would be willing to be contacted for future studies. Compiling such research is an important tool in the fight against COVID-19.
“This disease is new,” Comellas says. “We began seeing the effects of the pandemic in March. We haven’t even had a year to study the consequences of the disease. We haven’t had enough time to understand how many of these (complications) will remain permanently and how many will resolve.”
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