Long Covid, which encompasses a broad array of health problems that linger from three weeks to two years or longer after the initial infection, can be very difficult to treat and extremely frustrating for patients seeking help. One resource that can provide a comprehensive, multi-disciplinary evaluation and proposed treatment plan is the University of Arkansas for Medical Sciences (UAMS) Long Covid Clinic in Fayetteville.
Long Covid or post-acute Covid can affect any part of the body, according to Sheena CarlLee, M.D., a UAMS internal medicine doctor who is director of the UAMS Long Covid Clinic.
“We don’t know who is going to be affected or in what way,” CarlLee said. “It can cause brain fog, fatigue, insomnia, digestive problems, headaches and heart trouble. A lot of patients have lung problems such as shortness of breath after Covid, particularly if they had a bad lung infection with Covid. It can have long-lasting effects on taste and smell and make people more susceptible to bacterial and viral infections. It can cause rashes. It can affect any organ system.”
Even patients who initially had mild cases can develop symptoms months later related to their bout with Covid-19. CarlLee said the decision to open the clinic, one of the only long Covid clinics in the state, came about because she and her colleagues frequently saw former Covid patients return to the clinic with lingering symptoms.
Covid-19 has had a particularly devastating impact on older adults. The Centers for Disease Control and Prevention (CDC) has reported that 92 percent of Covid deaths have been in people over the age of 65, but there is no specific profile for what age group is most likely to get long Covid.
“We do have some trends,” CarlLee said. “It is affecting young, healthier, active people more than most other chronic illnesses. Long Covid tends to be more frequent in patients who have not received the Covid vaccine, women and people with chronic medical conditions. We also see it in patients who don’t fit any of those criteria. We don’t totally understand the mechanism of who gets it and who doesn’t get it.”
Some research published indicates that symptoms such as brain fog and headaches seem to get better after a year, but CarlLee said they are also seeing people with symptoms lasting two years or longer.
CDC recommends a multi-disciplinary, patient-centered approach to Covid care, which is exactly the way the UAMS Long Covid Clinic operates.
“It is a complex disease process,” CarlLee said. “It affects various people in many different ways. It can’t be tackled in a primary care visit lasting 15 or 20 minutes. Our Long Covid Clinic is run by medical, nursing, physical therapy, occupational therapy and pharmacy students. Students go in as a team of four or five and work together on an initial assessment. It takes two to three hours for a new patient evaluation. That is followed by a big team discussion and the student teams consult with faculty. Then an appointment is made to go in and talk with patients about some good next steps.”
Long Covid is more common than many people realize and can affect 20 to 30 percent of people who get Covid. CarlLee said that number seems to be a little higher in Arkansas. There is great demand for the services.
“We are getting a lot of calls, and we have a long waitlist, unfortunately,” CarlLee said. “We are limited with how many days of the month we can have appointments, and appointment times are long. Right now, we have a six-month waitlist for new patients, but we are hoping to expand our services in the future and make our model more accessible to patients all over the state.”
One Eureka resident with long Covid reported that when she went to her health care practitioner and asked for advice about treatment with natural supplements, the practitioner refused to even consult with the patient, telling her that herbal supplements are useless and potentially dangerous. But CarlLee said there is good evidence in that certain supplements and non-traditional medicine used for some of the symptoms for people with long Covid have been successful.
“We evaluate patients based on symptoms,” CarlLee said. “There is always a risk when you prescribe medications that there can be negative side effects or interactions with other medications. If we can try natural alternatives that may be less risky, we are happy to look at that with the patients. It depends on the person and the symptoms they are having.”
Another complication is that any kind of underlying illness can cloud the picture and delay the diagnosis.
The National Institutes of Health announced recently that it is launching four clinical trials to test the safety and effectiveness of potential long Covid treatments. One of the trials, which will test using the antiviral medication Paxlovid for longer periods of time on people who have been unable to clear the SARS-CoV-2 virus that causes Covid from their system, is underway. The virus has been found to persist as long as 280 days after an infection.
CarlLee said they are not participating in the trial, but are interested in the results.
“Right now, there is not enough data or evidence to support antivirals for first-line support,” she said. “This medicine is not FDA-approved for long Covid. There is not a lot of data to support that yet.”
The Long Covid Clinic is located at the UAMS Health Neighborhood Clinic – 1125 N. College Ave. in Fayetteville. To schedule an appointment, call 479-713-8701.
Editor’s note: This article was originally published in the Eureka Springs Independent.
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