As cases of COVID-19 and its delta variant continue to rise, a number of clinics have been created in Maryland to exclusively treat patients recovering from the virus.
Kennedy Krieger Institute opened its Pediatric Post COVID-19 Rehabilitation Clinic last summer and began seeing patients in the fall and winter. Evolving the clinic model over time to address the needs of patients, its focus is interdisciplinary rehabilitation in areas affected by the virus, including neurology, behavioral psychology and physical therapy.
“We really focus on the functioning of children and their families to help them maintain as much normalcy as much as possible as they recover,” said Dr. Laura Malone, child neurologist.
The main conditions the Baltimore-based facility is seeing in pediatric cases is lingering fatigue, debilitating headaches, dizziness, lightheadedness when standing, decreased endurance and mood/attention issues. “The different complaints vary a lot, so we really focus on an individualized approach to the plan for each patient,” Malone said.
A lot of symptoms that Kennedy Krieger staff are seeing in children are similar to what can be reported in adults. However, children may not be able to express or describe those symptoms in the same way.
“I think it is important for families and primary care doctors to be aware and be cognizant to look for symptoms because (children) may not readily say ‘I am having difficulty with focusing on my school work’ but grades might be dropping,” Malone said. She encourages families to look for signs if their child(ren) are not acting like they did before the virus.
Many of the pediatric patients they are treating complain that the virus has affected their quality of life and their ability to do activities they used to do with no issues, such as school work and extracurricular activities. “We help provide support and services for them as their body is recovering and also work to try and increase their endurance, to increase their activities without having them have (issues) or have worsening of these symptoms,” Malone says. “It requires a lot of support for the patient and their families in order to help them manage and function with these symptoms that they are having.”
The clinic has seen a fairly steady increase in patient visits over time with many appointments already scheduled throughout the rest of the year. Malone believes this is because of the increasing awareness of Post-COVID clinics as well as rising pediatric virus cases.
“Our goal is to overall help (patients) be able to function to the best of their ability,” Malone said. “For some patients that is complete recovery that we are seeing over time. Their symptoms become much more manageable. They are able to do their activities. For others, it is about helping them learn to modify some of the activities they are doing based on the symptoms and how to live their lives to the best of their abilities with these symptoms that continue to exist.”
The University of Maryland Medical Center opened a post-COVID clinic at its Midtown Campus about a year ago offering a one half-day clinic a week. Dr. Andrea Levine, who runs the multidisciplinary clinic and is a trained pulmonary and clinical care physician, can see 10 patients during each session. There is a waiting list to get in, and the number continues to grow.
She is joined by a pharmacist who does a comprehensive pharmacological assessment to see what kinds of medications patients are on and discuss which treatments they received for COVID-19. This assessment is completed to make sure none of the medications are contributing to their ongoing symptoms. Levine makes referrals if necessary to other specialists to help patients with specific symptoms.
Some of the persisting COVID symptoms she has seen include shortness of breath, forgetfulness, heart palpitations and exercise intolerance.
“A lot of my patients are otherwise young and healthy patients who were jogging and running and training for marathons … before they got COVID and now they are limited to walking the dog before they felt winded,” Levine said. Her goal for patients is to get them as close to back to normal as possible.
Follow-up care after COVID remains important, Levine said. “For the patient, if you really aren’t fully recovering and you are still having some ongoing symptoms, you may find that you have some injury.” She points out shortness of breath could be due to an airway injury and an inhaler could make a difference with symptoms.
“You don’t have to tolerate or accept a lower quality of life,” she said. “For some of these patients, they may have some injury to their organ that they can’t even appreciate. They may say, ‘Oh my heart is racing occasionally but I’m fine.’ You may have an actual injury to your heart that is dangerous and it may be important to see a cardiologist and have someone provide that care to you so you don’t get sicker.”