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COVID-19: UTSW Rehab Program Offers Help For Long Haulers

A person with a breathing mask is lying in a hospital bed, being tended to by two nurses.
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Many hospitalized with COVID-19 recover fully, but some experience lingering symptoms that can last weeks and even months.

Many who survive COVID-19 go back to life as normal. But a few after the worst of it experience lingering physical and/or mental symptoms that go on for weeks or even a few months.

KERA's Sam Baker talked with Kathleen Bell, chair of UT Southwestern Medical Center's physical medicine and rehabilitation department, about a rehab program there for so-called COVID-19 "long haulers."

Interview Highlights:

Why Some Covid-19 Patients Become Long Haulers And Not Others

That is really the $64,000 question. Certainly for some of the people who have been hospitalized for long periods of time and had been intubated on a ventilator, some of those people, for instance, have what we call superinfections so that they can get bacterial infections on top of the viral infections and have actual serious, serious lung damage.

Or we see people who have holes in their lung tissue from the bacterial infection. So, it's fairly obvious why they're having problems.

We suspect people react to inflammation in different ways. Some people seem to react with pretty flagrant inflammation and persistent inflammation. And we think that those are the people who really are having these persistent issues.

Someday, we're going to understand the genomics behind why some people react and some people don't. But right now, it's a little bit of a crapshoot.

UT Southwestern’s Rehab Program For Long Haulers

The first thing we do is really try to get a really good history of what their whole process has been, whether they've been in the hospital or whether they've been home, really going into depth about, you know, how long they were in bed, how long they were isolated.

Depending on their needs, we may have them see a physical therapist who will work on things like breathing exercises, dizziness, or their ability to tolerate exercise while they're monitoring their oxygen levels. And we’re monitoring their pulse rates so they can do it safely under supervision.

If they're having problems with their cognition, we may have them work with a speech therapist on their ability to think and strategies on how to improve their memories. If this is really a significant problem for them, and it may be impairing their work, we might send them to a neuropsychologist to actually have some cognitive testing so we can sort out precisely where they're having problems.

If they're having problems with their daily activities, they may see an occupational therapist that will help develop ways of managing their home activities, for instance, without getting fatigued.

And lastly, we decided one of the things we wanted to help people do is to start looking at wellness after COVID. How do you go back to being a healthy person? We talk about things like healthy sleep. How do you get your brain to feel healthy again? How do you start resuming your activities in the community safely? And how do you deal with your emotions over having been so ill unexpectedly?

This allows people who've experienced COVID to talk together about what their experiences have been. I think that's been one of the best things for them. First of all, they figure out “I'm not crazy.” And, they get some good clues on how other people are dealing with some of the same physical and mental symptoms.

The Goal: A Cure Or Managing Their Symptoms?

Both. Most are going to get better. It's helping them get better faster, and to get better more completely. Some people can see the difference within three or four weeks.

It's a small group of patients who really are perhaps going to have some very, very long-lasting effects. It's really helping them navigate how to get back to doing what they want to do. How do they get their lives back with some difference in the way that they function?

Should Long Haulers Get The COVID 19 Vaccine?

One who is outside that 90-day window after having COVID should get the vaccine because they are at risk for getting another infection. We have no reason to suspect they're not. And we think that having the vaccination would be far less damaging than having another infection.

RESOURCES:

Long haulers: Why some people experience long-term coronavirus symptoms

New trial aims to treat COVID long-haulers, giving Utahns hope

UT Southwestern Medical Centers: Long Haulers Rehabilitation Program

Interview highlights were lightly edited for clarity.

Got a tip? Email Sam Baker at sbaker@kera.org. You can follow Sam on Twitter @srbkera.

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