This study summarizes evaluations from a COVID recovery clinic that treated 200 patients experiencing prolonged symptoms after COVID-19 infection. The most common symptoms patients sought care for were dyspnea in 69%, fatigue in 48%, and cognitive dysfunction in 26%. These symptoms were consistent regardless of hospitalization status or time since initial infection. A quarter of patients were under 40 years old, and 10% could not return to work due to severity of prolonged symptoms.

1. COVID-19 Recovery
Clinic Services
Patient Characteristics in an
Integrated Health System
Danesh V, Arroliga AC, Bourgeois JA,
Widmer AJ, McNeal MJ, McNeal TM.
Post-acute sequelae of COVID-19 in
adults referred to COVID recovery clinic
services in an integrated health system in
Texas. BUMC Proceedings.
2021;34(6):645-648.

2. Background
u The complications associated with post-acute sequelae
of COVID-19 include dyspnea, fatigue, and
neuropsychiatric symptoms among other syndromic
features.
u Cross-sectional epidemiologic assessments of post-acute
sequelae of COVID-19 (PASC) include effects spanning
most organ symptoms including pulmonary,
musculoskeletal, neuropsychiatric and cardiovascular.
Nalbandian 2021 Nat Med
Logue 2021 JAMA Netw Open
Carfi 2020 JAMA

3. Purpose
u The epidemiology and organ-specific sequelae following
acute illness due to COVID-19 and prompting patients to
seek COVID recovery care are not yet well characterized.
u We report on an integrated health system multidisciplinary
telemedicine-based consultation service for post-COVID
patients to monitor and facilitate management of persistent
post-COVID symptoms.
Danesh 2021 BUMC Proceedings

4. Methods
Cross-sectional study of adult patients with prolonged symptoms of
COVID-19 (>14 days after symptom onset) not resolved following usual
primary or specialist care who were referred for COVID-specific follow-
up.
Telehealth evaluations by internal medicine physicians and advanced
practice providers for symptom management recommendations and/or
specialist referral
Consulting specialists reviewed narratives written by the internal
medicine providers conducting the post-COVID telemedicine
assessments to offer care plan advisement.
Danesh 2021 BUMC Proceedings

5. Sequelae category by organ system when seeking
COVID-19 recovery clinic assessments
In 200 patients seeking care via a
COVID Recovery Clinic, the most
prominent sequelae by organ
system were
u pulmonary (81%)
u musculoskeletal (56%), and
u neuropsychiatric (54%)
Danesh 2021 BUMC Proceedings

6. Sequelae category by specific symptomatic sequelae
when seeking COVID-19 recovery clinic assessment
In 200 patients seeking care via a
COVID Recovery Clinic, specific
sequelae most commonly endorsed
during the telehealth assessment were
u Dyspnea (69%)
u Fatigue (48%) and
u Subjective cognitive dysfunction
(i.e., ‘brain fog’; 26%)
Danesh 2021 BUMC Proceedings

7. COVID-19 Recovery Clinic Services:
Sequelae prompting care
u The prominent specific symptom sequelae prompting patients to
seek COVID-specific were the same (dyspnea; fatigue;
subjective cognitive dysfunction) irrespective of whether
patients had required hospitalization.
u Similarly, the top 3 sequelae were the same irrespective of the
time since COVID-19 symptom onset (2-8 weeks since onset vs 2-
10 months since onset).
Danesh 2021 BUMC Proceedings

8. COVID-19 Recovery Clinic Services:
Patient characteristics
In our sample of 200 consecutive patients,
u Almost 1 in 4 were under 40 years old
u 1 in 10 were seeking COVID-specific recovery care while
unable to return to work due to the severity and persistence
of sequelae
Danesh 2021 BUMC Proceedings

9. Summary
This consecutive case series report distills comprehensive telehealth
evaluations by COVID-focused internal medicine physicians to offer
preliminary profiles and durations of sequelae presentations stratified by
duration of sequelae and severity of disease:
u Patient seeking COVID recovery clinic services are experiencing
subjective cognitive dysfunction, fatigue and dyspnea.
u The proportions of patients reporting cognitive dysfunction and
pulmonary sequelae are similar in care seekers who experienced mild
disease (non-hospitalized) and moderate/severe disease
(hospitalized).
Danesh V, Arroliga AC, Bourgeois JA, Widmer AJ,
McNeal MJ, McNeal TM. Post-acute sequelae of
COVID-19 in adults referred to COVID recovery
clinic services in an integrated health system in
Texas. BUMC Proceedings. 2021;34(6):645-648.

10. References
u Danesh V, Arroliga AC, Bourgeois JA, Widmer AJ, McNeal MJ, McNeal TM.
Post-acute sequelae of COVID-19 in adults referred to COVID recovery clinic
services in an integrated health system in Texas. BUMC Proceedings.
2021;34(6):645-648.
u Carfi A, Bernabei R, Landi F. Persistent Symptoms in Patients After Acute
COVID-19. JAMA. 2020;324(6):603-605.
u Logue JK, Franko NM, McCulloch DJ, et al. Sequelae in adults at 6 months after
COVID-19 infection. JAMA Network Open. 2021;4(2):e210830-e210830.
u Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat
Med. 2021.