Lessons Learned in Implementing a Multidisciplinary Long COVID Clinic

Area of Science:

• Internal Medicine
• Rehabilitation Medicine
• Public Health

Background:

• Long COVID presents diagnostic and therapeutic challenges, particularly within healthcare systems serving large populations.
• A multidisciplinary approach is crucial for managing the complex, multi-systemic nature of post-acute sequelae of SARS-CoV-2 infection (PASC).

Purpose of the Study:

• To share lessons learned from establishing and operating a multidisciplinary long COVID clinic within the Veterans Affairs (VA) system.
• To describe the integrated care model and diagnostic work-up for patients with long COVID.

Main Methods:

• The long COVID clinic integrated primary care with embedded rehabilitation specialists, nutritionists, whole health practitioners, and internal medicine subspecialists.
• An extensive diagnostic work-up was performed to identify end-organ damage, persistent inflammation, and autonomic dysfunction (dysautonomia).
• Treatment strategies were informed by existing VA expertise in managing chronic fatigue syndrome and Gulf War illness.

Main Results:

• The multidisciplinary model facilitated comprehensive evaluation and management of long COVID patients.
• Diagnostic work-up identified key sequelae including end-organ damage, inflammation, and dysautonomia.
• Treatment protocols adapted from chronic fatigue syndrome and Gulf War illness provided a foundation for care.

Conclusions:

• A primary care-based, multidisciplinary clinic within the VA system can effectively address the complexities of long COVID.
• Integrating specialized services and leveraging existing expertise in related chronic illnesses is a viable strategy for long COVID care.
• Further research is needed to optimize diagnostic and therapeutic pathways for long COVID patients.