UW Medicine launches telehealth clinic for COVID-19 patients in recovery

Even after surviving a really bad case of COVID-19 and spending time in an intensive care unit, a patient’s fight may not yet be over.

Aaron Bunnell, assistant professor of rehabilitation medicine at the University of Washington and the medical director of Rehabilitation Consults at Harborview Medical Center, says there are after-effects that can linger as a patient recovers from the virus.

“It’s not just that you get a respiratory infection and then you get better, and it’s done,” he said. “What’s coming out is that you get the infection, and a lot of people have other areas that are affected.”

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Bunnell explains that patients recovering from COVID-19 have had problems with breathing, endurance, and physical functioning, among other issues, even after they leave the ICU. To help address the needs of these patients, UW Medicine created a post-COVID-19 telehealth clinic.

“With the COVID pandemic, we have been transitioning to a lot of telehealth resources for patients in general, and we thought that this would also be an ideal program for our patients with COVID,” Bunnell said. “There are obvious challenges having a patient with an active infection following up an in outpatient setting, so how can we deliver those resources to the patient in a way that is safe for them and for everyone else?”

Bunnell says a major benefit of a telehealth program like this is that it allows the doctors to see a patient’s environment and reactions in real time.

“I think there’s also a human component, so when I’m asking you questions about your mood or whether you’re having flashbacks to the ICU, it’s just better to be able to look someone in the eye and ask those questions rather than by telephone,” he added.

The two top post-COVID conditions have been shortness of breath and cardio-pulmonary endurance.

“So you’re short of breath, but you’re also not able to walk very far, or move very far, or have endurance for activities that we kind of take for granted,” Bunnell said. “Other areas are your physical functioning, so self-care ability, to take care of your daily needs. So can I dress, bathe, groom, feed myself, those kinds of things.”

There have also been cognitive changes observed in recovering patients, as well as emotional and mental health issues, including anxiety, depression, and PTSD.

“We really want a comprehensive service to be delivered to that patient to address each of those
domains,” Bunnell said.

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In part, the goal of the telehealth program is to better understand COVID-19 itself, Bunnell explained, and be able to determine what percentage of people are going to have more severe symptoms and need this follow-up, and who could be fine with a home exercise program and education.

“This is actually a need that’s been identified in a lot of ICU survivors,” he added. “And I think building this clinic out to serve their needs as well, whether or not they’ve had COVID, or something else, like a pneumonia, or an influenza, I think this clinic can serve that need well, too.”