CORONAVIRUS

University of Iowa establishes clinic for former COVID-19 patients

Clinicians to diagnose, treat lasting health effects of virus

From left, University of Iowa Hospitals and Clinics physicians Dr. Joseph Zabner, Dr. Alejandro Comellas and Dr. Raul Vi
From left, University of Iowa Hospitals and Clinics physicians Dr. Joseph Zabner, Dr. Alejandro Comellas and Dr. Raul Villacreses are three of the four providers working in the newly-established clinic for patients after they have been infected with COVID-19. Photographed Aug. 5 outside of the hospital in Iowa City. (Liz Martin/The Gazette)
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IOWA CITY — In an effort to treat and study the still little-understood impact of the novel coronavirus, the University of Iowa Hospitals and Clinics has established a clinic to treat patients following an infection of COVID-19.

The Respiratory Illness Clinic is a designated space to diagnose and care for patients experiencing complications as a result of COVID-19, an initiative that its lead doctor says will help local health care providers discover trends in the virus’ impact and aid in future research.

Dr. Alejandro Comellas, UIHC pulmonologist and head of the Respiratory Illness Clinic, began having conversations with other providers back in March, the month the virus was confirmed in Iowa, At the time, he said clinicians weren’t sure — and still aren’t — of the long-term effects of the virus.

“This comes from the experience we have had with infections like influenza, where some people develop very severe disease and end up with lung fibrosis, in some cases,” Comellas said. “In the case of COVID-19, we were not really sure what type of consequences the patients would have as far as chronic health conditions.”

Since its opening at the end of June, the clinic’s four providers — all pulmonologists — have seen about 15 patients. The majority of these patients were not hospitalized because of COVID-19, Comellas said, but still experience lasting effects on their health.

Creating and maintaining this clinic was of minimal cost to UIHC, officials say. It was established in an existing office space, and officials did not purchase new equipment or recruit new providers and staff.

Clinic appointments, which currently take place only on Friday mornings, qualify for insurance coverage, according to officials.

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Patients who come through the Respiratory Illness Clinic will be asked to add their names to a registry of COVID-19 patients, giving consent to be contacted by researchers for future studies on the virus.

UIHC providers plan to keep it open “as long as we continue having COVID-19 cases,” Comellas said.

Plans to grow the clinic are underway, UIHC officials say. As the patient size expands, they predict providers will see many patients from minority groups and those from lower socio-economic backgrounds, who experts have found to be among the hardest hit by the pandemic nationwide.

In particular, Comellas expects to see Spanish-speaking patients whose infections tie back to outbreaks at meatpacking plants in Iowa.

According to the World Health Organization, most COVID-19 patients recover after two weeks. About 80 percent of infected COVID-19 patients experience mild symptoms, or no symptoms at all.

However, there’s a growing number of the total 5 million COVID-19 patients in the United States who continue to report symptoms — ranging from fatigue and trouble breathing to even neurological or cardiac issues — long after two weeks. In some cases, the impact of the virus still is felt months later.

Given this virus affects patient’s organs — in particular, the lungs — some patients may develop severe and chronic health conditions as a result. This has been seen in other patients following other kinds of illnesses, including influenza, Comellas said.

Research on long-haulers is limited. One study of more than 140 COVID-19 patients in Italy, which was published in JAMA Network, reported that 87 percent reported at least one remaining symptom, usually fatigue or trouble breathing.

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Comellas said doctors suspect many of the patients arriving at the clinic will be experiencing complications in their airways, which may manifest itself later as asthma or chronic obstructive pulmonary disease, or COPD.

While some of these complications are a direct result of the patient’s battle with COVID-19, Comellas said these complications could also be an underlying health condition that had not been diagnosed before the virus, but has recently manifested itself. For example, Comellas said a patient may not have exhibited symptoms of COPD before the bout with the novel coronavirus.

“We’re dealing with some of the consequences of the virus, but also in the context of somebody who already has some chronic health condition that had not been seen at the time,” he said.

Comellas said it’s still too early to tell whether the clinic’s patients, who are still reporting symptoms weeks after their diagnosis, will have a complete and full recovery “or whether they’re going to be left with some type of impairment.”

“That is something that will have to wait to see,” he said. “The reality is that this is new. A lot of these patients were diagnosed at the end of April or early May and now they’re coming into the clinic. It hasn’t even been six months.”

Comments: (319) 398-8469; michaela.ramm@thegazette.com

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