Post-acute COVID syndrome

Most Idahoans who caught the COVID virus have recovered and resumed their lives. However, thousands of COVID "long haulers" in Idaho continue to battle the ongoing effects of their infection. Difficulty breathing, extreme fatigue, muscle aches, racing heartrate, brain fog, and chronic cough are just a few of the many symptoms attributed to “long COVID” or post-acute-COVID syndrome.

Post-acute COVID severity and symptoms can vary widely from patient to patient, which may complicate the diagnosis process. On top of that, long COVID can affect those who were hospitalized with the disease, but also those whose infections were mild. While their initial infection may have seemed more like a cold or the flu, long COVID symptoms can still hit weeks or months afterward.

Sometimes a patient’s symptoms are either misdiagnosed or not taken seriously. As Dr. Kenneth Krell explains, long haulers “often feel like there is nowhere for them to turn for help, or they’ve been told that their symptoms are all in their head. That’s just not true. Long COVID affects cognitive function, cardiopulmonary function, the nervous system… The effects are very real.”

Post-acute COVID’s debilitating symptoms can dramatically affect quality of life, often resulting in job loss, depression, and anxiety. The lack of a diagnosis and treatment can lead to feelings of hopelessness. But help for long COVID sufferers in Idaho is finally here.

East Falls Internal Medicine has opened two clinics to help patients. Dr. Krell, now retired from his position as a critical care specialist at Eastern Idaho Regional Medical Center (EIRMC), is an Internal Medicine physician and program coordinator of the new clinics. The first is the Post-Acute COVID Clinic; the second is the Post Intensive Care Syndrome (PICS) Clinic, which cares for survivors of critical care. Patients share many of the same problems, and both present an opportunity to improve the lives of survivors of these illnesses who have been unable to return to a full functioning life.

Anyone who believes they are experiencing the effects of long COVID can now make an appointment for an evaluation, no referral needed. The diagnostic process begins with a questionnaire, sent out prior to the patient’s first appointment. During the initial two-hour evaluation, a battery of tests may be given and the questionnaire is reviewed. Results are used to form a personalized, comprehensive treatment plan, which could include referrals for further testing, imaging, or specialized care from cardiologists, neurologists, psychologists, or physical therapists.

“We can do some things to hasten that recovery with graded physical therapy, with cognitive training, sometimes with specific drugs and with help from a social system,” Dr. Krell explained.

All patients’ care is supervised by an experienced physician. Initially that will be Dr. Krell, who has over 20 years of experience as a critical care specialist and is a veteran of EIRMC’s COVID ICU. Internal Medicine residents and nurse practitioners also participate in testing and tracking of each patient, carefully monitoring their progress toward wellness. And, emphasizes Dr. Krell, “We want to reassure primary care providers that they will be kept in the loop about their patients’ care.”

East Falls Internal Medicine is an Internal Medicine Clinic ran by Drs. Krell, John Grider, and Sean Huggins. They are assisted by Internal Medicine residents who are in their final years of training. At the COVID-19 clinic, residents play a critical role in helping long COVID patients. They participate in research studies of long-COVID treatments, giving clinic patients the opportunity to not only get help for themselves but to also help future patients by participating in treatment studies. This is more important than ever, now that COVID-19 and its many variants are here to stay.

The East Falls Internal Medicine COVID-19 Clinic meets both the physical and mental health needs of patients, and it provides long haulers with another very important thing: hope.

“This is not a hopeless situation. This is not a situation where we can’t do anything. Supporting [post-acute COVID] patients through their journey is important and helpful. We offer treatments and interventions that can improve their quality of life,” says Dr. Krell. “We offer them hope — hope that their quality of life can improve.”

And that may be the best medicine of all.

For an appointment at East Falls Internal Medicine, call (208) 535-4000.