For some patients, like Mr. Washington, lifelong nerve damage can be a particularly devastating consequence of Covid-19. A study published in the British Journal of Anaesthesia this month found that nerve injuries were common among patients on ventilators because they are frequently placed face down in their hospital beds. This practice, called “proning,” improves their breathing and can be lifesaving. But it can also compress nerves in the shoulders, legs and other limbs, increasing the odds of a disability. “It’s one of the more severe and substantial neurological problems that people can experience from Covid-19,” said the lead author of the study, Dr. Colin Franz, a doctor and scientist at the Shirley Ryan AbilityLab.
Across the country, dozens of hospitals have begun catering to recovering patients with specialized clinics for post-Covid care, which connect them to physical therapists, pulmonologists, psychologists and other specialists. In San Francisco, for example, patients who are discharged from UCSF Health are referred to the hospital’s specialized post-Covid Optimal Clinic, where they undergo an hourlong evaluation — done virtually — of their lung health, physical abilities and cognitive and mental health.
Then they undergo what the clinic’s founder, Dr. Lekshmi Santhosh, calls a “brain wellness check” to look for signs of psychological distress. For many critically ill Covid patients, the hospital experience — being isolated from family and friends, heavily sedated and hooked up to a ventilator — can be traumatizing, leading to delirium, depression or worse.
Dr. Santhosh and her colleagues then explore whether patients are experiencing other consequences as a result of their illness, such as job loss, shame and loneliness. “The benefit of clinics like this is that we have the luxury of time and connections that we can point people to so we can get them help,” said Dr. Santhosh, who specializes in pulmonary and critical care medicine. “A 15-minute visit with your primary care doctor is probably not enough time to delve into all of these different domains that are affected.”
It is not just the older and more vulnerable patients that become debilitated, said Dr. Justin Seashore, a pulmonary and critical care doctor and director of the Post Covid Recovery Clinic at the University of Texas Medical Branch in Galveston. “I have patients that were young and healthy people — people who say that before Covid-19 they could run a 5K and now they can’t run at all,” he said. “These are people that were normally very active.”