Study underscores need for multidisciplinary care for COVID-19 long-haulers

Long COVID can affect multiple organ systems and the most common symptoms include fatigue, shortness of breath, brain fog, anxiety, depression, and post-traumatic stress disorder (PTSD); Based on the limited data available, at least one-third of patients hospitalized for COVID-19 studied to date have experienced such long-term effects
Dana-Farber Cancer Institute

Newswise — Physicians across the country have analyzed the emerging scientific data about the long-term effects of COVID-19, creating an initial knowledge base about the clinical experiences of so-called “long-haulers” – patients with COVID-19 who experience prolonged symptoms and/or the emergence of new ones well after the initial viral infection has resolved. A comprehensive review published today in Nature Medicine offers an initial glimpse of the multi-organ effects of long-term COVID-19 and suggests a framework for the care of COVID-19 long-haulers through dedicated, multidisciplinary clinics.

“It was important to respond to our patients’ concerns and pay close attention to the symptoms they were experiencing beyond the acute phase of COVID-19,” said Kartik Sehgal, MD, a lead author of the new study and a medical oncologist at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, and instructor in medicine at Harvard Medical School. “While our knowledge in this area is still evolving and will continue to evolve over the next few years, we have provided a comprehensive resource for physicians caring for patients who have recovered from acute COVID-19 and scientists currently investigating the potential prolonged effects of COVID-19.”

Sehgal and his colleagues at hospitals affiliated with Harvard University and Columbia University worked at the frontlines of the pandemic last spring and have witnessed first-hand the myriad health effects that the responsible virus, known as SARS-CoV-2, can inflict. That includes the recognition that COVID-19 is not simply an illness of the lungs or respiratory tract but can also affect many other organ systems. Sehgal was among the co-authors of a study published last summer in Nature Medicine that summarized the vast constellation of multi-organ symptoms associated with the COVID-19.

As the pandemic wore on, the team heard from their own patients as well as patient advocacy groups about surprisingly persistent symptoms – complications that extended for weeks, even months, beyond the initial infection.

“COVID-19 is the first infectious disease that I’ve come across that has such an effect on a wide variety of organs. It’s changed my clinical practice. No matter what the patient comes in for, I now ask if they ever had COVID-19. It changes the possible range of diagnoses,” added Elaine Y. Wan, MD, the Esther Aboodi Assistant Professor of Medicine in Cardiology and Cardiac Electrophysiology at Columbia University Vagelos College of Physicians and Surgeons and senior author of the study.

These observations prompted the authors to undertake a comprehensive review of the published literature on long-term effects of COVID-19 so they could develop a better understanding of the condition themselves and share it with the physician and scientific community.

They found that the most common symptoms of long COVID include fatigue, shortness of breath, brain fog, loss of sense of smell or taste, anxiety, depression, and post-traumatic stress disorder (PTSD). Based on the limited number of studies published to date, at least one-third of patients who required hospitalization for COVID-19 have experienced one of these long-term side effects. While there is much more work yet to be done, this finding is consistent with what has been found in the few studies of survivors of the SARS epidemic in 2003 as well as the MERS outbreak in 2012, which involved viruses that are closely related to SARS-CoV-2.

“The medical needs of patients with COVID-19 don’t stop at the time of hospital discharge and they also don’t necessarily stop after three to four weeks, even for those who didn’t require hospitalization,” said Sehgal. “It is important for physicians to be aware of these possible symptoms and complications and to have resources available for early recognition to provide the best possible care.”

Because the symptoms of long COVID are not typically restricted to just one organ system, the researchers stress the importance of multidisciplinary care, such as a dedicated COVID-19 clinic that includes specialists with expertise in diverse areas of clinical medicine. “It is important to not forget about the mental health effects of COVID-19 in these patients, while taking care of their physical symptoms,” said Sehgal.

Some academic medical centers have already established such an effort. In response to the clinical need and the emerging research findings, the Brigham Lung Center has recently established a COVID Recovery Center to coordinate and deliver multi-disciplinary care for patients with long-term symptoms after infection.

Moving forward, Sehgal and his colleagues believe it will also be essential to develop mechanisms for appropriately sharing and pooling patient data across organizations and institutions, including from patient advocacy groups, which played a major role in highlighting the health struggles of long haulers. 

“There are a lot of questions we’ll need to answer,” said Sehgal. “The only way we can do that quickly is by systematically collecting and harnessing all of the data that’s out there.”

The co-authors of the study are Ani Nalbandian, MD; Aakriti Gupta, MD, MS; Mahesh Madhavan, MD; Claire McGroder, MD; Jacob Stevens, MD; Joshua Cook, MD, PhD; Anna Nordvig, MD; Daniel Shalev, MD; Tejasav Sehrawat, MBBS; Neha Ahluwalia, MD; Behnood Bikdeli, MD; Donald Dietz, MD; Caroline Der-Nigoghossian, PharmD; Nadia Liyanage-Don, MD; Gregg Rosner, MD; Elana Bernstein, MD, MSc; Sumit Mohan, MD; Akinpelumi Beckley, MD, MBA; David Seres, MD, ScM, PNS; Toni Choueiri, MD; Nir Uriel, MD, MSc; John Ausiello, MD; Domenico Accili, MD; Daniel Freedberg, MD; Matthew Baldwin, MD, MS; Allan Schwartz, MD; Daniel Brodie, MD; Christine Kim Garcia, MD, PhD; Mitchell S.V. Elkind, MD, MS, MPhil; Jean M. Connors, MD; John Bilezikian, MD; Donald Landry, MD; and Elaine Wan, MD, FACC, FAHA, FHRS.

Funding for this work came from the following organizations and grants: National Institutes of Health (K23 DK111847, T32 HL007854, R01 HL152236, and R03HL146881), National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK114893, R01-MD014161, U01-DK116066), National Institute of Neurological Disorders and Stroke (T32 NS007153-36), National Institute of Aging (P30 AG066462-01), Department of Defense (PR181960), the Esther Aboodi Endowed Professorship at Columbia University, the Foundation for Gender-Specific Medicine, Louis V. Gerstner, Jr. Scholars Program, and the Wu Family Research fund.


About Dana-Farber/Brigham and Women’s Cancer Center

Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) brings together specialists from two world-class medical centers. Physicians from both hospitals bring deep experience in treating various cancers and the care teams include experts from a wide span of disciplines, such as medical and radiation oncologists, cancer surgeons and many others. DF/BWCC offers access to the latest treatments, many of which were pioneered at DF/BWCC, along with clinical trials for promising new therapies.

For more information visit:




Filters close

Showing results

110 of 6133
Released: 5-Aug-2021 2:30 PM EDT
Research Shows Many with Mild COVID-19 Infections Still Experience Long-Term Symptoms
University of Arizona Health Sciences Center

The majority of individuals who experience mild or moderate COVID-19 infection also experience long COVID, or persistent symptoms more than 30 days after they test positive, according to research data from the longitudinal CoVHORT study at the University of Arizona Health Sciences.

Released: 5-Aug-2021 2:10 PM EDT
Should COVID-19 Vaccination Be Mandatory for Health and Care Staff?

Italy, France, and Greece have made covid-19 vaccination mandatory for healthcare workers, and England is making it compulsory for care home workers and consulting on whether to extend this to healthcare workers and other social care staff.

Newswise: Organ Transplant Recipients Significantly Protected by COVID-19 Vaccination
Released: 5-Aug-2021 1:55 PM EDT
Organ Transplant Recipients Significantly Protected by COVID-19 Vaccination
University of California San Diego Health

UC San Diego researchers report that solid organ transplant recipients who were vaccinated experienced an almost 80 percent reduction in the incidence of symptomatic COVID-19 compared to unvaccinated counterparts during the same time.

Newswise: Statement: Employers Need to Require COVID-19 Vaccination for Healthcare Workforce
Released: 5-Aug-2021 1:30 PM EDT
Statement: Employers Need to Require COVID-19 Vaccination for Healthcare Workforce
American Association of Critical-Care Nurses (AACN)

The American Association of Critical-Care Nurses calls for all healthcare and long-term-care employers to require every member of the healthcare team to be vaccinated against COVID-19, except when medically contraindicated.

Newswise: 17d548cf-cfe0-4673
Released: 5-Aug-2021 1:10 PM EDT
Heads Reveal How ‘Overwhelming’ Government Guidance Held Schools Back as COVID Hit
University of Cambridge

Headteachers and school leaders have described how an ‘avalanche’ of confused and shifting Government guidance severely impeded schools during the critical first months of COVID lockdown in a new study.

Released: 5-Aug-2021 10:55 AM EDT
AMSSM Partners with White House and 11 Organizations to Encourage Vaccine Conversations During Sports Physicals
American Medical Society for Sports Medicine (AMSSM)

AMSSM and 11 other leading sports and medical organizations signed on to a consensus statement to encourage healthcare providers to include conversations about COVID-19 vaccinations as part of the pre-participation physical.

Newswise: August Issue of Issue of The American Journal of Gastroenterology Includes Diet-Associated NAFLD Risk and Increased Risk of Mortality from COVID-19 Among PPI Users
Released: 5-Aug-2021 9:25 AM EDT
August Issue of Issue of The American Journal of Gastroenterology Includes Diet-Associated NAFLD Risk and Increased Risk of Mortality from COVID-19 Among PPI Users
American College of Gastroenterology (ACG)

The August issue of The American Journal of Gastroenterology includes clinical discussions of diet-associated NAFLD risk and increased risk of mortality from COVID-19 among PPI users. In addition, this issue features clinical research and reviews on IBS, gender barriers for CRC screening, hepatitis C, eosinophilic esophagitis, and more.

Released: 5-Aug-2021 8:45 AM EDT
Research Reveals that Flu Shot Protects Against Severe Effects of COVID-19
University of Miami Health System, Miller School of Medicine

In a newly published study, physician-scientists at the University of Miami Miller School of Medicine have shown that the flu vaccine may provide vital protection against COVID-19.

Released: 5-Aug-2021 8:45 AM EDT
Persistent COVID-19 Infections in Immunocompromised People May Give Rise to Variants of Concern
Fred Hutchinson Cancer Research Center

In an article in the New England Journal of Medicine, scientists from Fred Hutchinson Cancer Research Center, Johns Hopkins Bloomberg School of Medicine, the U.S. Military HIV Research Program and the Institute for Global Health and Infectious Diseases at the University of North Carolina urged increased attention to persistent COVID-19 infections in immunocompromised people.

Newswise: Novel Model Predicts COVID-19 Outbreak Two Weeks Ahead of Time
Released: 5-Aug-2021 8:30 AM EDT
Novel Model Predicts COVID-19 Outbreak Two Weeks Ahead of Time
Florida Atlantic University

People’s social behavior, reflected in their mobility data, is providing scientists with a way to forecast the spread of COVID-19 nationwide at the county level. Researchers have developed the first data-driven deep learning model with the potential to predict an outbreak in COVID-19 cases two weeks in advance. Feeding the mobility data to epidemiological forecasting models helps to estimate COVID-19 growth as well as evaluating the effects of government policies such as mandating masks on the spread of COVID-19.

Showing results

110 of 6133