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Johns Hopkins Medicine Is Trying To Help COVID-19 Patients With Long-Term Symptoms


Most people recover from COVID-19, but a small percentage of people have lingering, sometimes debilitating symptoms. NPR's Allison Aubrey reports on a clinic at Johns Hopkins University in Baltimore that's helping patients get to the bottom of their ongoing struggles.

ALLISON AUBREY, BYLINE: Dr. Emily Brigham is a pulmonologist by training. And given that COVID-19 often hits the lungs first, she sees a lot of patients with respiratory issues. But the lingering struggles of so-called COVID long-haulers go beyond that. The infection can damage or affect multiple organs and systems within the body and lead to a variety of symptoms.

EMILY BRIGHAM: There's a wide range, very wide range. But I would say we often see persistent shortness of breath. Fatigue is a common symptom; cognitive complaint, like difficulties with memory, remembering things or just thinking in general; and certainly, changes in mood.

AUBREY: Brigham is now collaborating with other doctors at Johns Hopkins Medicine who have a range of specialties - neurologists, psychiatrists, physical therapists and heart specialists - trying to help sort out and treat patients with long-term symptoms. The goal of their post-COVID clinic is to establish an interdisciplinary approach to address the unique needs of COVID survivors. One patient is Michaeline Karlton (ph).

MICHAELINE KARLTON: My health plummeted. Daily I have a headache. The fatigue is unreal. Like, I literally feel like my body is shutting down.

AUBREY: Up to 10% of people who've had COVID experience prolonged symptoms in the weeks after an infection. That's according to an estimate published in the British Medical Journal. But for Michaeline Karlton, who is 47 years old, her symptoms have persisted for more than six months.

KARLTON: I was in pretty decent shape, and I was, you know, the typical soccer mom. I was running constantly with my kids. And now it's a struggle to, you know, get around my house. And it's truly debilitating.

AUBREY: The day I interviewed her, she began our conversation by saying sorry for being just a bit late.

KARLTON: I want to start off by apologizing. I completely had a brain fog moment.

AUBREY: This is a common complaint among long-haulers, and it's out of character for Michaeline Karlton. She's now out on disability from her job. She works as a paraeducator with special education students. Depression and anxiety are also common. In fact, a recent study found that following COVID, about 1 in 5 patients is diagnosed with a mental health condition. Psychiatrist Adam Kaplin, who is also part of the Johns Hopkins post-COVID clinic, says he is seeing this in patients.

ADAM KAPLIN: What we know is that inflammation, when it affects the brain, has an impact on the parts of our brain that does things like regulate mood. This is one of the awful longer-term consequence of the infection for many people.

AUBREY: Michaeline Karlton attributes her anxiety to all the uncertainty about her condition. But she says she's not depressed. She's very determined to get to the bottom of her struggles and get better. And now it seems she may be one step closer. Turns out the root of her post-COVID struggles may stem from a syndrome known as POTS. That stands for postural orthostatic tachycardia syndrome.

KARLTON: So what happens is when I go from a horizontal position to a vertical position - so say, you know, sitting on the couch or lying on the couch - to a standing position, my heart starts pumping really, really fast. So that's where I get heart palpitations. I have - my heart rate will spike up high.

AUBREY: Which can help explain the headaches and the brain fog. Karlton is now being treated by Dr. Tae Chung. He's a specialist in POTS at Johns Hopkins.

TAE CHUNG: She has a very classic symptoms of POTS. And it can be extremely debilitating.

AUBREY: Chung explains that patients with POTS lose the capacity to regulate blood flow. And this can cause a cascade of symptoms, including the brain fog, chronic fatigue, dizziness and sometimes chronic nausea and vomiting. The condition is not new, and Chung says it's not a total surprise to see it post-COVID because up to half of all people diagnosed with POTS develop their symptoms after an infection. And Chung says POTS is often misdiagnosed or not recognized at all. But there are specific tests to diagnose it.

CHUNG: Symptoms can fluctuate, sometimes get better, sometimes get worse. But usually, they have it for quite a long time.

AUBREY: There are treatments to improve the symptoms, including aggressive hydration - so having patients drink a lot of water - and certain medications. Exercise can help, too. As for Michaeline Karlton, she's starting to feel as if her recovery has begun.

KARLTON: Mine is very slow, but I feel like even though I have my ups and downs, I have more ups than downs. And I started physical therapy virtually this morning.

AUBREY: She's hoping this will help her get some strength back. And beginning to exercise may help her manage her symptoms and help her along the path to feeling better.

Allison Aubrey, NPR News. Transcript provided by NPR, Copyright NPR.

Allison Aubrey is a correspondent for NPR News, where her stories can be heard on Morning Edition and All Things Considered. She's also a contributor to the PBS NewsHour and is one of the hosts of NPR's Life Kit.
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