Center will coordinate care across specialties and advance research for those with persistent symptoms after COVID-19 infection
BOSTON — Although approximately 10 percent of the U.S. population has been infected with COVID-19, the complex symptoms that may linger for recovered individuals are not well understood. The new COVID Recovery Center (CRC) at Brigham and Women's Hospital will serve as a resource for patients suffering from these persistent symptoms, providing efficient access to medical services from a wide range of providers. Through a multidisciplinary, patient-centered approach, the CRC will support targeted care for patients by connecting them with appropriate specialists and advancing research on the physical and psychological impact of the disease.
Elizabeth Gay, MD, and Daniela Lamas, MD, both of the Lung Center in the Division of Pulmonary and Critical Care Medicine, serve as director and co-director, respectively, of the CRC, which is housed in Lung Center A at 15 Francis Street on the Brigham campus.
"There's a lot we don't know about this disease," said Gay. "Being able to see patients in a setting where other clinicians and providers are thinking about a similar set of issues can allow us to identify patterns and understand needs. And from a research perspective, that offers the ability to develop a cohort you can follow and try to answer some of these questions."
The center provides a centralized location to evaluate post-COVID symptoms. Patients may have a spectrum of symptoms, including persistent cough, shortness of breath, fatigue, "brain fog," changes to taste and smell, gastrointestinal and cardiovascular symptoms, or mental health needs. CRC patients first undergo a comprehensive pulmonary (lung) evaluation. As their care evolves, multidisciplinary teams for a patient will be assembled and may include specialists in infectious disease, cardiology (heart and vascular), nephrology (kidney), neurology (brain and nervous system), otolaryngology (ear, nose and throat), surgery and psychiatry or social work (mental health).
Patients must have a previous documented positive COVID PCR test or positive serology but do not need to be an existing Brigham patient to receive care.
"A new illness mandates a new approach to treatment," said Bruce Levy, MD, chief of the Division of Pulmonary and Critical Care Medicine. "We are still learning about the clinical spectrum and natural history of the long-term symptoms that follow COVID-19, and we need expertise from many domains."
As part of a broader commitment to health equity, the CRC has applied for an internal grant from the Department of Medicine to fund the work of a community health worker. A patient navigator will also work to contact previously admitted hospital patients and alert them of the services offered by the center.
"One of the most striking things about working in the COVID ICUs in the spring was the terrible impact COVID had on patients from disadvantaged communities," said Lamas. "We really do want to make sure that we are offering services to the group who bore the brunt of this disease, especially in the initial wave, and to me that is an essential part of what we're doing."
The CRC will also advance research on the long-term impact of COVID-19 from pulmonary, vascular, immunologic, neuropsychiatric, psychological, and social perspectives. Patients are invited to contribute to biospecimen collections, stored at the Mass General Brigham (MGB) BioBank. A Multidisciplinary Care Conference facilitated by the CRC will allow medical providers to come together to discuss observations that may improve patient care and establish standardized courses of therapy. The MGB system facilitates collaboration between the CRC and other clinics system-wide recently established for recovering COVID-19 patients, including those at Massachusetts General Hospital and the Spaulding Rehabilitation Hospital.
"People from all corners of the Brigham community are extremely energized and motivated to think about the clinical challenges these patients are facing and help find innovative solutions," Levy said. "We have had the privilege and responsibility of caring for patients on the front lines, and now we've broadened our efforts to actively assist in their care during the weeks to months after their initial infections. To be engaged in the care of these patients with COVID-19 or its longer-term sequelae and to hopefully uncover novel therapeutic strategies is central to our mission."
