COVID-19 may seem under control as thousands of people have become vaccinated and boosted. Its variants, however, call for continued caution and safe habits. Additionally, for many individuals who did become infected with the virus, remaining symptoms are cause for concern. For these individuals, who have developed post-acute sequelae of COVID-19 (PASC) or in layman’s terms, long-haul COVID, the need for continued medical care is essential. Many of them are relying on a team of clinicians including their primary care physician, various specialists, and a case manager. Case management services for these so-called “long-haulers” is especially vital.
Multiple Symptoms to Manage
Long COVID can involve a wide range of symptoms ranging from mild to very serious. According to the Centers for Disease Control and Prevention (CDC), among the most common symptoms of long COVID are: breathing difficulties, cough, fatigue, chest or stomach pain, joint or muscle pain, diarrhea, fever, dizziness, changes in taste and smell, pins and needles, brain fog, and sleeping difficulties. Depending on a patient’s age, general health, and whether he/she has any pre-exiting conditions (e.g., heart disease, chronic obstructive pulmonary disease, cancer, diabetes, etc.), long COVID can require a multidisciplinary approach to care.
Long COVID symptoms can last months, up to a year and beyond. These symptoms can have a major impact on an individual’s quality of life. It can interfere with their employment (i.e., many long-haul COVID patients have difficulty returning to work and performing their role), as well as their social and recreational activities. For long-haulers, depression is a common occurrence. Case management for long-haul COVID patients requires best practices across areas of patient engagement and advocacy, communications, and reporting.
Case Management for Long-Haul COVID Patients
It is important to recognize that, because of the relative newness of the COVID-19 virus, there is not a lot of clinical data on long-haul COVID. Some believe long-haul COVID attacks the autonomic system, while another theory is that it may be a blood vessel disease. As a result of the continued assessment of this condition, there can be many misdiagnoses and/or some clinicians dismissing a patient’s account of what they are experiencing. Here is where the case manager’s role as a patient advocate becomes even more critical. The case manager will strive to educate the patient and his/her family regarding long-haul COVID, and make sure the patient is adhering to the prescribed treatment plan.
Care coordination is foremost for long-haul COVID patients. The case manager’s role in coordinating services, keeping other medical team members informed, and maintaining open communications with the patient, family and medical team members is essential.
It is also part of the case manager’s role to coordinate additional medical and/or other services such as social and/or recreational supports required by the patient. The case manager will recommend the appropriate resources and make sure the patient can access these additional services.
When it comes to a patient’s employment, the case manager will also reach out to the patient’s employer, helping to educate the organization regarding long-haul COVID and the ongoing symptoms an employee is experiencing. This is especially important since many employers may not understand why an employee is taking so long to return to work after the acute infection has subsided.
A Detailed, Fiscally-Prudent Case Management Plan
The case management plan for long-haul COVID patients is highly-detailed with specific action items designed to achieve measurable goals. As with all case management, there is attention given to a plan that is also fiscally-prudent and reflecting a value-based healthcare approach.