Carolyn Rodgers, 55, of Hendersonville, Tennessee, is one of countless COVID-1

9 survivors now plagued by long-term complications.

Nashville Tennessee

COVID-19 began as a headache for 14-year-old Madison Foore of Dundee, and then developed into shortness of breath, which simply did not go away weeks after she had to recover.

Her mother, Maricha Foor, knew something was wrong. Her active and fit daughter, a dancer who competed in fountain, ballet and jazz, could not climb the stairs without winding up.

Madison’s doctors referred her to specialists at CS Mott Children’s Hospital at the University of Michigan, who admitted that the eighth-grader was among the thousands of Americans who had contracted the virus and were not fully recovering.

Madison and others like her have a syndrome after COVID-19, known as long COVID-19.

They continue to have sometimes debilitating symptoms that can affect almost any organ system in the body – from pulmonary to cardiovascular, gastrointestinal to neurological – and have also been linked to changes in mental health, ranging from mood problems to anxiety. and depression.

And although the condition is best known among adults, children are not immune to it. Michigan Medicine already treats more than a dozen cases of children and teens with persistent COVID symptoms such as Madison’s.

Even people who have relatively mild cases of coronavirus may initially develop these ongoing chronic effects. That’s why Michigan Medicine is launching two new clinics aimed at treating and studying the little-understood long-term symptoms of COVID-19 in adults and children.

“The whole idea was to help patients overcome these longer-term effects of COVID … when it became clear that patients who had COVID did not have to fully recover,” said Dr. Rodica Pop-Busui. , director of the new multidisciplinary post Clinic COVID-19 for adults at UM.

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“At first we thought, like others, that this seemed to be mainly related to severe forms that required hospital admission. But later we and others noticed that this was not necessarily the case. Even people who had a milder form of the disease and have never been admitted (to the hospital) begin to develop many of these symptoms, such as pain and fatigue and inability to concentrate, etc. “

The work will be partially funded by the National Institutes of Health, Pop-Busui said, and will help doctors better understand why some people continue to develop COVID-19 for a long time and others do not.

“We are very interested in patients who have had certain pre-existing conditions, such as diabetes and obesity and chronic kidney disease. … The mechanism that seems to explain why some people develop these long-term effects is also very consistent with the reason that people with diabetes, for example, develop complications in the kidneys, cardiovascular system, nervous system, etc. “

It is not clear exactly how long COVID-19 predominates in adults.

A new study suggests that six months after infection with the virus, about 20% to 30% of people had ongoing complications, according to a study published April 22 in the journal Nature, which examined the results of nearly 90,000 patients with COVID-19 in health care databases of the U.S. Department of Veterans Affairs.

If this statistic is true, it means that approximately 170,000 to 250,000 people in Michigan alone may suffer from long-term symptoms of COVID, given that state health department data show that more than 840,000 Michiganers are infected. with the virus.

“We want to provide people with the best care, but we also want to learn what drives these (cases) so we can be prepared and prevent them if we can,” said Pop-Busui, who is also a professor of diabetes. at the University of Michigan and vice president of clinical research in the Department of Internal Medicine.

The adult clinic opened on Friday and offers virtual and face-to-face meetings at Domino’s farms in Ann Arbor.

Initially, the goal will be to enroll people hospitalized for COVID-19. Eligible patients in the clinic should:

  • Be 18 years of age and older with a history of laboratory-confirmed COVID-19.
  • Be referred by a primary care provider or inpatient on discharge.
  • You have a basic health condition such as diabetes, prediabetes, obesity, thyroid or adrenal diagnosis with continued symptoms after COVID-19, including fatigue, shortness of breath, joint and muscle pain, weakness, dizziness, chest pain and memory problems.

However, Pop-Busui said the clinic could be expanded if there is a high demand to include people who have not been hospitalized.

“We have to start somewhere,” she said. “It’s a good start. And if we have to expand, if there is a need, … we’ll be happy to do it.”

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For children like Madison, Michigan Medicine has also launched a pediatric clinic for post-COVID syndrome. It will run outside CS Mott Children’s Hospital and will include treatment not only for children who have had COVID-19, but also for those who develop a multisystem inflammatory syndrome in children known as MIS-C.

To be eligible, children must:

  • Be under 21 years of age with a history of laboratory-confirmed COVID-19.
  • Be directed by a primary care provider.
  • You have a continuation of symptoms, including fatigue, shortness of breath, joint pain, chest pain and cough that last for more than two months or 60 days after COVID-19.
  • No other exposures or explanations for new or worsening symptoms.

For Madison, she had trouble walking for 15 minutes on a treadmill without having to stop to catch her breath. The simplest tasks left her completely exhausted.

“I was so worried,” said Mariha Foor. “She’s 14. She’s been dancing for five years. I mean, she’s muscular and she’s used to walking and dancing and … she’s full of energy. It’s not typical for her to be without breath like walking around. “

Madison had cardiac work at Mott, which was normal, and was then treated by Dr. Carey Nien-Kai Lumeng, a professor of pediatrics in the Department of Pediatric Pulmonology at the University of Michigan.

He explained that the prevalence of long-term COVID-19 in children is not well understood.

Many children do not become seriously ill with an initial infection with the virus. So when they continue to develop these long-term complications of COVID-19, their cases are often not documented by a doctor or hospital system.

“In fact, we don’t know the scale of the problem, and there have really been very few studies on how many children have long-term symptoms,” Lumeng said. “I think the most recent study I’ve seen in children estimates that maybe 30% to 40% have some degree of long-term symptoms.

“I think there are 115,000 children in Michigan who have been diagnosed with COVID, so that’s a lot of kids,” he said. “Most of these symptoms coincide with what is seen in adults – shortness of breath, fatigue, chest pain, joint pain. These are the most common.”

As a pulmonologist, Lumeng treats children with respiratory symptoms and shortness of breath.

“We have seen elevated conditions in patients referred to us who did not have any disease before, had no problems before COVID, had COVID and now have more prolonged shortness of breath,” he said. “A lot of them have been athletes who are used to or actively involved in sports – whether it’s gymnastics or dancing or basketball, and when they try to get back to activity, they find that they just can’t do it. which they were able to do. “

The goals of the pediatric clinic will be to become a centralized place where children with long COVID-19 can go for treatment in Michigan and help them recover.

And Lumeng said he would like to investigate the phenomenon “to understand what’s going on and ways to help in the long run.”

“We will live with some of these things for a while, and I think the need for that will expand,” Lumeng said. “But honestly, I have no idea how many patients we will get for this clinic.”

Madison is already a patient. In addition to the headache and shortness of breath, Madison developed a strange taste in her mouth that did not completely disappear from her diagnosis of COVID-19 in mid-January.

Lumeng found that Madison had used an albuterol inhaler before training, and that her lung function had improved by 38 percent, Maricha Foor said.

“She’s still tired for a long time,” her mother said. “She’s getting better. She needs to take less breaks now.”

And she doesn’t need an inhaler that often when she’s dancing.

“But it’s just sad because she never had to worry about something like that,” Maricha Foor said.

Contact Kristen Shamus: Follow her on Twitter @kristenshamus.

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