While there is still much to learn about residual health issues in COVID-19 survivors, the Department of Medicine's newly opened COVID-19 Recovery Clinic (CORE) is providing follow-up and recovery engagement to patients experiencing a wide range of physical, cognitive or emotional effects after a recent hospitalization or outpatient care. These may include persistent pulmonary issues, such as coughing or shortness of breath; feeling tired, dizzy or weak; numbness or tingling; and abdominal pain. The virus can also take its toll on the emotional health of survivors.
“Just as physical weakness is common, so too are challenges with thinking, anxiety, fear, loneliness, difficulty coping, and difficulty sleeping,” said Aluko A. Hope, MD, MSCE, a pulmonary/critical care specialist and co-director of the CORE Clinic.
Demystifying these complex issues was the impetus for the Department of Medicine to create the CORE clinic, which is currently located at MAP-2 on Bainbridge Ave. Under the leadership of Dr. Hope and co-director Seth Congdon, MD, a primary care physician in the Division of General Internal Medicine, the CORE clinic will treat any patient who has had a COVID-19 + test—whether PCR or IgG antibody, and whether the illness was treated at home or was severe enough to require hospitalization.
Giving Back to the Community
Having suffered the highest rates of COVID-19 infections in NYC, the Bronx clinic is a sorely needed service in the hard-hit community.
“Montefiore is uniquely positioned to support this innovative clinic given our deep expertise across the health center, our deep roots within the Bronx community, and our proximity to Westchester and Connecticut as well,” said Dr. Hope. “We develop care approaches that can intentionally engage patients across all racial/ethnic and socioeconomic levels.”
Through a mix of telemedicine, telephone, and in-person visits, Dr. Hope will care for survivors with more serious COVID-related complications. He will also direct a Critical and Acute Illness Recovery Engagement (CAIRE) clinic for survivors of critical illness.
Dr. Congdon will focus on patients who were treated for COVID-related complications outside of the hospital setting. “I'll see people who never were admitted to the hospital or were admitted for less than 10 days,” he said.
When not seeing CORE patients, Dr. Congdon works as a primary care physician at the Family Care Center, where a large part of his job is teaching internal medicine residents. During the COVID-19 surge, the 2019 graduate of the Moses/Weiler Internal Medicine Residency Program spent three weeks on the front lines at Moses, including one week in the emergency department during the height of the pandemic.
Developing Infrastructures to Treat Critically Ill Patients
As an Attending in the Division of Critical Care Medicine, Dr. Hope spent much of his time during the COVID-19 surge either as an attending in the ICU or as an attending on the busy critical care consultation service. When he wasn’t seeing patients in the hospital, he was collaborating with his research colleagues and mentors both locally at Montefiore/Einstein and nationally, to develop robust research infrastructures to better understand how to treat seriously ill patients with COVID-19 related complications. “There is much that we know about the kinds of issues that plague survivors of acute and serious illness, yet there is also much that we do not know about the struggles of our COVID-19 survivors,” he said.
“I am passionate about listening to my patients’ stories and assessing and managing their symptoms,” Dr. Hope said. Patients who come to CORE clinic after a recent hospitalization, for example, are rigorously assessed for new or worsening impairments across multiple domains of health (including physical, emotional, cognitive, and social). These assessments are used to develop a comprehensive plan of care for each patient. Such a care paradigm emerges from the decades of research cataloging the high prevalence of new or worsening impairments in these health domains in survivors of serious illness.
Dr. Hope completed his postgraduate training in primary care internal medicine at Columbia University Medical Center. He then pursued a fellowship in Pulmonary/Critical Care at Mount Sinai Hospital. He spent a year training in Palliative Medicine where he learned how to manage complex symptoms for seriously ill adults. “As a clinical researcher, my focus over many years has been on understanding and improving the long-term impact of critical illness on patients and families,” said Dr. Hope, who is a founding and executive member of the Critical and Acute Illness Recovery Organization (CAIRO), an international organization whose mission is to advance innovations in critical and acute illness recovery. “We are poised to listen, learn, treat, and innovate where necessary to improve our patients’ quality of life.”
All Department of Medicine subspecialties can make internal referrals to CORE, as can other departments (Rehabilitation Medicine, Neurology, etc.). Patient referrals can be made by calling 844-556-6683, extension #36. In the near future, a dedicated EPIC ambulatory referral will be available for internal referrals.
Posted on: Friday, July 17, 2020