Speakers
Michael Choo, MD, FACEP, FAAEM, Chief Medical Officer, Paradigm
Stan Smith, LNFA, MBA, Vice President, Post-Acute Care, Paradigm
Kathy Galia, RN, BSN, SVP and General Manager, Clinical Solutions, Paradigm
Lawrence Lottenberg, MD, FACS, Paradigm Medical Director
Paul Dongilli Jr., PhD, FACHE, Chief Executive Officer, Madonna Rehabilitation Hospitals

Exploring the long-term effects and management of COVID-19 cases
As the industry and the country as a whole look ahead past the pandemic and return to a level of normalcy, many questions remain about the novel coronavirus and the ongoing implications of COVID-19.

While most people with COVID-19 recover within weeks, new research estimates 25% of patients will experience long-term complications. This condition, commonly referred to as “long-haul COVID,” is characterized by a range of unpredictable, difficult-to-diagnose symptoms.

On Tuesday, July 27, 2021, a panel of clinical experts continued to discuss what they have learned about this unprecedented disease and explored the unique categories of post-COVID conditions. In this fourth Paradigm webinar series covering the COVID-19 pandemic, the panelists reviewed the latest clinical guidance on the disease. They also explored the implications of treating long-haul COVID.

Kevin Turner, Chief Clinical Solutions Officer for Paradigm, began by reviewing the previous panels held in 2020 and earlier this year. He then introduced the speakers and laid out the objectives for the presentation. Specifically, he noted that the session would cover the current status of the COVID-19 pandemic and vaccine rollout, and take a deep dive into hospitalization, post-acute care, and the long-term effects of the virus. Finally, he stated that the webinar would end with the effect on workers’ compensation and a review of case studies.

Latest overview on the state of the COVID-19 pandemic
First up was Dr. Michael Choo, Paradigm’s Chief Medical Officer, to give the latest updates of the coronavirus and what the medical community has learned in nearly a year-and-a-half. He shared the latest vaccination figure of 49% in the United States and remarked on the potential implications of a slowing vaccination rate. He noted that one major area of concern is the emergence of COVID-19 variants with higher infection rates.

Dr. Choo also discussed how research is showing reinfection rates and breakthrough infection rates to be very low. This is a positive indicator for immunity in the population and the effectiveness of vaccines. Dr. Choo then transitioned the panel to discuss the clinical aspects of COVID-19, including the long-term after-effects of infection.

Exploring the long-term effects of the disease
Dr. Lawrence Lottenberg, a Paradigm Medical Director and trauma surgeon, led this part of the discussion. He began by emphasizing the recent and alarming rise in COVID-19 infections among the unvaccinated population. As an example, he noted the uptick from five cases three weeks ago to the current population of 38 patients at the facility where he is based.

Dr. Lottenberg then went on to cover the long-term effects of COVID-19, with a focus on respiratory distress, organ dysfunction, and immune system deficit. He also shared updates on the emerging treatments and clinical management strategies for these challenging cases, citing data from recently published studies. He noted that, in one study, patients with severe COVID infection were twice as likely to require future hospitalization, highlighting the need for comprehensive treatment and a long-term approach. Dr. Lottenberg wrapped up by introducing the next section of the webinar, which would cover post-acute care for COVID-19 and the challenges that providers have been encountering.

Post-acute care and COVID-19: what we have learned
The next speaker was Stan Smith, the Vice President of Post-Acute Care at Paradigm, who shared insights on how post-acute facilities have been responding to the ever-changing environment created by the pandemic. Stan emphasized the need for a multidisciplinary approach to COVID-19 post-acute care and how therapeutic programs have needed to adapt. In addition to the reduced lung capacity and cardiac function post-COVID patients encounter, he also emphasized the behavioral and psychological needs of these patients, many of whom exhibit PTSD-type symptoms.

Stan then turned the presentation over to Paul Dongilli Jr., PhD, Chief Executive Officer of Madonna Rehabilitation Hospitals, to speak about their experience in treating post-COVID patients. Dr. Dongilli also stressed the need for an interdisciplinary approach for these patients, discussing the importance of integrating pulmonary and physical rehabilitation. In closing, he explained that, due to the prolonged and incomplete recovery needs of the post-COVID group, they often require ongoing outpatient care to decrease the risk of secondary complications.

COVID-19 case management and case studies
Finally, Senior Vice President & General Manager of Clinical Solutions for Paradigm, Kathy Galia, closed the session by discussing current case management aspects of COVID-19. She stressed the need for nurse case managers to obtain pre-infection records to establish a baseline and address any comorbid conditions. Kathy also brought up the importance of neuropsychological evaluations to identify and address cognitive impairment related to the virus as well as the immense positive impact that family support can have on these patients.

To underscore these points, Kathy shared two recent case studies of injured workers with COVID-19.

The first was a 50-year-old male who required hospitalization and prolonged ventilator support before Paradigm coordinated rehabilitative care. He was eventually discharged home in February. The second was a 50 year-old-female with respiratory and kidney dysfunction who, while still in a skilled nursing facility, has clear recovery goals with a plan for eventual home discharge.

Webinar resources
Kevin Turner closed the webinar by remarking on the need to continue vaccination efforts, the importance of high-quality clinics for post-COVID 19 care, and the critical role of family support. He also highlighted Paradigm’s partnership with Kids’ Chance of America, and the important work this organization has continued to do throughout this challenging time.

Access a replay of the webinar and presentation slides here.