Podcast recap: Careful data capture of long COVID cases can help future patients

by A.J. Plunkett

CDI professionals have a critical role to play in how clinicians recognize long COVID and treat COVID-19 patients in the long-term.

Patients can experience effects from COVID-19 for months after the initial infection, said Kim Conner, BSN, CCDS, CCDS-O, CDI education specialist for ACDIS/HCPro, during the September 14 episode of the ACDIS Podcast. “As I always say, it’s the gift that keeps on giving,” she said.

According to a study by the CDC, at least one-in-five patients infected with COVID-19 will experience at least one lasting symptom, she noted. The CDC reviewed the records of millions of COVID-19 cases to narrow down what may or may not be associated with long COVID and came up with more than 200 conditions or disease processes associated with the virus. Experts are still working out a good definition for long COVID, but the top three symptoms are fatigue, shortness of breath, and brain fog.

Brain fog is “this conglomeration of symptoms,” Conner said. “It can be forgetfulness. It could be confusion, short-term memory loss, word-finding problems—there is kind of myriad of symptomology. And it is pretty significant. In some people, it can take months for it to go away. It’s no joke.”

Because the virus causes a tremendous abnormal inflammatory response, it can attack neurologically in two ways: A direct attack to the brain and an indirect attack connected to lung damage and hypoxia caused in the initial infection, she noted.

The virus continues to evolve as do treatments, she said, noting that there is still much to learn, citing the continuing mysteries behind the ability for one of the newest treatments, a five-day course of Paxlovid antiviral medication to help patients recover, only to see some of them—but not all of them—relapse soon thereafter.

“It’s a virus you’ve got to have some respect for,” she said.

CDI professions must continue to track the clinical aspects of the evolving virus, in part to help both clinicians and the government track the future impact and treatment of the infection. While there is a new code for long COVID, there are other symptoms in play, which is why coding professionals need to be sure to code all of the symptoms, Conner said. That includes inpatient and outpatient cases, and CDI professionals need to work together on this.

Look for patients with neurological changes, including encephalopathy and seizures, she suggested. Be sure to capture the chronic conditions of a patient as well as the changes to look not only at how they are being treated now but in the future. Even mundane symptoms can offer clues. That may require nuanced queries to clinicians, Conner said, but it is worth the effort.

As the fight to deal with COVID continues, she said, CDI professionals are in the thick of it. “We are capturing the data,” she said.

Editor’s note: This article is a recap of the September 14, 2022, episode of the ACDIS Podcast. Plunkett is an editor with ACDIS’ sister brand, DecisionHealth.