Co-RIG Blog – Dr. Akber Mithani

After the Outbreaks: Care for long-term sequelae of COVID-19 and mental health in long-term care

In another successful collaboration with the CMA Foundation, the COVID-19 Pandemic Response and Impact Grant (Co-RIG) Program Phase II focuses on innovations and initiatives that prepare family physicians and their interprofessional teams to cope with challenges related to the pandemic and its long-term impact. 

This week we are highlighting the After the Outbreaks: Care for long-term sequelae of COVID-19 and mental health in long-term care project led by Dr. Akber Mithani, Regional Medical Director, Long Term Care and Assisted Living, Fraser Health Authority, British Columbia, to develop a clinical practice guideline to identify, assess, and manage long COVID among long-term care residents.

Dr. Mithani and the Fraser Health Authority team are taking a three-pronged approach to assess the impact of long COVID on long-term care residents to create a strategy on how to support residents whose health and well-being are negatively impacted by pandemic-related restrictions. 

Phase 1: Clinical data, routinely collected by long-term care homes in the Fraser Health Authority, will be used in a retrospective cohort study. Symptom profiles, course of illness, and care of COVID-19 survivors with or without long COVID will be compared in long-term care residents. Additionally, a review of long COVID in long-term care residents and a qualitative study on the perspectives of long-term care staff and physicians caring for COVID-19 survivor residents will be conducted.

Phase 2: The findings from Phase 1 will provide evidence to develop guidelines and resources for managing long COVID in long-term care residents. This will involve the engagement of a team of physicians, interprofessional care staff, long-term care residents and care partners, researchers, BC-based decision makers, and an expert on the management of long COVID.

Phase 3: The guideline developed in Phase 2 will be disseminated across long-term care homes in BC to be implemented through an integrated knowledge translation strategy. A formative evaluation will be conducted to ensure evidence-based best practices for the ongoing care of COVID-19 survivor residents in long-term care.

Dr. Mithani’s project is complex, as differentiating between what symptoms are long COVID related and what symptoms come with multi-morbidity, frailty, dementia, and functional disability in the later stages of life is difficult. These challenges are outlined in a call to action to enhance understanding of long COVID in long-term care home residents in a recently published letter in the Journal of the American Geriatrics Society.