Essential Updates in the Physiatric Management of Post COVID Conditions: Autonomic, Neurologic, Cognitive, and Pediatric Disorders-Session Recording

Video Transcription

Video Summary

The session provided comprehensive updates on managing post-COVID-19 conditions (PASC), focusing on essential knowledge for physiatrists. Dr. Talia Fleming highlighted healthcare disparities linked to PASC, emphasizing that post-COVID syndrome involves over 200 symptoms affecting multiple body systems. The CDC estimates one in five adults may experience PASC, with greater prevalence in women, middle-aged adults, racial minorities, and those in less urban areas. She distinguished between equality, equity, justice, and inclusion in healthcare resource distribution and stressed the importance of addressing social determinants of health and healthcare biases. Drs. John Baratta and Monica Verduzco-Gutierrez discussed autonomic dysfunction in PASC, including dysautonomia types like POTS and orthostatic intolerance, detailing evaluation (history, stand tests, biomarkers) and treatment strategies ranging from education and non-pharmacologic management to pharmacologic agents and specialist referrals. Neurologic complications were summarized by Drs. Leslie Reitberg and Esther Melamed, who described a wide spectrum from cognitive dysfunction and neuropathies to headaches and sleep disturbances. Assessment includes thorough history, exam, laboratory testing, and multidisciplinary management, with attention to “red flags.” Dr. Jeff Fine reviewed cognitive impairments associated with COVID, discussing pathophysiology involving blood-brain barrier disruption, inflammation, and viral persistence, along with current research on diagnostics and rehabilitation interventions. Dr. Laura Malone addressed pediatric post-COVID conditions, noting a prevalence of 5–25% with symptoms similar to adults but with distinct evaluation challenges. She emphasized significant impacts on pediatric quality of life, family functioning, and school absenteeism, advocating for early intervention and accommodations. Overall, speakers underscored the importance of recognizing disparities, comprehensive evaluations, personalized treatments, and ongoing research to improve outcomes for patients with post-COVID conditions.

Keywords

post-COVID-19 conditions

PASC

physiatrists

healthcare disparities

autonomic dysfunction

dysautonomia

neurologic complications

cognitive impairments

pediatric post-COVID

social determinants of health

multidisciplinary management