The House Energy and Commerce Subcommittee on Health convened federal officials, patients, and experts from academic medicine for an April 28 hearing on the lingering effects of COVID-19.
Witnesses described the diverse and debilitating symptoms of post-acute sequelae of SARS-CoV-2 (PASC) or “long COVID,”, as shortness of breath, chest pain, heart palpitations, brain fog, depression, and decreased energy. The symptoms, which last for weeks to months, have been documented both in patients who did and did not seek hospital care for initial COVID-19 symptoms, appear to disproportionately impact women, and occur in up to 30% of COVID-19 patients, according to early studies.
“I want to help get people back to work and back to their daily lives before COVID-19,” Subcommittee Ranking Member Brett Guthrie (R-Ky.) said in his opening statement. “We must help patients receive proper treatments and learn ways to resolve these symptoms.”
In her opening statement, Subcommittee Chairwoman Anna Eshoo (D-Calif.) noted, “My fear is that as acute COVID uncovered our nation’s failures at emergency response and equitable health care, long COVID will uncover our failures at fairly treating chronic disease and disability.” She added, “We’ll need federal leadership to coordinate and address the swell of long COVID patients. We may need a nationwide network of long COVID clinics with multidisciplinary clinical teams.”
National Institutes of Health (NIH) Director Francis Collins, MD, PhD, outlined the agency’s planned research efforts to better understand PASC, initiated by a $1.15 billion investment Congress provided through the Consolidated Appropriations Act, 2021 (P.L. 116-260) [refer to Washington Highlights, Dec. 23, 2020]. The agency received nearly 300 grant proposals in response to NIH’s PASC funding opportunity announcement earlier this year and plans to make awards “in the next few weeks.”
Collins described important research parameters to better understand long-term COVID-19 effects, including recruiting tens of thousands of patients with diversity across gender, age, race, as well as treatment regimen for primary SARS-CoV-2 infection.
“To do this complex kind of recruitment rapidly, we are launching a meta-cohort: essentially leveraging some existing cohorts…as well as forming new ones that we can knit together in ways that make their data comparable and collectively powerful for answering pressing questions about this virus,” Collins said. This includes leveraging NIH’s All of Us research program as well as existing COVID-19 clinical trials cohorts.
Centers for Disease Control and Prevention (CDC) Medical Officer John Brooks, MD, outlined CDC’s work with other federal agencies and health care providers to study PASC epidemiology, and is working to compile interim guidance for health care providers to better diagnose and care for patients impacted by PASC.
Brooks added, “More data would allow researchers to better determine how common post-COVID conditions are, monitor for disparities, better characterize conditions typical of a case of post-COVID conditions, identify risk factors for developing post-COVID conditions, provide key information to better prevent and treat the condition, and to monitor its impact at a population level.”
Health care providers also testified on the urgency of addressing PASC. Steven Deeks, MD, professor of medicine at the University of California, San Francisco, reiterated the range of symptoms in his patients and described the challenges in addressing PASC with no clear diagnostic criteria, no known prevalence, and little understanding of the mechanism that causes long COVID.
Yale School of Medicine Associate Professor of Medicine Jennifer Possick, MD, recommended several measures to address PASC including increasing public awareness of long-term COVID-19 symptoms, ensuring equitable access to care for patients with PASC, appropriately resourcing health care institutions, and addressing the socioeconomic consequences of PASC on individuals’ ability to return to work.
Eshoo closed the hearing by thanking the witnesses for deepening and broadening the subcommittee’s knowledge and highlighting the subcommittee’s continued interest in working with federal agencies in addressing long-term COVID-19 symptoms.