Post-Acute & Long COVID Clinic

What is Long-COVID?

The Post COVID condition or "Long-COVID" is the persistence of new or unexplained symptoms and signs that last for more than 12 weeks after the initial COVID-19 infection (caused by the SARS-CoV-2 virus).

The symptoms of Long COVID may affect one or several parts of the body and may vary in severity from being hardly noticeable to impacting daily activities. Some symptoms are more severe in people sick with acute COVID disease. However, Long COVID can still occur in people who did not require hospitalisation with acute COVID and those vaccinated against COVID-19.

There is not one specific test for Long COVID, and the diagnosis requires an expert assessment from a health care professional such as a Physician or General Practitioner.

For more information, please refer to the following:  

What are the symptoms of Long COVID?

Common symptoms can include:

  • Fatigue 
  • Lethargy 
  • Shortness of breath 
  • Chest pain or discomfort 
  • Cough 
  • Difficulty thinking clearly or poor concentration “Brain fog” 
  • Headache 
  • Loss of smell or taste 
  • Hair loss 
  • Sleep disturbance 
  • Heart palpitations (racing heartbeat) 
  • Reduced exercise tolerance 

For most people, symptoms of Long COVID tend to improve over time. Although a recovery process can vary wildly between individuals. Some may recover in weeks, while others might experience symptoms for months. It is crucial to seek treatment as soon as possible. Like other illnesses.

Long COVID may impact a person's quality of life, such as the ability to return to work, study, or resume other daily activities. This can also negatively impact job security, finances, social life, and mental health. 

What does essential care for Long COVID patients involve?

  • Adequate basic assessment and medical care - People with Long COVID should undergo a thorough assessment by their General Practitioner (GP) or a specialist to identify and manage symptoms. This may include tests to rule out other causes and to assess the severity of ongoing issue  

  • Allied health support - Managing energy levels is crucial in Long COVID. Allied health professionals (such as physiotherapists and occupational therapists) can teach pacing strategies to help individuals balance rest and activity, reducing the risk of Post-exertional Malaise (PEM) (a worsening of symptoms after physical or mental exertion) Understanding long COVID - Lung Foundation Australia. 

  • Optimizing Daily Activity - It is important to encourage a gradual return to daily activities without over exertion. This can help individuals manage fatigue, improve function, and avoid the Boom-and-Bust Cycle, where individuals push themselves too hard on good days, leading to significant crashes on bad days.
     
  • Psychological support - Many people with Long COVID experience anxiety, depression, or other mental health challenges due to prolonged illness and lifestyle changes. Psychological support from mental health professionals (psychologists, counselors) is essential in helping patients manage these emotional struggles 

  • Self-management strategies - They set realistic expectations and encourage engagement in their own care. 

Each person is different, so your recovery journey post-COVID requires a personalised approach. Recovery may take time. Therefore, by adopting appropriate pacing, managing mental health, and coordinating with healthcare professionals, people with Long COVID can improve their recovery and quality of life. 

Other resources: 

Lung Foundation Australia

National Health Service (NHS UK) 

World Health Organisation (WHO) 

Overview of the St Vincent’s Long COVID Clinic

The St Vincent's Long COVID clinic is a multi-disciplinary specialist medical and allied health outpatient service to diagnose and manage symptoms of Long COVID in adult patients over the age of 16 years and living in Sydney.

The service includes:

  • Associate Professor Anthony Byrne - Respiratory Physician
  • Professor Steven Faux AM - Rehabilitation Physician
  • Ellie Asgary - Clinical Nurse Consultant and Care Coordinator
  • Dr Han Gyul (Betty) Jo - Rehabilitation Physician
  • Dr Daniel Ishak- Respiratory physician  
  • Dr Usama Mohamed- Respiratory physician  
  • Dr Sonia Shahid- Rehabilitation physician 
  • Dr Jane Wheatley - Clinical Psychologist 
  • Amy Kennedy – Physiotherapist 

Associate Professor Anthony Byrne leads the Long COVID Respiratory Clinic on Mondays.

Professor Steven Faux leads the Long COVID Rehabilitation Clinic on Wednesdays.

What happens after my doctor refers me to St Vincent's Long COVID Clinic?

Depending on the severity of the COVID - associated complications and the residential address, the Clinical Nurse Consultant will contact you to obtain further relevant information and triage you to the appropriate clinic, respiratory or rehabilitation. 

What happens during my Long COVID Clinic appointment?

Long COVID Respiratory Clinic

First, you will have your observations assessed while sitting and standing. Then you will have a Lung Function Test (LFT), which may take up to 40 minutes. Please wear comfortable clothing and bring your respiratory inhaler if you have one.

You do not need to withhold any respiratory inhaler on the day of your appointment.

Later, a Clinical Nurse Consultant will review your completed COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) results through the HOPE platform.  Following your test, a Respiratory Physician will assess you further. 

Your appointment may take up to two hours.

Long COVID Rehabilitation Clinic

To begin, you will have your observations checked while lying down and standing up for 10 minutes. Then, a Clinical Nurse Consultant will review your completed COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) through HOPE platform. 

A rehabilitation physician will then assess you further.

Your appointment may take up to two hours.  

What happens after my Long COVID Clinic appointment?

A Multi-Disciplinary Team (MDT) meeting takes place every Thursday to discuss individual patient cases reviewed during the same week. Patients do not need to attend this meeting. 

Staff at the meetings include: 

  • Two respiratory physicians 
  • Two rehab physicians 
  • A Clinical Nurse Consultant 
  • A psychologist 
  • A physiotherapist 

This MDT meeting aims to discuss patients' conditions and diagnoses to optimise the management plan. In addition, patients may require further investigations or reviews by other healthcare professionals or specialties, who may or may not be part of our healthcare team. 

Referral and clinical guidelines for medical professionals

Please refer to the following Agency for clinical Innovation (ACI) guidelines for Long COVID assessment and management based on the four - stage approach: 

 You can also refer to the following resources to enhance your assessment and management plan for patients who may suffer from Long COVID associated complications: 

 High-risk patients for developing Long COVID are considered as follows:  

  • Female gender 
  • Aged 50 or over with additional risk factors, including diabetes, cardiovascular disease, chronic lung disease  
  • Moderately to severely immunocompromised   
  • Severe persistent symptoms lasted after 28 days (about four weeks) from the initial infection  
  • Required hospital admission   
  • Unvaccinated for Covid-19  
  • Exhibiting more than five symptoms during an acute phase 

Please see below for eligibility criteria.

Inclusion Criteria: 

  • Age over 16 years old
  • Reside within NSW
  • Long COVID symptoms associated with COVID infection (Covid-19) WHO, Post Covid 19 Condition 
  • At least 12 weeks (about 3 months) from the date of Covid-19 infection
  • Be able to arrange their own transport to and from the appointments  

Exclusion criteria:

  • Paediatric 
  • Inpatients 
  • Vaccine-associated symptoms  
  • Interstate patients 
  • ED discharge referrals 
  • Earlier than 12 weeks (about 3 months) following COVID-19 infection  

Please note that General Practitioners are encouraged to lead investigations outlined on this page (CXR and blood tests) for high-risk patients before 12 weeks (about three months) following their initial COVID infection.  

How to refer

As Long COVID is a diagnosis of exclusion, all patients must be seen by a General Practitioner, Specialist or Doctor prior to referral. 

To assist triaging, GP/specialist/doctor referral is requested to be addressed to either:  

  • Professor Steven Faux (Rehabilitation physician) (pain, brain fog, myalgia, PEM, dizziness, returning to work)  
    Long COVID Clinic  
    St Vincent's Hospital,   
    Darlinghurst NSW 2010  

    OR   

  • A/Professor Anthony Byrne (Respiratory Physician) (respiratory symptoms, chest pain, palpitation)  
    Long COVID Clinic  
    St Vincent's Hospital,   
    Darlinghurst NSW 2010   

All previous reports and results for patients MUST be sent with referral to optimise the triaging process. 

Referrals must include the patient's phone number and email address. 

Patients have a right not to use Medicare for their consultations and in these circumstances the GP can refer to the clinic rather than a named referral. 

What to order

A Chest X-Ray

The following blood tests:

  • FBC
  • EUC
  • LFT
  • CMP
  • LDH
  • Uric Acid
  • D-Dimer
  • Coagulation profile
  • Troponin
  • CK
  • CRP
  • Fasting BSL and Cholesterol
  • Iron Studies
  • Vitamin D, B12, Folate, Selenium, Zinc
  • TSH
  • EBV and CMV serology and quantitative PCR
  • Hepatitis B and C serology

Where is the St Vincent's Long COVID Clinic located?

The St Vincent's Long COVID Clinic is on level 3 (entry-level) of the hospital in the St Vincent's Public Hospital Outpatient Clinic.

The St Vincent's Public Hospital's address is 390 Victoria St, Darlinghurst NSW 2010.