Five years since first post-Covid clinic at UCLH

It has been five years since the first post-Covid clinic was hastily assembled inside a van outside University College Hospital in May 2020.

“Post-viral illness has long been recognised but we were surprised by how common and severe post-Covid illness turned out to be in the first wave of the pandemic. It became clear that ‘long covid’ didn’t correlate well with how severe the initial illness had been and affected children and adults,” says clinic lead Melissa Heightman.

“In May 2020, we had to learn quickly by listening and reacting to how patients described their symptoms. We hadn’t anticipated such a multi-system illness and had thought it would be more focused on lung effects." 

“We initially started a telephone follow up service in April 2020 but realised that we needed to see patients in person because they were so unwell. UCLH had high readmission rates to ED from patients with ongoing illness. We needed to see patients outside the hospital, for infection control reasons, but we needed to see them face to face so we borrowed the van used by the Find and Treat team which was parked up outside the hospital.”

The first face to face clinic was held on 11 May 2020 and in the beginning the team saw patients four days a week.

"I and Toby Hillman began as a two doctor and two physiotherapist team in the van but we had a lot of support from colleagues in respiratory medicine and infectious diseases,” says Melissa, herself a consultant respiratory physician. Early members of the team were Kay Roy, Michael Marks, Rebecca Livingston and Rebecca Gore.

But as the team learnt more about the condition, the need for multidisciplinary input saw them evolve to include other specialties. The team is particularly grateful to senior occupational therapist Jasbir Kaur Ranu, infectious diseases consultant Emma Wall, cardiologist Robert Bell, haematologist Marie Scully, neurologists Michael Zandi and Patricia McNamara, endocrinologist Catherine Lunken and several other specialists from rheumatology and ENT. They also had help from some fantastic resident doctors seeking additional training.

The team has grown and learnt a lot since the first days of Covid. Some time ago they were awarded a significant NIHR grant to run the STIMULATE ICP trial. The service remains busy as people continue to develop long covid for the first time and it is a long-lasting condition for some. More than 6,000 people have been through the integrated pathway between UCLH and North Central London. 

The team is also working on a project to expand referral criteria and are working closely with fatigue and MECFS services in North Central London to evolve the pathway for post-infectious illness.