Long COVID Shared Medical Appointments: Lifestyle and Mind-Body Medicine With Peer Support

Patient Enrollment Process

Primary care physicians or specialists refer patients to our center for long COVID symptom management. Patients attend an initial 60-minute appointment during which one of our cllinicians reviews detailed medical, lifestyle, and psychosocial history, and makes individual integrative treatment recommendations. Based on symptom severity and interest, patients are referred to the long COVID SMA and the coordinator contacts and enrolls patients. Since May 2021, eight SMA cohorts (n = 91 patients) have been conducted, and more than 80% of participants attended at least 4 of the 6 sessions.

Long-COVID SMA Content

We share information on the role of lifestyle factors in causing systemic inflammation. Every session includes mindfulness practice and nutrition advice. We assign daily homework consisting of lifestyle modification goals and mindfulness practices. Each appointment includes time for peer support during which participants share their progress, setbacks, experiences, and successes.

Weeks 1 and 2: We share information about the effect of diet on physical health. Patients are encouraged to remove pro-inflammatory foods (sugar, processed food) and introduce anti-inflammatory foods such as the Mediterranean diet.^8,9 Week 3: We review how emotional stress contributes to chronic disease and share mindfulness practices to reduce the stress responses. Week 4: We teach the importance of sleep for regeneration and recovery with practical tools to maintain good sleep hygiene (Supplemental Appendix).¹⁰ Week 5: We review the benefits of exercise on mental and physical health. Patients are encouraged to add some form of movement into their daily living, being mindful of their physical limitations post COVID. Patients are led through a chair yoga practice. Week 6: The final session includes a review of all materials and progress made by the participants.