How SLPs Can Positively Impact Long COVID Patients

SLP checking patient's throat

In the spring of 2020, COVID-19 patients overwhelmed hospitals across the United States.

George Washington University (GW) Hospital Outpatient Rehabilitation Center responded by promptly opening a long COVID—or Post-Acute Sequelae of COVID (PASC)—multidisciplinary rehabilitation clinic. The new clinic, which incorporated speech-language pathology, physical therapy, and occupational therapy, had a goal of providing comprehensive outpatient rehabilitation to those patients who had been hospitalized with COVID-19.

In the SLP clinic, we prepared to see long COVID patients with dysphagia, dysphonia, and cognitive-communication deficits following prolonged intubations and complex hospitalizations with demographics similar to those hospitalized. Instead, few of those patients were hospitalized.

The vast majority of patients had a variety of debilitating symptoms including:

  • Brain fog
  • Fatigue
  • Dysautonomia
  • Headache
  • Psychiatric stress

The referred patients were primarily female (81 percent), white (74 percent), highly educated (81 percent had a Bachelor’s degree), and had a median age of 44 years. By comparison, in the general U.S. adult population, long COVID was most common among females, those aged 40 to 49, Hispanic or Latino adults, and those with less than a high school diploma or some college.1

An Opportunity for SLPs

Fatigue and neurocognitive impairment are among the most common symptoms in patients with long COVID.2

Using their experience managing other similar medical conditions, SLPs can make a significant impact on the long COVID population in helping them understand and manage symptoms, including neurocognitive impairment and cognitive fatigue.

Upon initiating GW’s COVID Recovery Clinic, we educated physicians on the relevant knowledge and skills SLPs offer by providing person-centered care targeting individuals’ specific cognitive-communication needs, including:

  • Increasing meta-awareness of cognitive-communication strengths and difficulties
  • Providing education and training in cognitive compensatory strategies and cognitive pacing
  • Educating patients on lifestyle factors that can both positively and negatively impact their cognition
  • Increasing individuals’ resilience and motivation through interviewing and dynamic coaching models3-5

Immediately, we received a large influx of referrals from infectious disease, neurology, geriatrics, psychiatry, and primary care seeking our help in working with these patients to manage their symptoms.

In order for SLPs to make a significant impact on those living with long COVID, we must advocate for patients, make our skills known both to physicians and the greater public, and use person-centered and evidence-based practice to help patients understand and manage their cognitive deficits. Doing so will help individuals living with long COVID maximize their awareness and control over their cognitive difficulties as well as their quality of life.

  1. National Center for Health Statistics. Long COVID Household Pulse Survey. Generated interactively: Dec 31 2022 from
  2. Peter, R. S., Nieters, A., Kräusslich, H.-G., Brockmann, S. O., Göpel, S., Kindle, G., Merle, U., Steinacker. J. M., Rothenbacher, D., & Kern, W. V. (2022). Post-acute sequelae of covid-19 six to 12 months after infection: population based study. British Medical Journal, 379, 3071050.
  3. Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change. Guilford press.
  4. Mashima, P. A., Waldron-Perrine, B., MacLennan, D., Sohlberg, M. M., Perla, L. Y., & Eapen, B. C. (2021). Interprofessional collaborative management of postconcussion cognitive symptoms. American Journal of Speech-Language Pathology30(4), 1598–1610.
  5. Sohlberg, M. M., & Turkstra, L. S. (2011). Optimizing cognitive rehabilitation: Effective instructional methods. The Guilford Press.