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The effect of the ongoing pandemic has rippled through the whole healthcare ecosystem; and healthcare workers continue to battle on the frontlines to treat as many patients as possible. Many patients with Covid-19 needed intensive care, and with great support and impeccable clinical acumen, patients have emerged victorious. However, those who have been critically ill, and those who were treated for prolonged periods in intensive care units may need a few more months to recover fully, despite completing treatment for Covid-19.
There is significant evidence that some people with relatively mild symptoms, who were treated at home, may also have a prolonged sickness, even after beating the infection, says Dr Rahul Pandit, Director-Critical Care, Fortis Hospital, Mulund.
“It is observed that the virus not only affects the lungs but also has an impact on one’s heart, brain, the digestive system, and kidneys amongst other organs. This new phenomenon that has emerged is termed as the ‘Post Covid-19 syndrome,” he says.
Abnormal heart rate
Chronic fatigue
Persistent diarrhea
Rapid weight loss and digestive issues
Mild to severe inflammation in the brain
Nausea
Loss of appetite, taste and smell
Reduced exercise tolerance
Disturbed sleep patterns
Muscle weakness
Neuropsychiatric implications like Depression, Insomnia, etc.
The symptoms, especially fatigue, may be a continuation of the recovery process and some symptoms may be only noticed after the patient is discharged. In almost 80 per cent of patients, fatigue post illness stays for several weeks and gradually resolves. Poor exercise tolerance, disturbance in sleep wake cycles are noticed usually when the patient returns to confines of his home. The most difficult are the neuropsychiatric and depressive symptoms; it needs specialised training like that of a Clinical Psychologist to diagnose it.
It is important to seek post Covid-19 care right from the 1st follow up post discharge, or usually around 2 weeks post discharge. Then as per requirements, clinical support, physical rehabilitation and psychological support can be offered.
The post-Covid-19 Syndrome must be tackled through clinical assessment, psychological intervention and comprehensive rehabilitative care. An expert panel of doctors, at a dedicated post Covid-19 OPD must help clinically assess the patient. This is the first step towards helping the patient tackle the residual impact of the infection. Physical rehabilitation will play a crucial role in assessing the impact on mobility, decreased/ increased exercise tolerance and muscle weakness. Also, psychological evaluation plays a big role in addressing Post Traumatic Stress Disorder (PTSD) amongst those who have battled severe Covid-19 and had a prolonged stay in the hospital. These areas of focus will help diagnose and treat the long and short term complications amongst Covid-19 survivors.
Those with pre-existing conditions such as Diabetes, Hypertension, Obesity, etc. must be evaluated to gauge the seriousness of the disease before, and after contracting Covid-19. It is noticed that due to the impact on ACE 2 receptors during Covid-19, the blood glucose levels are usually high. This is compounded by steroids, which patient receives. Especially in diabetics, patients may need a short course of Insulin before returning to tablets; dosage may also need alterations. Similarly, Hypertensive patients may need altering of their medication regime, post Covid-19 Tachycardia (a condition that makes your heart beat more than 100 times per minute) may need betablockers to be added to the routine medication. Similarly, patients with Chronic Lung Disease or Asthmatics may need additional evaluation of the Pulmonary Function Test.
Puja Gupta can be contacted at puja.g@ians.in