Long-term care for recovered COVID-19 patients

The COVID-19 is an ongoing pandemic of coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). As per the COVID-19 dashboard by the Centre for Systems Science and Engineering (CSSE) at Johns Hopkins University, as of 20 June 2020, above 8,685,046 cases have been reported in 188 countries and territories, resulting in more than 460,506 deaths; more than 4,270,000 people have recovered.

SARS-CoV-2 is a novel infectious agent and recovery from it has a steep learning curve since patients who have survived the COVID-19 infection continue to experience feelings of fatigue, shortness of breath and reduced exercise tolerance.

Small-scale studies conducted in Hong Kong and Wuhan, China, show that survivors face poorer functioning in their lungs, heart and liver.

The hospital authority of Hong Kong has been observing a group of COVID-19 patients for up to two months since they were released. They found about 50% of the 20 survivors had lung function below the normal range. Moreover, a study of blood samples from 25 patients, who recovered from COVID-19 in Wuhan, found that they had not fully recovered normal functioning regardless of the severity of their coronavirus symptoms.

According to the doctors at the Cedars-Sinai Medical Centre in Los Angeles, chronic cardiac complications could arise in patients even after recovery as a result of persistent inflammation.

Since there is not sufficient data regarding the after-effects of novel coronavirus infection, for clues on how COVID-19 may leave its mark, doctors and researchers are looking to the experience of Severe Acute Respiratory Syndrome (SARS) which is part of the same family as the new coronavirus. Some survivors of the SARS suffered long-term effects years after they first got the disease.

Researchers in China analysed 25 SARS patients 12 years after they contracted the virus, contrasting their results with a control group not infected with SARS. They found that more than 50% of the recovered patients suffered another lung infection since their session with SARS and also had higher cholesterol levels. Also, half the patients had at least five colds in the previous year — a characteristic no one in the control group shared.

These data proved that the recovered SARS patients had a poor quality of life 12 years after recovery, and were susceptible to inflammation, tumours, glucose and lipid metabolic disorders as researchers wrote. A similar scenario might be seen in the case of COVID-19 recovered patients if precautionary measures are not taken.

Many experts suggest that breathing exercises can probably be advised to COVID-19 recovered patients in the hope of producing a short term benefit in the improvement of their breathing. As for nutritional support, consumption of fruits and vegetables every day should be advised, along with increased intake of high-quality protein to provide resources for the repair of muscles which will have been challenged considerably during the COVID-19 symptoms.

To improve the patient's respiratory function, termination of smoking should be encouraged.

To improve mental health conditions, COVID-19 recovered patients should be advised to actively engage with mental health services, whether directly or via home-based approaches.

Additionally, a person just recovered should continue with the hygiene practices undertaken while s/he was in quarantine. Distance must be maintained from people around and immediate mingling is not advisable.

The writer works at Eskayef Pharmaceuticals Limited.

E-mail: ekhtearuap@gmail.com