Slowly many confirmed cases of COVID-19 are recovering from the disease, and that is good news. They will start living their normal lives again after spending weeks breathing with the help of a mechanical ventilator.
But will they really go back to normal and without complications? Many of them will likely deal with the lingering effects of the virus and the emergency methods that was needed to be done for them to survive.
Higher risk to chronic diseases and illnesses
Coronavirus attacks the body extensively. It mainly targets the lungs that is why most of the patients complain of shortness of breath. The lack of oxygen and widespread inflammation caused by the virus can damage the internal organs including the kidneys, liver, heart, and brain.
Although it is still too early to know the lasting disabilities of COVID-19 survivors will have, available studies about severe pneumonia suggest that some of these infections may result in acute distress syndrome (ARDS) in which the lungs will be filled with fluid which could sometimes lead to long-term breathing problems.
A combination of long-term diseases and prolonged inflammation seems to increase the risk of illnesses in the future after a severe case of pneumonia. This includes a higher risk for heart attack, stroke, and kidney disease, according to an epidemiologist and critical care physician named Sachin Yende from the University of Pittsburgh.
In 2015, Yende and his team reported that people admitted to hospitals due to severe pneumonia have 4 times higher risk of developing heart disease, as high as that of age-matched controls in the year after they were released. After 9 years, they are 1.5 times more at risk of developing heart disease.
Yende said, with the COVID-19 pandemic this could prompt "a big increase in these sorts of events."
According to Sciencemag, patients who spent time in ICU regardless of the illness that put them there, experience post-intensive care syndrome. They become more prone to physical, cognitive, and mental health problems after leaving the ICU.
In particular, COVID-19 patients who have been put into ICU might become at risk of these problems, according to Dale Needham who works at Johns Hopkins University's School of Medicine as a critical care physician. Those patients have severe lung damage and may spend prolonged periods on a ventilator under deep sedation even after recovery. For ARDS patients, they might rely on life support for 7 to 10 days; but COVID-19 survivors require more than 2 weeks.
COVID-19 survivors who were put on a ventilator for a long time are prone to muscle atrophy and weakness. Another risk for them is delirium or a state of confused thinking that can lead to chronic cognitive impairments including memory deficits. Scientists believe that just like MERS-CoV and SARS, the novel coronavirus can damage and limit blood flow to the brain and kill brain cells.
Improving patient care and outcomes
Wesley Ely, a pulmonologist and critical care physician at Vanderbilt University, and his colleagues have developed a checklist to improve patient care and outcomes. They highlighted the daily interruption of narcotics and sedatives and a decrease in the use of ventilator pressure to know if patients can wake up, breathe, and tolerate the ventilator without drugs.
Hospitals are also limiting bedside interactions which can help patients to stay calm and reduce the need for delirium-inducing drugs. Additionally, the mindset that we are all in this together may help provide hope and support for survivors of any critical illness.