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PHILADELPHIA - Veronica Alexander came to physical therapy in a wheelchair on a recent afternoon wearing a bright red dress and a blue mask that covered the oxygen tube she still needed nearly two months after her coronavirus symptoms began in June.

She didn't remember the month she spent in Temple University Hospital, where she was on a ventilator for weeks. After that, she needed a month of therapy at PowerBack Rehabilitation in Center City before she could go home.

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The rehabilitation and recovery of those who have had coronavirus (COVID-19) as well as those who have been affected by lockdown is to be supported through a new rehabilitation framework.

The framework will assist health boards as well as health and social care partnerships and independent and third sector health organisations with their planning for recovery and rehabilitation services following the pandemic.

It focuses on adults recovering from COVID-19 who have ongoing health problems, as well as those whose health has been affected by lockdown, including those who had treatment and procedures paused due to the outbreak.

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University of Leeds researchers have identified a pattern of long-term symptoms experienced by people hospitalised with COVID-19. The findings — published in the Journal of Medical Virology — provide the first detailed insight into problems facing patients recovering from the disease.

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We do not know what the long-term impact of coronavirus will be on mental health. We are still not through the pandemic, for one thing, which means that many people who have found the experience of lockdown, of losing their livelihood, or of losing loved ones traumatic, have not yet had the chance to process what has happened.

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The admission of a critically ill patient to an intensive care unit (ICU) is a distressing event for the patient, their family and friends, which has been amplified by the impact of the covid-19 pandemic. Many hospitals now prohibit visits by all relatives and friends for all patients, sometimes even when a patient is dying. The consequent inability to see, touch, and talk to loved ones increases the burden of critical illness on families. The lack of face-to-face communication has also greatly changed the dynamic of interactions between healthcare providers and families. These changes affect how we communicate with families, and could have long lasting impacts for patients who survive an ICU admission, their families, and healthcare providers in ICUs.

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Background

Severe respiratory failure patients with coronavirus disease (COVID-19) sometimes do not receive post-intensive care syndrome prevention bundles. No detailed report has been published on the practical observations of mental impairments in these patients.
Case presentation

A 33-year-old man was admitted with COVID-19 pneumonia. On day 6, he was admitted to the intensive care unit (ICU). Considering the risk of nosocomial infection, as per the hospital policy, early rehabilitation could not be initiated for COVID-19 patients at that time and family visits were not allowed. Thereafter, his respiratory condition gradually improved; he was discharged on day 19. When the ICU nurse called to assess his medical condition, the patient complained of insomnia after ICU discharge. Therefore, we called him for an outpatient visit 28 days after discharge and scored his mental health status.
Conclusion

Careful follow-up is required to treat mental impairment in patients with COVID-19.

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As a result of the pandemic and reduced access to face-to-face appointments, there has been a significant drop in the number of face to face assessments being carried out, and in the delivery of hands-on rehabilitation, leading many patients to be treated remotely.

A one-year project, led by the University of Plymouth and funded by the National Institute for Health Research (NIHR) and UK Research and Innovation (UKRI), is seeking to address these issues through the creation of a toolkit and training package for current and future clinicians. Professor of Physiotherapy and Rehabilitation Jenny Freeman will be running the project with collaborators from the University’s Faculty of Health, the University of Warwick, and partners in NHS Trusts and the social care sector across the region.

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While the world battles against coronavirus, scientists have discovered that people hospitalized with COVID-19 infection can experience long term symptoms. These sets of symptoms include fatigue, confusion, breathlessness, and a general decline in the quality of life. One of the scientists on the research team is of Indian origin and the study has been published in the journal of Medical Virology.

The study also reveals that the patients in the Intensive care unit experience severe post-traumatic stress disorder. Manoj Sivan, Associate Clinical Professor, University of Leeds, UK, says, “COVID-19 is a new illness and we have very little information on longer-term problems in individuals after discharging from the hospital.”

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Do not let your guard down”, is what researchers have warned patients who have recovered from the coronavirus infection. For, they said, the road to recovery for infection-recovered patients may take months and need vital specialist rehabilitation to ensure quality life.

The researchers found that infection-free patients faced one or many health issues like fatigue, breathlessness, psychological distress - including problems with concentration and memory - and a general decline in quality of life.

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CHICAGO – Prior to the COVID-19 pandemic, 28-year-old Mayra Ramirez was working as a paralegal for an immigration law firm in Chicago. She enjoyed walking her dogs and running 5K races.
Ramirez has a condition requiring medication that could’ve suppressed her immune system but was otherwise healthy. When the Illinois governor issued a shelter-in-place order in March, she began working from home, hardly leaving the house. So she has no idea how she contracted COVID-19.
In April, she started experiencing chronic spasms, diarrhea, loss of taste and smell and a slight fever.
“I felt very fatigued,” Ramirez says. “I wasn’t able to walk long distances without falling over. And that’s when I decided to go into the emergency room.”
What she thought would be a short stay led to a months-long hospitalization in the intensive care unit. Her lungs were so severely damaged that Ramirez was unlikely to survive, even after clearing the virus from her system.
As a last resort, on June 5, her doctors at Northwestern Memorial Hospital performed a rare double-lung transplant that gave Ramirez a second chance at life. She became the first known COVID-19 patient in the U.S. to undergo the procedure.
Since that time, she has been steadily regaining function but has a long road to recovery ahead.

Brief description of media:

Researchers have identified a pattern of longer-term symptoms likely to be experienced by people who were hospitalized with the COVID-19 infection.

They include fatigue, breathlessness, psychological distress—including problems with concentration and memory—and a general decline in quality of life.

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The first-of-its-kind free of cost COVID-19 Rehabilitation Programme in the UAE has been launched by a multispecialty hospital located in Ras Al Khaimah to improve the health prospects of COVID-19 patients, through optimising health and functioning outcomes, facilitating early discharge, and reducing the risk of readmission.