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PETALING JAYA: Health experts have warned of threats to the mental well-being of frontliners in the fight against Covid-19 and also of recovered patients and their family members.

One expert said frontliners could develop symptoms of post-traumatic stress disorder (PTSD) from treating patients who eventually died and another said patients who underwent critical care could experience what he referred to as the “post-intensive-care syndrome”.

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One great thing modern medicine has given us is the ability to study and record the effects of different diseases in human beings. For the most part, doctors can tell patients what to expect and how to take care of themselves after a new diagnosis, whether it’s a viral infection or an autoimmune disease. But the coronavirus is a brand-new pathogen, and everyone has a lot of questions about it.

As 2020 drags on, experts are learning more about the way COVID-19 affects people – both in the first few weeks and months after their initial diagnosis. And there’s still so much to be discovered. “We are still in the learning phase of this disease,” says Rashid Chotani, M.D., Vice President of Medical Affairs at CareLife Medical in Fairfax, VA. “However, as the disease spreads across the globe, we have observed that the infectivity, symptoms, and severity of COVID-19 varies.”

Essentially, COVID-19 infection looks different for different people, and it’s impossible to predict how your body might react. But here’s what to look out for based on available data, and what you can do to stay safe and healthy.

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MILWAUKEE (CBS 58) -- Local doctors say it could be some time before we know how the coronavirus impacts patients long-term.

"The answer is we don’t know yet, we don’t know the full population that are infected," said Dr. John Fangman, Infectious Disease Specialist at Froedtert & the Medical College of Wisconsin.

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As the number of COVID-19 patients discharged from intensive care units increases, medical experts are warning that extended stays in the ICU can have long lasting effects.

Dr. Sophia Wang is an assistant professor of clinical psychiatry at Indiana University School of Medicine. She says the longer a patient remains in the ICU, the more likely they are to develop post intensive care syndrome or delirium.

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Hundreds of thousands of seriously ill coronavirus patients who survive and leave the hospital are facing a new and difficult challenge: recovery. Many are struggling to overcome a range of troubling residual symptoms, and some problems may persist for months, years or even the rest of their lives.

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Many patients admitted to intensive care units (ICU) for health complications related to the new coronavirus have experienced hospital delirium, a condition that causes hallucinations, confusion and other cognition issues.

As The New York Times reported on Monday, hospital delirium was predominantly observed in older patients prior to the pandemic's onset, some of whom were already diagnosed with dementia. However, medical practitioners and researchers have noted the incidence of delirium is more widespread among COVID-19 patients, particularly those who require ICU treatment. The Times released its report as states across the U.S. report sharp increases in hospitalizations and ICU admissions related to the virus.

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“Mrs. Croft, I truly regret that I’m calling you about a covid-19 research program only an hour after your husband, John, died of his coronavirus infection. None of us know what you are feeling, and we want you to know how immensely sorry we are for all that you and your family are going through. It’s just that the whole world is trying to grapple with this pandemic, and we are trying to understand what the virus is doing to the brain, since so many people are presenting with an inability to smell, confusion and strokes. I am calling to see if you might consider a priceless gift to the world so we can learn and hopefully help others: We are studying the brain in those who die of covid, and I’d like to talk with you about the possibility of donating John’s brain to our NIH-funded scientific research program.”
As a physician-scientist, I have spent 30 years at the bedside of my patients and their families. There is no place I’d rather be, but I wouldn’t have stayed here for so long without the research part. Alongside 90 others in Vanderbilt’s Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, I now study covid-19, the disease caused by the novel coronavirus. The pandemic is different: tough, inspiring and exasperating all at once. Answering questions to help reduce human suffering is what we do. Attempts to flatten the curve have shuttered our existing projects and catapulted us into new work and international collaborations in what seemed like one day. And then almost as quickly this month, we were immersed in disparities. The pandemic has amplified elements of the everyday disadvantages that millions face, and it’s obvious to all of us that it’s not fair or just.

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With more than 122 million cases of COVID-19 reported globally, and with a growing second pandemic wave underway, the long-term consequences of COVID-19 are an urgent public health priority.1
An international survey of individuals with so-called long COVID reported a wide range of symptoms that persisted for months and resulted in substantial disability.2
Latest UK estimates from an unweighted sample of 9063 individuals with COVID-19 suggest that 22% of individuals still have symptoms 5 weeks after initial infection, and 10% still have symptoms at 12 weeks.3
People with long COVID have struggled to be heard, and it is encouraging that the scientific and medical communities are finally listening. In the UK, a five-point National Health Service plan has allocated £10 million to support sufferers of long COVID through specialist clinics and an online rehabilitation service, alongside £20 million for National Institute for Health Research (NIHR)-funded research.4

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The true prevalence of cognitive problems in COVID-19 survivors is elusive, and the underlying causes of lingering symptoms are the subject of ongoing studies. But it’s now clear that trouble thinking, concentrating, and remembering can be among the most debilitating “long-haul” symptoms and can persist for months. As more and more people seek help to overcome their brain fog at clinics set up for post–COVID-19 care, researchers and physicians are turning to treatments developed for stroke and traumatic brain injuries. And a few are setting out to test cognitive training video games they hope will expand the reach of therapy.

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One night in March 2020, Joy Wu felt like her heart was going to explode. She tried to get up and fell down. She didn’t recognize friends’ names in her list of phone contacts. Remembering how to dial 9-1-1 took “quite a bit of time,” she recalled recently.

Wu, 38, didn’t have a fever, cough or sore throat — the symptoms most associated with covid-19 at the time — so doctors at the hospital told her she was having a panic attack. But later she developed those symptoms, along with difficulty breathing, fatigue and neurological issues.

Wu, of San Carlos, California, believes she had covid — although, like many others who were unable to get tested early in the pandemic, she never got an official diagnosis. And, she said, its aftereffects continue to plague her.

Wu has struggled to get help from doctors, even those who take her symptoms seriously. “There’s no actual treatment,” she said, for people experiencing these lasting symptoms, often referred to as long covid. When seeking help, “you’re basically a guinea pig at this point.”

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A recent report by medical specialists at Johns Hopkins University about a peculiar after effect of COVID-19 in some patients caught my attention. I had heard about “long COVID”—patients who don’t fully recover or who feel even worse weeks or months after catching the virus. But the reference to postural orthostatic tachycardia syndrome, my condition, was new.

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KINGSTON — As Dr. Gordon Boyd walks around the crowded intensive care unit at Kingston General Hospital treating his patients, he knows this is just the beginning for them.

He knows that because of his research while leading in the post-ICU discharge clinic.

I do worry about the incredible wave of long-term morbidity this could have because of the COVID pandemic,” Boyd said.

He explained that the research — speaking to patients who have been discharged from the ICU — shows they develop anxiety, depression and cognitive impairments. He also said that 35 per cent of ICU survivors develop severe post-traumatic stress disorder.