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Improvements in quality of care have resulted in a growing population of patients who survive critical illness each year. However, these intensive care unit (ICU) survivors frequently report a wide range of complications that may persist for months to years after their hospital discharge, calling attention to a need for extended support.

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This booklet deals with some common problems that people may
experience when they leave intensive care. However, everyone is
different and you might find you do not experience any of these
problems at all. If you do, we have tried to offer some ways of
dealing with them, which we hope will be helpful to you and
your family.

Brief description of media:

A stay in the hospital's Intensive Care Unit (ICU) can be daunting. Wires, tubes, beeping monitors, unfamiliar noises lurking in the background, and the constant fear of whether you will make it through the illness.
For critically ill patients who survive, the near-death experience can leave a lasting impact on their health. The road to recovery, then, stretches way beyond getting off the ventilator and coming back home.
Post Intensive Care Syndrome (PICS) is characterized by physical, cognitive and psychological symptoms that appear after a patient leaves the ICU.

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Early on, patients with both mild and severe Covid-19 say they can’t breathe. Now, after recovering from the infection, some of them say they can’t think.

Even people who were never sick enough to go to a hospital, much less lie in an ICU bed with a ventilator, report feeling something as ill-defined as “Covid fog” or as frightening as numbed limbs. They’re unable to carry on with their lives, exhausted by crossing the street, fumbling for words, or laid low by depression, anxiety, or PTSD.

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The NHS will launch a network of more than 40 ‘Long Covid’ specialist clinics – which includes one for Kent and Medway – within weeks to help thousands of patients suffering debilitating effects of the virus months after being infected.

The clinics, due to start opening at the end of November, will bring together doctors, nurses, therapists and other NHS staff for physical and psychological assessments of those experiencing enduring symptoms.

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Craig Spencer, an emergency room doctor in New York City, was no stranger to dangerous viruses when a brush with one landed him in Bellevue Hospital for 19 days. But it was only after he was discharged, and declared virus-free, that the really bizarre symptoms set in.
Back at home, he noticed he couldn’t taste anything for several days. For months, he was tired all the time and his joints felt heavy and painful. When he woke up in the morning, his back was “stiff like a bamboo rod.” His weight dropped, and clumps of hair fell out. Though the physical effects eventually faded, cognitive complications persist to this day — what he describes as “a subtle but noticeable difference in concentration and ability to form new memories.”
If Spencer’s constellation of ongoing symptoms — fatigue, muscle and joint pain, memory issues — sounds familiar, it’s because it has become a frightening feature of some coronavirus infections, an epidemic of long-term illness within the pandemic. For the Covid-19 “long-haulers,” symptoms can persist for weeks or even months, long after being discharged from the hospital or testing positive for the virus, if they even saw a doctor or got diagnosed at all.
But Spencer never had Covid-19. His persistent aches, pains, and memory problems arose after contracting Ebola in late 2014, when he was working with Doctors Without Borders in Guéckédou, Guinea, the epicenter of the West Africa Ebola epidemic. The experience led him to join the growing chorus of health professionals, patient advocates, and researchers who argue we need to reframe how we think about coronavirus long-haulers.

Brief description of media:

The dominant narrative about long Covid has been that it’s a uniquely perplexing feature of Covid-19. Reports of “Covid brain fog” or “Covid dementia,” for example, suggest a disturbing and extraordinary ability of the coronavirus to destroy the lives of survivors. Even a year later, some patients are still struggling to return to work or have their illness recognized, let alone access disability benefits.

While there’s no doubt long Covid is a real condition worthy of diagnosis and treatment, “this isn’t unique to Covid,” Akiko Iwasaki, an immunologist at the Yale School of Medicine, said. Covid-19 appears to be one of many infections, from Ebola to strep throat, that can give rise to stubbornly persistent symptoms in an unlucky subset of patients. “If Covid didn’t cause chronic symptoms to occur in some people,” PolyBio Research Foundation microbiologist Amy Proal told Vox, “it would be the only virus that didn’t do that.”

Even with growing awareness about long Covid, patients with chronic “medically unexplained” symptoms — that don’t correspond to problematic blood tests or imaging — are still too often minimized and dismissed by health professionals. It’s a frustrating blind spot in health care, but one that can’t be as easily ignored with so many new patients entering this category, said Megan Hosey, assistant professor at the Johns Hopkins Department of Physical Medicine and Rehabilitation.

“It has always been [and] is the case that patients who get sick experience high levels of symptoms like those described by long-Covid patients,” she said. “We have just done a terrible job of acknowledging [and] treating them.”

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A FORMER sales representative has spoken out about living with long covid to show the lasting impact the virus has for certain sufferers.

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A “significant” number of people will require long-term aftercare such as the physiotherapy and speech therapy being received by Derek Draper after a year in intensive care following Covid, a leading doctor has said.

Brief description of media:

Since March, I have been working online with patients who have had a positive diagnosis for Covid-19. Many patients are still sick months after catching the virus as a result of post-viral symptoms. These symptoms are not just physical symptomatology we are seeing, but more psychological in nature.
Patients both young and old are describing severe anxiety, pandemic insomnia, depression, OCD, fatigue and brain fog. While most patients recover within two weeks, those with so called 'long Covid' have symptoms that persist beyond a three-week period and up to 6 months after their positive diagnosis.

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In its most recent report—published on pre-print server medRxiv and yet to be peer reviewed—the ADAPT team revealed only 80 percent of patients reported full recovery at eight months. Additionally,there was no significant improvement in symptoms or measures of health-related quality of life between the four- and eight-month assessments.

Brief description of media:

This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn.