After a Hospital Stay for Covid, Patients May Face Months of Rehabilitation

Many patients who were critically ill with Covid-19 face arduous recoveries, often requiring extensive physical rehabilitation.


By Anahad O’Connor

Not long ago, Allen Washington was a busy executive who traveled the country on business trips while trying to stay healthy and active, walking up to two miles a day for exercise.

But that came to an end when he developed Covid-19, the disease caused by the new coronavirus, in June. Mr. Washington spent three weeks lying in a hospital bed in a medically induced coma. When he woke up, he discovered his body had deteriorated. He had bedsores and was too weak to walk or stand. He had nerve damage in his legs, neck and shoulders. He suffered from memory loss and kidney failure.

While he survived Covid-19, Mr. Washington, 60, is now grappling with the aftermath of the disease. To regain his strength and motor skills, he undergoes physical and occupational therapy at the Shirley Ryan AbilityLab in Chicago, which specializes in helping people who have been debilitated by Covid-19 and other illnesses. Since leaving the hospital, he has had to relearn simple tasks that became too difficult because of his memory loss and muscle weakness, like walking up stairs, tying his shoes and getting dressed in the morning.

“I came back from death’s door, and now I have a lot of work to do to get better,” he said.

Even after surviving Covid-19, many patients who were critically ill face long and arduous recoveries, often requiring extensive physical rehabilitation. The problems they encounter are wide ranging. Some patients suffer muscle atrophy, kidney damage or reduced lung capacity, making it difficult for them to leave their homes or get out of bed. Many struggle with cognitive and psychological issues like memory loss, depression and anxiety. Among the most common problems they face are shortness of breath, fatigue, confusion and body aches.

Doctors have known for some time that survivors of critical illness can develop long-term physical, cognitive and mental health problems, which can persist for years after they leave intensive care units. The phenomenon is known as post-intensive care syndrome, or PICS, and the risk factors for it are especially common among patients hospitalized with Covid-19: prolonged periods of time on a ventilator, heavy sedation, organ failure and acute respiratory distress syndrome, in which fluid builds up in the lungs, causing low blood oxygen levels.

The scale of the coronavirus pandemic, with more than seven million people in the United States infected so far, suggests that a significant number of patients who survive Covid-19 will go on to develop post-intensive care syndrome, said Dr. Michelle Biehl, a pulmonary and critical care specialist at the Cleveland Clinic. A recent report by public health experts at Harvard estimated that millions of Americans could require intensive care by the time the pandemic is over. Another report in the medical journal Heart & Lung suggested that the number of Covid patients needing rehabilitation could become another public health crisis.

“A lot of us are still dealing with the initial crisis — the patients in the hospital and the I.C.U.,” Dr. Biehl said. “But as a health care system we need to get better prepared and organized for what is coming, which is going to be a lot of patients needing specialty care.”

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