Surviving COVID-19 : Is it the end of a battle or beginning of another one

Dr Th Hrishikesh *

A dedicated COVID Block at JN Institute of Medical Sciences, (JNIMS) Porompat in May 2021 :: Pix - Shankar Khangembam

Just like a child with no surety of what the future awaits him, the course of the COVID-19 pandemic is very uncertain. New symptoms are adding up in association with COVID-19 infections as it evolves into new variants with time as well as in post-COVID-19 period.

It is still unclear what kind of post complications will the recovered patients have in the long run. The data we have is not sufficient to predict anything regarding this matter as of now.

As we are very familiar with COVID-19 infections and transmission, we now need to give equal emphasis on the post-COVID-19 period also. It is not about instilling a sense of fear amongst the public but for precautionary measures that should be adopted to avoid and minimise unwanted mortality and morbidity in the long run.

After recovering from COVID-19 infection, depending on individual to individual some mild symptoms may persist like fatigue, loss of taste or smell, body pain, headache, concentration deficit, brain fog, breathlessness, cough etc.

If any of these symptoms appear within 4 to 12 weeks, it is known as Post-acute COVID-19 Syndrome and if the symptoms still persist after 12 weeks, it is considered as Post- COVID Syndrome. The symptomatic treatment is usually given and it will be a wise decision to keep in touch with medical team and seek advice irrespective of severity of sign and symptoms.

Some unwanted complications may also occur such as pulmonary which may include severe pneumonia, acute respiratory distress syndrome, pulmonary embolism and extra pulmonary such as stroke, acute kidney injury, cardiac arrests, hyperglycaemia, fungal infections like mucormycosisetc as well in the mental sphere like post traumatic stress disorder, depression, anxiety which may be due to the experience of suffering as well stigma and discrimination that are attached with COVID-19 patients.

If one finds swelling of limbs, breathlessness, burning sensation on the chest or chest pain, headache then it is advisable to seek immediate medical help as it may be the warning sign of embolism which may prove to be fatal in serious cases.

Irrespective of whether you are fully recovered without persistent symptoms or with Post-COVID Syndrome it is vital that your health indexes are monitored and adopt these routines on priority basis:

1. Always follow the guidelines issued from time to time by experts like Health Departments and WHO.

2. Access physical rehabilitation for patients with prolonged hospitalisation, mechanical ventilation and long ICU stay.

3. Timely intervention through regular health check-up which may include physical examination, CT scan and X-ray of lung and various lab investigations like liver function test (LFT), kidney function tests (KFT), lipid profile, sugar and serum electrolytes etc.

4. Take adequate rest and sleep as fatigue and lethargy may be present even after the recovery also.

5. Monitor blood oxygen level by pulse oximeter for few weeks after recovery.

6. Drink plenty of fluids as adequate hydration is vital.

7. Proper intake of rich nutritious diet should be obtained.

8. Maintain hygiene to avoid any opportunistic infections (fungal).

9. Covid appropriate behaviour such as wearing mask, regular washing of hand, maintaining social distance and sanitization is to be followed to avoid reinfection.

10. Breathing exercises are to be practised by taking deep inhalation and exhalation.

11. Seek help from a psychiatrist whenever needed.

12. Perform 6 minute walk test (it is not advisable if the patients is suffering from pulmonary diseases):

Ø Before the test, check the oxygen level.
Ø Walk for 6 minutes straight without any pause.
Ø And then check the oxygen level again. If oxygen levels drop below 93% and have breathlessness then seek medical advice as a routine check up. If the oxygen level stays same or above 94% then it can be considered as healthy.

N.B: This test is to check the functioning of lungs after post Covid infection. Elderly people or above 60 years can perform the test with 3 minutes walk.

13. Encourage yourself to be motivated to overcome all the hurdles by obtaining self care and positive mindsets.

In addition to the public awareness, it is high time that we keep some tools such as thermometer, oximeter, sanitizer, disinfectant, good quality masks etc. ready at home to successfully fight this deadly virus. Each and every one of us is individually responsible towards our ownselves and collectively towards the society in fighting this pandemic.

As there is a means of fighting every war this pandemic is no exception. Timely testing, monitoring symptoms, following Covid appropriate behaviours are few to be mentioned. There shouldn’t be any stigmatisation to the patients who are suffering from COVID-19 as this can knock at anyone’s door unannounced, so if today it is him or her tomorrow it can be me or us.

LET US BECOME COVIDWISE AND NOT COVIDIOTS.