COVID Recovery
[ photo by Gaspar Zaldo ]
COVID-19 recovery, what it actually looks like.
We are now at the one-year mark when COVID-19 changed our world and how we live in it. I am sure by now many of you have read so many articles about COVID recovery and what to expect in the process. I am also guessing that most of you know of at least one person who has experienced COVID and, for those fortunate enough to have survived it, experienced the recovery process after the COVID infection. Maybe you yourself have experienced COVID first-hand.
I am going to take the next few weeks to share some COVID recovery stories I have witnessed with some of my post-COVID rehab patients. This past year I have treated several patients in rehabilitation following a hospitalization for COVID-19, and each patient has had a very different recovery process. I think this just reaffirms the mystery of COVID. There is so much variability as to who it affects, how it effects each person, survival of that person, and if they do, what the recovery looks like.
Recovery from “mild” COVID infection.
The patient stories I am going to tell you in the next few weeks all come from those who were sick enough to require hospitalization. I know there were so many cases of people who didn’t require hospitalization but were still very ill, becoming quite debilitated from the prolonged illness. I wanted to take time for today’s post to talk about these cases first.
According to information from a study in China looking at over 44,000 people with COVID-19 infections described on CDC.gov, 81% of COVID-19 cases were in the mild to moderate category, meaning from mild symptoms up to mild pneumonia. The numbers described in this study similarly match the numbers in the US. The recovery for those who experienced COVID-19 and remained at home was often nothing to scoff at, especially for those that might have already been frail without much in regard to reserves. Maybe you know someone like that. This is especially true in the elderly or in those with chronic illnesses.
Physical weakness due to COVID-19.
The average length of symptoms for one with a mild case of COVID-19 is one to two weeks. Once the telltale symptoms of COVID have improved and one is allowed out of isolation, there are effects of COVID that are still felt. Laying in bed for one to two weeks leads to loss of muscle strength and decreased pulmonary function. In the young and healthy, this can be a minor annoyance that can just be worked through with consistent exercise and adequate nutrition.
In the frail who already had limited reserves, overcoming two weeks of being in bed might be more than one can do on his or her own. I recently wrote a post on how to help your loved one obtain services following the prolonged quarantine. In the situation of someone who was frail to begin with and then was infected with a mild to moderate case of COVID-19, my advice is similar.
It is harder for someone who has not been hospitalized to receive inpatient rehabilitation. With that being said, there are some instances in which that would be appropriate. It requires more legwork on the end of the patient and his or her family, as certain requirements must be met before one would be able to be admitted to subacute or acute inpatient rehabilitation.
Oftentimes, the primary care provider can help to assist this transition to inpatient rehabilitation. I would advise this for someone who just cannot care for himself, performing basic ADLs, without assistance from someone. This is especially the case for someone who had previously functioned fairly independently prior to her illness.
My first recommendation for someone who experienced COVID-19 but remained at home would be to see the primary care provider once out of the necessary window for quarantine. COVID-19, as we all know, can wreak havoc on the body, sometimes even unknowingly causing damage to organ systems. A check-up of one’s overall health is imperative to ensure that nothing that might cause health issues down the road get missed.
At that appointment, the discussion of rehabilitation can be had. As I said in the previous paragraph, inpatient rehabilitation might be one option. The other more likely option would be for physical, occupational, and maybe even speech therapy through home healthcare or in the outpatient setting. The decision to go with outpatient or home health therapies could really be determined by one’s ability to get to and from appointments.
Nutrition is vital for COVID recovery.
Once the need for therapy is addressed, it is of utmost importance to talk about nutrition. Many of those with COVID-19 have their taste affected. It is common for the elderly and frail to already have diminished appetites even without COVID, so adding altered taste to this could lead to further decline in adequate nutrition. The primary care provider might do lab work to check levels of certain vitamins and minerals. In addition, the PCP might be able to recommend a dietician to see for further guidance on how to make up for the nutritional deficiencies.
Sometimes, however, the verbal advice is not enough to get one to improve his or her food intake. It is in these situations that the PCP would potentially prescribe an appetite stimulant. I have prescribed these medications to several of my patients recovering from COVID with good results.
In my experience, debility and poor nutrition, are the two biggest things that need to be addressed during COVID recovery for those with mild to moderate infection. Hopefully, addressing these two major issues and making sure your loved one is evaluated by his or her primary care physician will help to facilitate a smoother, faster recovery from this infection.
Later this month, I will specifically talk about those that were sick enough to be hospitalized and what the COVID recovery processes look like for them. Check back next week to hear Bob’s story.
Share your thoughts on or specific experience with COVID recovery in the Comments section.
© 2021 Jessica Kluetz, DO