Almost half of COVID-19 patients have lasting health issues

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covid

A new study documents the post-hospitalization health of people who developed COVID-19 in its first wave.
The researchers found that nearly half of those who survived COVID-19 experienced lasting damage.
In addition, more than 40% of those left in poor health were never assessed for further treatment prior to discharge.
For many, recovery from COVID-19’s acute phase is just the beginning of the story. COVID-19 can affectTrusted Source the long-term health of a person’s heart, brain, lungs, kidneys, and skin. It can also cause a host of lasting symptoms, referred to collectively as “long COVID.”

A new study has found that 45% of patients hospitalized and treated for COVID-19 were still experiencing related health issues when they were discharged.

The study’s lead author, Dr. Alecia K. Daunter, a clinical assistant professor at the University of Michigan, in Ann Arbor, says, “Physicians and others in the healthcare system were working appropriately to discharge patients.” However, she notes:

“[Patients] survived, but these people left the hospital in worse physical condition than they started. If they needed outpatient therapy or are now walking with a cane, something happened that impacted their discharge plan.”

The researcher explains why this happened so often during the pandemic’s early crisis stage:

“[Doctors and hospitals] needed to keep patients safe while maximizing available beds and minimizing exposure to staff. I think that contributed to many people not being assessed by a therapist or [physical medicine and rehabilitation (PM&R)] physician.”

The new study helmed by Dr. Daunter now appears in the journal PM&RTrusted Source.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

 

Of the 45% of COVID-19 patients who were in worse shape after hospitalization than before, 40.6% were not assessed by a PM&R physician, physical therapist, occupational therapist, or speech and language pathologist prior to discharge. This suggests that post-COVID problems have been underreported, notes Dr. Daunter.

Nonetheless, doctors referred 80% of these patients for post-discharge therapy. Durable medical equipment, such as wheelchairs, were necessary for 67.6% of the patients, and 26.7% had ongoing difficulty swallowing, or dysphagia.

The unresolved health issues were so serious that almost 20% of the patients were no longer able to live independently after being discharged from the hospital

Build collaborative relationships between rehabilitation and acute care medical teams to ensure that appropriate screening tools and referral pathways are in place, during and after hospitalization.
Ensure that rehabilitation teams are appropriately staffed to provide optimal care in times of high capacity.
Create programs that address functional decline in patients who have experienced a serious illness, and prioritize access to them in times of crisis.
Continue to research ways to prevent or mitigate functional decline in hospitalized patients.
Speaking with MNT, emergency physician Dr. Joseph Fraiman recalled the critical shortage of nurses during the early days of the pandemic.

He would like to see the federal government develop a flex-staffing system similar to that of the Federal Emergency Management Agency, better known as FEMA. This way, enough staff would be ready for rapid deployment in the event of another pandemic.

Dr. Fraiman explained: “It would be ideal if you had a federal team of nurses. […] You would have sent a bunch of them to New York, a bunch to New Orleans, a bunch to wherever [the disease] was raging.”
COVID-19’s underreported impact
The study demonstrates that while much attention is directed toward COVID-19 case numbers and mortality rates, the impact of the disease on individuals extends well beyond these metrics.

“These results help to highlight the true impact of the COVID-19 disease on our patients. They fill in that gap in knowledge about how patients with COVID-19 recover and what kind of rehabilitation needs they have.”

“These problems are frequent, and the stakes are pretty high if we miss them or allow them to progress during hospitalization,” Dr. Daunter adds.

She continues: “Some of these people were working and many were living independently. To lose that level of function is meaningful.”

COVID-19 vaccine: What to do about side effects
In this feature, we look at over-the-counter options and home remedies for COVID-19 vaccine side effects.

Image credit: Getty Images
All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub and follow our live updates page for the most recent information on the COVID-19 pandemic.

All vaccines, including those for COVID-19, carry the possibility of side effects. Across the globe, there are currently 15 COVID-19 vaccines that are authorized for use in at least one country each.

The most common side effects following COVID-19 vaccines are fatigue, a fever, headaches, body aches, chills, nausea, diarrhea, and pain at the site of injection, according to the World Health OrganizationTrusted Source.

Everyone is affected differently by vaccination. Some people may experience few or no side effects while others may experience multiple side effects and feel pretty ill.

In this feature, we explain what to do about side effects of a COVID-19 vaccine.

Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.

Over-the-counter treatments
Anyone concerned about the side effects of vaccination might wonder they should take an over-the-counter medication before getting the vaccine, to ward off any side effects before they occur.

However, the Centers for Disease Control and Prevention (CDC)Trusted Source do not recommend it. While taking steps to prevent symptoms of other health issues is a good idea, that is not the case here.

It is best to wait and see whether any side effects arise, then treat these individually, as opposed to guessing and taking several over-the-counter products ahead of time.

A person should visit their local pharmacist before taking any over-the-counter medications to ease side effects of the vaccine. Because a pharmacist is aware of a person’s medications and medical history, they have a good understanding of any interactions that may occur.

But what if a person is unable to contact their pharmacist and needs immediate relief from muscle aches, injection site pain, a fever, or a combination of these issues? In this case, the following may help:

ibuprofen (Advil)
acetaminophen or paracetamol (Tylenol)
aspirin
Home remedies
For anyone who prefers not to take over-the-counter medications or is looking for additional treatments, several self-care techniques can help ease any COVID-19 vaccination side effects.

For reactions at the injection site, such as pain or swelling, use a clean, cool wet washcloth to create a compress. This might also help with muscle and joint aches.

To ease soreness or stiffness in the arm, move it as much as possible. This may seem counterintuitive and cause a little discomfort, but it helps prevent further stiffness by loosening up sore muscles.

Anyone with chills and a low-grade fever should make sure to drink plenty of water to avoid dehydration. Wearing light clothing and dressing in layers will help prevent overheating.

What is ‘COVID arm’?
This can be a side effect of the Moderna COVID-19 vaccination. It is a red, blotchy rash that can appear around the injection site, typically about 7 daysTrusted Source after receiving the first dose of vaccine, though the timing can vary.

While the appearance of the rash may be alarming, it is not life threatening. If this rash develops and is bothersome, use a cool compress — either a cool, clean wet washcloth or an ice pack wrapped in a towel.

Another option is to speak with a pharmacist to determine whether taking an antihistamine, such as diphenhydramine (Benadryl), would be safe. Antihistamines can cause drowsiness, so a person should not drive until they are certain about the effects of the medication.

The rash tends to last about 5 days, but it may last as long as 3 weeks. There is no need for concern if it develops after and lasts longer than other vaccine side effects.

How long do side effects last?
Adverse effects of COVID-19 vaccines should only last for a few daysTrusted Source. If they last longer, contact a doctor.

Some side effects, such as a fever, chills, and fatigue, are also symptoms of COVID-19. It is possible to get a SARS-CoV-2 infection right before or after receiving the vaccine — before the body has a chance to produce the right antibodies and build up immunity. Also, while the vaccines are very effective, they do not guarantee 100% protection against the virus.

It is important to keep in mind that no vaccine can cause COVID-19 because none contains the entire SARS-CoV-2 virus. Anyone who develops COVID-19 after receiving the vaccine was likely exposed to the virus before they could build up enough immunity.

If side effects that resemble COVID-19 symptoms persist, take a COVID-19 test and follow local guidelines about self-isolation.

When to see a pharmacist
A pharmacist can help determine whether over-the-counter medications are safe and appropriate for each person, and if so, which are the best options.

They consider a person’s health history and make sure that any over-the-counter products will not interact with other medications. In addition, a pharmacist can recommend home remedies and advise about whether to contact a doctor. They can also explain how to use a medication, how it works, and what side effects to look out for.

When to see a doctor
Contact a healthcare professional if any side effects grow significantly worse. This might involve extreme tenderness, pain, or redness at the injection site. Also, seek professional care if any side effects last longer than a few daysTrusted Source.

Anyone who may be having a severe allergic reaction to the vaccine should call 911 or otherwise receive emergency medical attention. This reaction can lead to anaphylaxis and may involve difficulty breathing, closing of the throat, facial swelling, and hives.

These reactions to the vaccine are very rare, and anaphylaxis affects 2–5 in every 1 millionTrusted Source people who receive a COVID-19 vaccine.

Anaphylactic reactions to the vaccine tend to occur quickly. After having a dose of the vaccine, a person will be observed by a healthcare professional for about 15 minutes. This is to ensure that if an allergic reaction occurs, medical professionals are on hand and prepared with treatment.

Monitoring side effects
Above, we described some of the more common side effects of the vaccine, but experiencing other adverse effects does not necessarily indicate that anything is wrong.

Side effects show that the vaccine is working, that the body is creating antibodies and developing immune memory to fight off future SARS-CoV-2 infections.

Everyone reacts to vaccines differently, and some people experience more severe side effects than others. The severity of side effects does not correlate with the body’s level of immunity.

People in the United States might consider downloading the CDC’s V-safe appTrusted Source after receiving a vaccination. This app allows a person to track and report side effects. It also allows the CDC to contact the person and ask any questions about the reported effects.

V-safe enables the CDC to collect data in real time and monitor trends in adverse reactions. It also has a reminder feature for people who receive the vaccine in two doses.

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