Four months after the start of the pandemic coronavirus disease still continues to amaze doctors. And one of the unpleasant surprises that she gave, — duration of symptoms in some patients. Dr. John Wright from the Bradford Institute for health research (BRI) were two such patients: young women who a few weeks after the onset of the disease continue to complain of fatigue and shortness of breath, BBC reports.
Professor-epidemiology, the interlocutor of the air force is headed by John Wright Bradford Institute for health research. He is a veteran of the fight against epidemics of cholera, Ebola and AIDS in sub-Saharan Africa. Further, his story in the first person.
A doctor from the nearby hospital, 27-year-old Amir valley can’t catch my breath, breaking only one flight of stairs.
34-year-old physical therapist from our hospital named Molly Williams in General have always been an athlete, but now she says that the shortness of breath became her constant companion. Besides, she would often experience bouts of severe anxiety and problems with memory.
They both got sick with coronavirus three months ago.
In March, we knew about the coronavirus too little. We thought that this is a purely respiratory disease, but later it turned out that it affects almost all the organs. We proceeded from the fact that we have to rely on invasive lung ventilation (ALV) under conditions of intensive care units, however, as it turned out, non-invasive ventilation (NIVL) in the hospital at an early stage is much more effective.
We also thought, congratulating recovery from this acute infectious disease of patients leaving the hospital, we more to avoid them.
But four months later a new enemy has become our oldest and from time to time, it seems the only enemy.
We also learned about long-term consequences of this disease for patients — not only those who were in the hospital, but those treated at home and seems to have coped with the acute form of the disease — only to then to suffer from returning or continuing symptoms.
As a result, patients who recover from a few months ago, still cannot return to normal life.
Previous medical experience, we knew that almost half of survivors of severe acute respiratory syndrome (SARS), similar to the coronavirus epidemic, which broke out in 2003, I developed chronic fatigue or other long-term symptoms. So for anybody should not be a surprise that the wicked descendant of that virus, Sars-CoV2, inherits many bad features of its predecessor.
We receive more calls from patients and their doctors with requests for assistance.
Some continue to suffer from initial symptoms like chest pain and shortness of breath. Others have been new symptoms — headaches, memory loss, problems with vision. Many have developed depression and anxiety. Most complains of constant fatigue, and all want to return to normal life. They hastened to celebrate the recovery from Covid-19, but now they are gnawing doubt and growing despair.
In the first week of the disease in Amira the valley had only mild symptoms: headache, aching throat, a slight fever. By the end of the week she already thought the worst was over but a new week brought shortness of breath and shortness of breath is not going anywhere.
“It is especially hard for me are the stairs. After one flight the heart rate goes up to 140. Last week was especially heavy, I couldn’t sleep because I was out of air and I feel extremely exhausted,” complains Amir.
This, according to her, added another and a growing sense of alarm.
Fluoroscopy of the chest it does not show any anomalies, and listening too all in norm. But something is still wrong and we will try to get to the root of the problem.
Physical therapist Molly Williams volunteered to work with sick coronavirus, and most likely she contracted in the hospital.
In her youth she was a successful gymnast, then started crossfit (an integrated system of exercise, incorporating elements of light and heavy athletics), and even among the twenty best athletes of Britain. However, now she has problems with shortness of breath.
“Before, my pulse at rest 50 beats per minute, and now about 90, says Molly. — I’m getting shortness of breath even when I speak, the muscles of the legs are incredibly tired, and when walking my heart rate quickens to 133 beats”.
According to Molly, she will be the uncontrollable urge to cry, and she is incredibly worried about everything. Besides, she started having memory problems.
“I constantly forget everything, many times repeating the same thing, but the head is unable to retain information. I’m trying and I can’t remember the right word. I now have to write everything down to not forget,” she says.
“I have in the past had no health problems, I find it very hard to survive such a blow.”
However, we still do not understand why these patients have such long-term problems.
Maybe a virus hiding somewhere in their body and causing these symptoms lasting as it happens I had been ill with Ebola. Some of our patients give a positive result for the virus and a few weeks after they became infected.
Perhaps this is due to the fact that the reagent residual finds fragments of viral RNA. If so, then it is possible that these fragments of RNA cause long-lasting immune system response, which explains these persisting symptoms.
But it is more likely that patients with lingering symptoms of more severe immune system response to initial infection, which is the damage caused by the infection of their lungs and other organs.
Our task as clinicians and researchers is to find out what actually causes these long term effects, and then develop a course of treatment that would help these and other patients who developed severe post-infectious fatigue.
This little-studied topic of research, because to find the answers here very difficult. However, Covid-19 became the catalyst for incredible research and attention to patients with long term symptoms, can bring the understanding of these processes.
Notes from the front
My colleague, Dr. Paul Whitaker, at the request of patients created the first clinic for those who had Kovalam.
According to the original plan we were supposed to watch patients recover from Covid-19, for 12 weeks after their discharge from the hospital. However, it soon became clear that some of those who needed hospital treatment, was fully back to normal life, while some of those who were not treated in the hospital, such as Amir and Molly, still feel bad.
So now we accept into our clinic and people in the direction of the attending physicians.
When people come to our clinic, we do a chest x-ray, check the function of the lungs and musculoskeletal system and ask you to complete several questionnaires. For those who have severe symptoms, you can offer to do an echocardiogram (ultrasound of the heart), a CT scan and an extended scan of the lungs.
“If we talk about people who recover from Covid-19, but have not yet returned to normal, I think we see only the tip of the iceberg. Every week I get three to four calls from therapists who explain that they see a patient who had coronavirus infection a couple of months ago, but still manifests the symptoms of the disease,” says Paul Whittaker.
“In our clinic will soon be a nutritionist, a physiotherapist, and we will also need considerable support to psychologists, because patients arise not only cardiorespiratory complications, but also develop post-traumatic stress disorder and depression, neurological problems and chronic fatigue syndrome”.
“So it’s important to support them and to offer them psychological support and rehabilitation. In addition, we need to know exactly what works and what does not”.
According to the consultant psychologist Rob Whitaker, to recover from Covid-19 often rolled the waves of wanton desire to cry, and this may indicate the occurrence of cognitive disorders such as memory problems, Molly.
“But at the moment it is very difficult to say that this is due to emotions and fatigue, and that is physiological in nature. To judge it is still too early.”