COVID-19: A Survivor’s Tale
It’s 1100hrs on Tuesday. The alarm goes off and Tola reaches out and dismisses the alarm. He is alone in the house as his wife and kids have all left for the day. He has piles of emails unattended to at the company he runs jointly with his brother. This is now the 8th week since he was discharged from the hospital, having spent 3weeks on admission, and is yet to get his mojo back.
He was indeed cleared of the COVID infection before discharge but still finds himself easily fatigued, breathless, and his brain foggy. He manages to drag himself up, get dressed, eat and instead of heading to work, books in for an appointment with his hospital.
Tola’s story is among many of what life can be after COVID-19. As the world pushes back at the pandemic with vaccines, advances in management and new drugs, what we have is a long list of survivors of whom quite a few went through hell and are back. Among these, COVID leaves in its wake the Long COVID sequelae (like with Tola), the mental health challenges, the lost jobs, the trauma of loved ones lost and even, in some cases, the stigma. Healthcare professionals must be wary of these and carefully tease out these symptoms and offer appropriate management. For the survivors, awareness that their symptoms may not be unrelated to COVID improves their health-seeking behaviour.
This article seeks to point out what is known about life after COVID and how affected individuals can begin to settle back into a semblance of normalcy.
Long COVID/Post COVID syndrome: This can be diagnosed when symptoms which are consistent with COVID-19 infection persist for greater than 12 weeks and no other alternative diagnosis has been found.
The mechanism by which this happens is not clear and available studies have reported prevalence among survivors ranges from 3% to 50%. Symptoms may include tiredness, breathlessness, anxiety, chest pain, muscle pain, persistent cough, and inability to focus and think (brain fog).
Post-COVID immunity: Insights into immunity after COVID infection continues to grow. What is known is that the body mobilises antibodies (the disease-fighting agents) against the infection in the first few days following the infection. This response is usually robust by the 3rd month but begins to wane by the 6th month. Although this immune response may be detected after 1 year, it is not yet clear how much protection this offers at that point. Individuals who have had COVID before being vaccinated, however, have been noted to have a potent immunity for over 1 year.
Taking stock: Individuals who have been affected by COVID must take stock of their lives. You need to ask yourself whether you feel 100% okay. Identifying areas requiring recovery will help you seek appropriate help. Persistent cough and chest pain may be indicators of other illnesses. Therefore, seeking medical assistance is essential. Survivors struggling with mental health problems should not be ashamed of seeking mental health support from trusted health care providers. Individuals suffering from Long COVID may also benefit from simple therapies.
Examples are listed below
Fatigue and breathlessness: Pace yourself, go for short walks, have frequent brief rests in between tasks and do simple strength exercises. These are important. Lack of exercise will only worsen the condition.
Anxiety and mental health concerns: Minimise your screen time. Spend more time with friends and loved ones. Maintain a daily routine as this provides stability and boosts your mood.
Poor sleep: Minimise screen time, especially before sleep. Keep away from your screen at least 1 hr before sleep.
Brain fog: Write your tasks into smaller bits. Follow through with the task plan and keep checking through with your plan.
Joint and muscle pain: Flexibility exercises can be helpful.
Individuals with co-morbidities (background illnesses) appeared to have suffered the most from COVID-19 infection. Some of these illnesses are caused by bad habits, such as smoking and excessive alcohol consumption. Taking corrective steps to maintain a healthier lifestyle invariably minimises the risks of COVID-19 and its complications.
Emeka Kenechukwu (MBBS, FMCPAED Nig) is a Clinical Fellow Neonates, Wirral University Teaching Hospital, UK.