Weekend Argus (Saturday Edition)
Limit exercise after recovery
Expert outlines Covid-19 long-term effects on well-being
RECOVERIES from Covid-19 now stand at 14370 in South Africa, but with the first case of novel coronavirus only arriving in the country less than three months ago, little is known about the long-term health effects after recovery.
Dr Adri Kok, a specialist physician and president of the International Society for Internal Medicine and the Faculty of Consulting Physicians of South Africa, said those with the mild form of Covid-19 shouldn’t experience any long-term side effects.
“They recover fully so there’s really no lung impairment or any metabolic changes,” Kok said.
“The difficulty comes with the patients who have the more aggressive form. Those patients are the ones where we battle in hospital to get them to survive and get them out of ICU.”
Overseas, where the coronavirus has been active for longer, doctors are noticing some patients with long-term lung, heart and kidney complications after surviving severe Covid-19. Part of this could be damage from the extreme treatments necessary to save their lives.
“There is a risk that the ventilation itself can actually damage the lungs, which we call barotrauma. The majority of patients we try to support with non-invasive ventilation with a special mask or high flow oxygen,” Kok said.
Kok said one reason for poor outcomes seen in South Africa so far was that some patients with severe illness don’t have many symptoms early on.
Then they suddenly deteriorate within a few hours, and by the time they arrive at hospital, they’re already in a bad condition.
“Some patients seem to walk through this infection, and others get this aggressive form where they deteriorate very rapidly, and that is very difficult to tell.
“They can actually have quite a paucity of symptoms. The patients come with very bad blood oxygen levels at presentation and that’s why they do so poorly, because they’re already too sick at the time,” she said.
Kok said if you’re Covid-19 positive and not sure whether you’re in danger, a good way to judge is to buy a small device called a pulse oximeter that measures the levels of oxygen in your blood through your fingertip.
These are usually available in pharmacies, but are difficult to find currently with high demand on stock.
Once in recovery from Covid-19, Kok said people shouldn’t rush back into physical activity, and those with comorbidities should consult their GPs.
“The fatigue aspect can last for up to two weeks. We would ask patients to get slowly back to activity,” she said.
“Ensure that you have no fever, don’t feel unwell, can get dressed and walk without being short of breath.”
If you have a heart-rate monitor like on a fitness device, a good way to judge your recovery is to see if your resting heart rate is higher than normal. If it is, don’t return to exercising just yet.
“In a fair number of patients, there is myocarditis, inflammation of the heart muscle and you definitely don’t want to exercise if that is part of your presentation,” Kok said.
Local athlete Ashleigh Crosland had just run her fastest marathon when she started getting sick. She contracted the novel coronavirus when she went for a drink with a friend from London on Saturday March 21 – before President Cyril Ramaphosa announced there would be a national lockdown.
“I was still hiking and running in the first week of the virus since I thought it was tick bite fever or a mild cold,” she said. “But I remember getting to the top of a hill and just about fainting and then being unable to keep up with my dad on dog walks in the mountain. Ten days after running my fastest marathon ever, I couldn’t keep up on a gentle dog walk!”
During her illness, Crosland was often confined to her bed by fatigue. It took three weeks from her first symptoms to be able to jog outside again.
“I remember trying to do some sit-ups and push-ups in week three of the virus and gave up after one round. I was so tired,” she said.
Now, she is trying to regain fitness. “I can’t run a marathon, but I’m good for less than an hour,” she said.
“Getting back to full fitness was challenging. Even now, I still feel like I am not 100% there.
“But since level 4, I have been feeling perfectly fine. Just unfit.”
Insaaf Mohammed, an occupational therapist who works in Klipfontein, said recovering from the virus gave her a new perspective.
“You appreciate your family and the small things in life even more.
“I want people in any working environment to take responsibility for their health, to educate their families and children, especially now that kids are going back to school soon.
“Help your child find creative ways to show affection to their friends without going close and touching each other,” Mohammed said.