Long-term life after surviving Covid-19

Heart, lung, kidney complications for severely hit

RECOVERIES from Covid-19 now stand at more than 14 000 in South Africa, but with the first case of 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 the ventilation itself can actually damage the lungs, which we call barotrauma,” Kok said. “The majority of patients we try to support with non-invasive ventilation with a special mask or high flow oxygen.”

Kok said one reason for poor outcomes seen in South Africa was some patients with severe illness did not 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 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 have quite a paucity of symptoms,” she said.

“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.”

Kok advised that if you’re Covid-19 positive and not sure whether you’re

Some seem to walk through this infection, and others deteriorate very rapidly

Dr Adri Kok

SPECIALIST PHYSICIAN

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.

“It’s really worthwhile if you are Covid positive, to have one at home to monitor your oxygen levels,” she said.

Once in recovery from Covid-19, Kok said people shouldn’t rush back into physical activity, and those with comorbidities should consult their GP.

“The fatigue aspect can last for up to two weeks. We would ask patients to get slowly back to activity. “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 so, 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.

Insaaf Mohammed, an occupational therapist, said recovering from the virus had given 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.”