When Vinay Kumar recovered from COVID-19, little did his relieved family members realise that the ordeal was far from over. Sudden bouts of coughing persisted well over a month. Worse, Vinay began getting panic attacks about the possibility of developing other serious ailments. He became obsessed with the pulse oximeter, monitoring his oxygen saturation level every hour.
COVID-19, even the mild and moderate cases, is leaving recovered patients exposed to a plethora of problems for several weeks and months even after the virus leaves the body. Many recovered patients have been experiencing excessive hair loss, while many others have developed diabetes. Then there are others who’ve been suffering cardio-pulmonary complications, psychological issues like severe anxiety disorder and panic attacks and fatigue.
Dr P V Sudhakar, nodal officer for COVID-19 in north coastal Andhra and principal of Andhra Medical College (AMC) reiterates that the viral infection thrives in a multisystem environment, affecting people in a wide variety of ways, irrespective of the severity of the viral attack, usage of steroids, age and presence of co-morbidities. “While it affects the pancreatic cells in some, causing diabetes, it causes various gastrointestinal troubles, cardiac and muscular problems, damage to the lungs and breathlessness in others,” Dr Sudhakar says insisting the need for special post-COVID clinics and doctors who can deal exclusively with recovered patients undergoing various unpredictable health problems. “Most importantly, recovered patients need to eat a balanced diet, exercise and maintain a positive attitude.”
Adverse impact on psychological health
The impact of the coronavirus has been well-marked not only on the physical, but also at the neuro-psychiatric level. The viral attack has resulted in most patients suffering from panic attacks and anxiety disorder, especially hypochondriasis and globus pharynges, a feeling of some irritant stuck in the throat. Some recovered patients have also been displaying frustration, depression, aggression, loss of concentration and motivation.
Dr C Radhakant, professor and head of psychiatry department at NRI Institute of Medical Sciences and a consultant psychiatrist at Apollo Hospital, also points out that several patients have been suffering from obsessive-compulsive disorder (OCD) with regards to cleanliness.
“They’re constantly washing hands or disinfecting their surroundings even when it is not required,” says the doctor in clarification. “Social phobias and health anxiety disorder (hypochondriasis) have taken over some patients; for instance some irrationally fear that a cough may be indicative of lung fibrosis. Or they link a redness of the eyes to black fungus. And those with pre-existing psychiatric and neurological conditions like depression, migraine and attention deficit hyperactivity disorder (ADHD) show worsening of their symptoms and require more medication dosages.”
Post-COVID care nutrition, physiotherapy and well-being
As post-COVID complications keep adding despite prescribed medication, vitamin supplements and rest, one requires an integrated approach to the post recovery care. That means incorporating proper diet, yoga and physiotherapy under expert guidance based on the individual’s health condition.
Nutritionists have observed a sudden increase in appetite among patients post recovery. There have also been reports of change in digestion pattern and bowel movement among patients. V Anjali Dange, founder & chief nutrition consultant at Starlite Nutrition Centre, said, “Apart from the regular balanced diet, healthy snacking is very important to deal with the frequent cravings for food. We recommend controlled portions of raw or roasted dry fruits including almonds, walnuts, figs, dates, raisins and natural protein-based snacks and fresh fruits, rather than sugary sweets, deep-fried and processed items from confectionaries.”
Diet and yoga expert R Rekha adds that household herbs such as turmeric, ginger, lemon and amla should be incorporated in one’s daily diet as these have immune-boosting and anti-inflammatory properties.
Dr Priyalini Sarkar, Andhra Pradesh state coordinator (Women’s Cell) of the Indian Association of Physiotherapy (IAP) points out how COVID infection leaves the musculoskeletal system highly affected. “It causes muscle soreness and stiffness, fatigue, weakness of bones and breathing issues. However, most recovered patients make the mistake of hitting the gym and try strenuous exercises, which result in further collapse of energy,” adds Dr Sarkar. “At this stage, walking and other slow-pace exercises like extensions and muscle strengthening can be carried out under guidance of fitness experts. To clear the sputum from the airway, patients can practice simple breathing exercises like deep breathing, balloon breathing and blowing a candle regularly.”
Yoga and meditation
Researcher Ch Lalitha and faculty R Rekha from the Department of Yoga and Consciousness, Andhra University (AU) have recently undertaken a study on the efficacy of yoga in the management of COVID-19 complications on 40 recovered patients. Lalitha says, “We observed that yoga and pranayama have a rejuvenating effect on post COVID patients. One can practice neck, wrist and shoulder rotation asana like greeva sanchalana, skandhachakra, manibandha chakra and various prone postures (lying on the abdomen) to improve the oxygen saturation level. Pranayama should be taken up to enhance the lung capacity, which also reduce mental stress and improve concentration.”
Commonly-observed post-COVID problems and complications include the following:
· Breathing difficulties like shortness of breath, palpitations or pounding heartbeat, chest pain and tightness
· Muscle and joint pains
· Memory, concentration problems (brain fog)
· Sleep issues
· Severe hair loss (telogen effluvium)
· Gastro-intestinal problems
· Mental health issues like anxiety disorder, depression, hypochondriasis and OCD
· Severe cases show damage to the heart, lungs, nerves and pancreas, leading to heart attacks, lung fibrosis, stroke and diabetes, respectively.
Dos and don’ts of post-COVID recovery
Recovered patients must ensure the following
· Have a balanced healthy diet, exercise regularly, minimise stress and maintain a positive attitude
· Eat healthy homemade snacks but avoid deep fried, processed food and sweets
· Eat well-cooked natural proteins and vitamins, and consume artificial supplements and tablets only under medical advice
· Do not immediately hit the gym for strenuous exercises or weight lifting, but exercise at a slow and steady pace
· Stay hydrated and monitor their oxygen saturation levels daily especially after workouts
· Opt for yoga and pranayama, or breathing exercises, under expert guidance for rejuvenating, de-stressing and improving the lung capacity