People’s Daily Online, Beijing, December 31. In order to help and guide the self-health management of patients infected with the new coronavirus in the recovery period, the Beijing Municipal Health and Health Commission formulated the “Guidelines for Health Management Experts in the Recovery Period of New Coronavirus Infectors (First Edition)”, Gathering the opinions of experts and scholars in different fields and summarizing relevant clinical experience, it aims to help and guide the self-health management of patients infected with the new coronavirus in the recovery period.
According to the “Diagnosis and Treatment Program for Novel Coronavirus Pneumonia (Trial Ninth Edition)” and expert advice, when a person infected with the novel coronavirus meets any of the following criteria and other symptoms improve significantly, he or she has entered the recovery period: 1. Two consecutive nucleic acid tests The test is negative, and the Ct value is ≥ 35; 2. The antigen test results for three consecutive days are all negative; 3. After 7 days of home isolation, the fever symptoms have subsided for more than 24 hours without the use of antipyretic drugs.
[Main health problems and rehabilitation suggestions during the recovery period]
According to the World Health Organization’s “Guidelines for Personal Rehabilitation of New Coronary Pneumonia”, combined with clinical observations and population surveys, the following health problems currently exist in the convalescent population of patients infected with the new coronavirus: shortness of breath, limited physical activity and exercise, decreased physical strength and fatigue, voice Hoarseness and coughing, swallowing problems, smell and taste problems, anxiety, depression and sleep problems, body pain, etc.
(1) Shortness of breath (shortness of breath)
Shortness of breath is common after COVID-19 infection. Suggestions for shortness of breath: Try various positions that relieve shortness of breath to see which one works. Prone position: Lying flat on your belly (prone position) can help relieve shortness of breath; Forward leaning position: Sitting at a table, leaning forward from the waist up, head and neck resting on the table pillows, arms resting on the table, or sitting On the chair, the body leans forward, and the arms are placed on the knees or the armrest of the chair; the forward leaning position: in the standing position, the body leans forward, and lies on the window sill or other stable support surface; the back leaning position: the back is against the wall, with both hands Place on both sides of the body, feet about 30cm away from the wall, legs apart. In addition, pay attention to the following situations that require timely medical attention: very obvious shortness of breath after light activity, which cannot be improved by any posture to relieve shortness of breath; shortness of breath changes when resting, and cannot be improved by any breathing control technique Chest pain, racing heart, or dizziness during certain positions, activities, or exercises; Weakness in the face, arms, and legs, especially on one side of the body.
Cough is an important defensive reflex of the body, which is conducive to clearing respiratory secretions and harmful factors. Suggestions for coughing problems: General mild coughs can be treated without treatment. If there is a lot of phlegm or the phlegm is not easy to cough up, you can take expectorants such as acetylcysteine, ambroxol hydrochloride, eucalyptus, limonene and pinene capsules, and carbocisteine. If the cough is mainly dry cough, you can take dextromethorphan, compound methoxyphenamine capsules, antihistamines, etc. In terms of traditional Chinese medicine, if accompanied by sore throat or cough (especially dry cough) without other symptoms, you can take Jingfangbaidu Powder, Yinqiao Powder, and Sangju Drink to transform heat and promote body fluid, moisten the lungs and relieve cough. You can also use scraping and other traditional Chinese and foreign treatments. If the cough is severe, affects daily work or sleep, or lasts for more than 3 weeks, it is recommended to see a doctor.
Feeling weak or consciously fatigued, which is not relieved after rest, is the most commonly reported symptom during the recovery period of the new coronavirus infection. Suggestions for fatigue problems: maintain a regular rhythm of daily life, determine the priority of activities, and formulate a reasonable work plan. Symptoms are mild and there is no dyspnea. In addition to routine basic disease treatment, qi-invigorating drugs can be given appropriately, such as lily, platycodon, and other drugs to benefit lung qi and promote qi movement. If dyspnea cannot be relieved, you need to go to the hospital for medical treatment in time. You can use traditional Chinese medicine and external therapy such as soaking and washing. Take 3 slices of ginger (about the size of a one-yuan coin), add 5 grams of moxa, and 5 grams of salt, cook for 10 minutes, add water to above the ankle joint, control the temperature at 40-43 ° C, Soak at this temperature for about 30 minutes, once a day. It is advisable to sweat slightly, not profusely. If you have heart disease, soaking time needs to be halved, and the time must not be too long. If dyspnea cannot be relieved, you need to go to the hospital for medical treatment in time.
Symptoms such as difficulty falling asleep, short sleep time, shallow sleep, and dreaminess may occur during the recovery process of infection with the new coronavirus. Suggestion for insomnia problems: Have a regular bedtime and wake-up time. Make sure you are in an environment free of distractions such as excessive light or noise; try to stop using electronic devices such as phones and tablets an hour before bedtime; reduce nicotine (such as smoking), caffeine and alcohol as much as possible and try relaxation techniques to help you fall asleep, such as meditation, mindfulness-based stress reduction, mindfulness or bathing, aromatherapy, tai chi, yoga, and music. It can also be washed with traditional Chinese medicine.
During the process of infection and recovery from the new coronavirus, there will often be painful manifestations such as bone and joint pain, muscle soreness, and sore throat. Advice for pain problems: For joint, muscle or general pain, analgesics such as paracetamol or ibuprofen can be taken with meals. For sore throat, you can use Jinhoujian, mint lozenges and other drugs for treatment. A good night’s sleep can help reduce pain symptoms. Listening to relaxing music or meditation can also help relieve pain. Rhythm of daily activities is one of the keys to managing pain. You can also use hot compress, scraping and other traditional Chinese and foreign treatments. If you have obvious chest pain, you should go to a medical institution for treatment in time.
(6) Heart palpitations
During the recovery stage of the new coronavirus infection, some patients have symptoms of palpitation and heart palpitations. At this time, it is recommended to pay more attention to rest, adjust the daily routine, and maintain adequate sleep. disease resistance. If the symptoms of palpitations are obvious, and the beats per minute continue to exceed 100 but less than 60 beats, or irregular beats occur, you need to be alert to the occurrence of viral myocarditis. It is recommended to go to the hospital for examination in time to find out the cause and take measures.
(7) Sound problems
Coronavirus infection can cause a sore throat, irritating cough, and a feeling of phlegm in the throat that requires frequent throat clearing. There may also be a weak, wheezing, or hoarse voice, especially after being on a ventilator in the hospital. Suggestion for voice problems: Drink enough water, taking small amounts of water several times throughout the day, to try to keep your voice as normal as possible. Don’t strain your voice. Do not speak at a whispered volume, as this can strain the vocal cords, and try not to speak or shout loudly. Steam inhalation (from a cup of boiling water after covering the head with a towel) for 10-15 minutes can relieve dryness and moisturize the vocal tract. It is recommended to stop smoking.
(8) Swallowing problems
Difficulty swallowing food and drink because the muscles that help you swallow may have weakened. Advice for swallowing problems: Sit up straight when eating and drinking, and never eat or drink while lying down. Stay upright (sitting, standing, walking) for at least 30 minutes after meals. Try different textures of foods, either soft, smooth or moist, or eating solid foods in very small pieces. Chew slowly when eating, and don’t gobble it up. Be mindful when eating or drinking. Try to choose a quiet place to eat. Avoid talking while eating or drinking. Make sure there is no food in your mouth before eating or drinking another sip. Swallow first if necessary. If you feel tired after eating a full meal, eat smaller meals more often throughout the day. Keep your mouth clean by brushing your teeth and drinking water. If you cough or choke when you eat or drink, talk with healthcare provider because food or drink may get into your lungs.
(9) Decreased sense of smell and taste
If you experience a loss of smell or taste, try the following: Ensure oral hygiene by brushing your teeth twice a day. Do smell training, which involves smelling lemons, roses, cloves, or eucalyptus twice a day for 20 seconds. Try adding herbs and spices to your food, such as lemon juice and fresh herbs. Most people lose their sense of smell and taste and will recover within a month after infection with the new coronavirus.
[Psychological adjustment and nutritional support during the recovery period]
(1) Psychological adjustment during the recovery period
During the process of infection and recovery from the new coronavirus, it is natural to have emotions such as fear, nervousness and anxiety, and there is no need to be overly nervous. To overcome fear, tension and anxiety, you can start from the following aspects:
1. To achieve regular work and rest, ensure adequate sleep, exercise moderately, read books, listen to music, etc., and ensure a healthy diet. Do not adopt negative coping methods such as denial, avoidance and retreat, excessive dependence on others, accusations and complaints, transfer of emotions, tantrums, impulsiveness, etc., especially do not try to relieve tension through smoking and drinking.
2. Actively carry out psychological adjustment, communicate more with others, encourage each other, support each other psychologically, and divert attention.
3. You can carry out breathing relaxation training, aerobic exercise, mindfulness meditation, meditation and other methods to adjust your emotions.
(2) Nutritional support during the recovery period
You can eat small meals frequently, pay attention to the diet should be regular and quantitative, and the food is varied and reasonably matched. Maintain a variety of food, pay attention to the combination of meat and vegetables, and the combination of thickness; eat more fresh vegetables, fruits, soybeans, milk, and cereals; eat fish, poultry, eggs, and lean meat in moderation, preferably fish, shrimp, poultry, and lean meat. Eat less fatty meat, and eat a light and non-greasy diet. Avoid eating spicy and irritating food, fried and greasy food. Ensure the amount of drinking water, boiled water is the first choice, and drink less or no sugary drinks.
Reasonable use of medicinal diet for food maintenance and diet therapy, combined with winter climate characteristics, recommend the use of pear mangosteen water, corn silk orange peel water, white radish honey water, walnut scallion white ginger soup, pear soup, yam winter melon lotus seed porridge, coix seed Poria yam porridge, etc. Traditional Chinese Medicine Diet Therapy.
【Precautions for daily life】
During the recovery period of the new coronavirus infection, although the nucleic acid and antigen test results have turned negative, the body has not yet returned to the pre-disease level, and it will take 1-2 weeks or even longer to completely relieve. At this stage, in terms of personal protection, daily life, daily activities and exercise, and returning to work, we should follow the principle of gradual progress and do what we can, and gradually return to normal.
(1) Precautions for daily life
1. It is currently the period of high incidence of respiratory infectious diseases in winter, and the risk of superimposed epidemics of new coronavirus infection and influenza, common cold and other winter and spring respiratory infectious diseases cannot be ruled out. Self-protection standards should not be lowered due to “Yangkang”, and you must continue to adhere to it when you go out Wear masks scientifically, reduce gatherings, and do not go to crowded and confined places unless necessary. Perform hand hygiene at all times, especially after touching suspected pollutants or frequently touched public surfaces.
2. Ensure sufficient nutrition, regular work and rest and good sleep. In terms of diet, pay attention to eating more high-protein and nutritious foods. Smoking and drinking habits, especially those with risk factors, will aggravate underlying diseases. It is suggested that after “Yang Kang”, it is best to quit smoking and limit alcohol. For those who have poor appetite after “Yangkang”, or have taste disorders, it is recommended to eat less and more meals. Diabetic patients should maintain a regular diet to avoid large fluctuations in blood sugar.
3. After the symptoms of acute fever subside, you can take a bath if your physical strength permits, but you should avoid sauna. Avoid getting cold when bathing, pay attention to the appropriate indoor temperature, and the bath water temperature should not be too high.
(2) Precautions for daily exercise
1. On the basis of regular daily life, adequate nutrition and sleep, start with low-intensity activities, such as walking, Baduanjin, simple daily housework, etc. If there is no obvious discomfort, the activity intensity can be gradually increased within a few weeks, such as going up and down stairs, brisk walking, jogging, cycling, swimming, dancing, until returning to the normal activity state before the illness.
2. If chest pain, palpitations, dizziness and other discomfort symptoms occur during exercise, you should stop exercising immediately and seek medical treatment if necessary. For hospitalized rehabilitation patients, patients with original cardiopulmonary diseases, and patients with residual symptoms such as fatigue, chest tightness, and dyspnea, they should avoid strenuous exercise or heavy work within 2 weeks, and maintain low-intensity exercise for at least 1-2 weeks. After acclimatization, move on to higher intensity exercise.
(3) Precautions for returning to work
1. At the beginning of returning to work, start with lighter work, gradually return to normal workload and working status, and avoid stress, overtime, staying up late and other behaviors.
2. If possible, take a lunch break of 20-30 minutes.
3. Due to individual differences in physique, age, and illness, the recovery time will also vary. Therefore, the recovery work should be done step by step, and the intensity should be based on not feeling tired.
【Home Disinfection Suggestions】
After the new coronavirus infection enters the recovery period, indoor ventilation should be strengthened, and key areas and used items should be disinfected on the basis of cleaning and sanitation. Physical disinfection methods such as sun exposure and heat are preferred for disinfection methods, and chemical disinfectant wiping can be used for the surface of the home environment. Disinfectants can be used for home disinfection, such as chlorine-containing disinfectants, quaternary ammonium salt disinfectants, hand disinfectants, etc. Alcohol or quaternary ammonium salt disinfectant wipes can also be used.
(1) Disinfection methods for different objects
1. Indoor air. Open windows regularly every day for ventilation to maintain indoor air circulation. If natural ventilation conditions are not available, exhaust fans and air-conditioning systems can be used for mechanical ventilation.
2. The surface of the object. When there are pollutants on the surfaces of tables, chairs, furniture, doorknobs, faucets, etc., the pollutants should be cleaned first, and then wiped and disinfected with 500mg/L chlorine-containing disinfectant. You can also choose a less irritating quaternary ammonium salt disinfectant. After 30 minutes, wipe off with clean water. Small items such as mobile phones, remote controls, and mice can be wiped and disinfected with alcohol wipes.
3. Surfaces such as the ground and walls that may be contaminated. If there are pollutants, they should be completely cleaned and then disinfected. They can be wiped or sprayed with 500mg/L chlorine-containing disinfectant, and the disinfection time should not be less than 30 minutes.
4. Dining (drinking) utensils. Clean first and then disinfect. Boiling for 15 minutes is the first choice. You can also soak in 500mg/L chlorine-containing disinfectant for 15 minutes and then rinse with water.
5. Clothes, quilts, towels and other textiles. It can be sterilized by boiling for 15 minutes or washed with heated water and kept above 56°C for 30 minutes. It can also be soaked in 1000mg/L quaternary ammonium salt disinfectant or other clothing disinfectant for 30 minutes, and then cleaned as usual. For fabrics that cannot be washed with water, it can be left at room temperature for 7-10 days.
6. Hygienic appliances such as mops and rags. It should be used exclusively in a special area to avoid crossing. After use, soak and disinfect with 1000mg/L chlorine-containing disinfectant, rinse with clean water after 30 minutes, and dry and store.
7. Bathroom. After the toilet seat and its surroundings can be cleaned, wipe and disinfect with a disinfectant containing 1000mg/L-2000mg/L of available chlorine. Toilet door handles, faucets, hand washing countertops and other parts that are frequently touched by hands can be wiped with a disinfectant containing 500mg/L of available chlorine. Disinfection, after 30 minutes of action, wipe it clean with clean water, and strengthen the ventilation of the bathroom.
8. Refrigerator and frozen food. If the frozen food stored in the refrigerator is contaminated, it is recommended to dispose of it as garbage; if you need to eat it, you can also cook it thoroughly and eat it. Take personal protection during the food processing process, wear masks and gloves, and strictly observe hand hygiene. If the inner wall of the refrigerator is contaminated, it is recommended to refer to the “object surface” disinfection method after the temperature in the refrigerator returns to normal temperature.
9. Household garbage. Garbage should be collected and cleaned up in time. It is suggested that double-layer plastic bags should be tightly wrapped, and the outer surface of the garbage bags should be sprayed and disinfected with a chlorine-containing disinfectant containing 500mg/L-1000mg/L of available chlorine, and then transported to the garbage disposal point.
10. Other items. For items that are not suitable for disinfection, such as books and valuables, they can be processed by airtight storage and standing at room temperature for 5-7 days.
(2) Precautions related to disinfection
1. The disinfectant should be prepared immediately after use. Take a certain chlorine-containing disinfectant with an effective chlorine content of 5% as an example: when preparing 500mg/L, take 1 part of disinfectant and add 99 parts of water and mix well; prepare 1000mg/L Take 1 part of disinfectant and add 49 parts of water, mix well.
2. Disinfectants, especially chlorine-containing disinfectants, are irritating to a certain extent. Personal protection should be paid attention to when preparing and using, and prevent splashing into the eyes. At the same time, the disinfectant is corrosive to a certain extent. Pay attention to wipe it with clean water after the disinfection time is up to prevent damage to the items.
3. Disinfectants should be used alone and not mixed with other chemical components. Read the disinfection product instructions carefully before use, and use them correctly in strict accordance with the scope of use, method of use, concentration, and time specified in the instructions.
4. Disinfection at home should be scientific and standardized, avoid excessive disinfection, do not directly use disinfectants to disinfect the human body, do not disinfect indoor air under the condition of people, do not use alcohol to disinfect the air, and do not conduct large-scale disinfection.
5. The disinfectant should be stored in a cool and dark place, out of reach of children.
【Health guidance for key groups】
(1) Elderly people
1. Elderly people often still have a certain degree of fatigue after their nucleic acid or antigen turns negative, even for several weeks. If you feel tired, please rest as much as possible, try to adjust the daily rhythm of doing things, and don’t do too many things at once.
2. If energy permits, ask elderly friends to gradually resume your daily routine, and make a daily schedule for yourself, including sleep, meals, activities, etc.
3. Exercise safely and without fatigue to restore strength and stamina. If walking is difficult for you, consider exercising on a bed or chair, starting with stretching and gradually increasing the amount of activity, such as doing housework, walking, Tai Chi, Baduanjin, etc. When you first start exercising, start with 5-10 minutes and increase by a minute each day, and if you are worried about falling, do it when you have family or friends around. If you experience dizziness, chest pain, or difficulty breathing during or after exercising, stop, rest, and consult your doctor.
4. Drink 1500-2000ml of water every day, and there is no shortage of three meals a day, and you can add meals appropriately. It is recommended to record the daily food to help understand whether it is a healthy diet.
5. Stay socially connected. Talk to loved ones and people you trust by phone, video call or other means of communication as often as possible each day.
6. Try to think of three happy things every day, try to repeat the words “relax” and “calm” while taking a deep breath, try to avoid negative or unhealthy thoughts; if stress, worry, fear and sadness interfere with daily activities for several days in a row, please Contact your doctor for psychosocial support.
7. List emergency contact numbers: such as the numbers of nearby medical institutions, psychosocial support hotlines, family doctors, family members, friends, etc.
8. After the elderly with basic diseases are infected with the new crown virus, the basic diseases will aggravate. For example, the elderly with hypertension may have unstable blood pressure after infection, the elderly with diabetes may have unstable blood sugar after infection, the elderly with cerebrovascular disease may have a risk of cerebral infarction or hemorrhage after infection, and the elderly with chronic obstructive pulmonary disease may develop cough and aggravated dyspnea after infection Wait. Nucleic acid or antigen tests of the elderly turn negative after treatment, but the aggravated underlying disease may not be stable. Close monitoring of blood pressure, blood sugar, finger oxygen saturation, etc. is required. If the condition is unstable for a long time, please go to the hospital in time. Adjust the treatment plan for basic diseases.
(2) Pregnant women
1. Regardless of the gestational age, pregnant women should pay attention to rest within 1-2 weeks after recovering from the new coronavirus infection, and can exercise appropriately, but the exercise intensity should not be too large, and the time should not be too long, and should be done step by step. Warm up before exercising, and drink water before and after exercising. If you have threatened abortion, placenta previa and other conditions that are not suitable for exercise, you should follow the doctor’s advice.
2. Pay attention to ensure reasonable and adequate nutritional intake throughout pregnancy.
3. Maintain a happy and stable mood, and don’t worry too much about the adverse effects of the new coronavirus infection on the fetus. At present, it is believed that the vertical transmission of the new coronavirus has a very small chance of causing intrauterine infection to the fetus, and generally it will not cause deformities.
4. Pregnancy check-ups should be carried out regularly, and pregnant women in the second and third trimesters should monitor fetal movement by themselves. If you have abnormal fetal movement, abdominal pain, abdominal discomfort, vaginal bleeding and other symptoms, you should go to the hospital immediately.
(3) Children and adolescents
Generally speaking, the prognosis of most children and adolescents infected with the new coronavirus is good, showing a self-limited course of disease, and the probability of serious complications and sequelae is extremely low. Parents should first maintain a peaceful mind, understand the natural course of the new coronavirus infection, and not be overly anxious.
1. Continue to take good protection and develop good hygiene habits.
(1) Do not take children and adolescents to crowded places, poorly ventilated rooms or in contact with others for a long time. Wear a mask (for children over 3 years old) when going out, and keep a distance from others as much as possible.
(2) When staying at home for a long time, indoor ventilation should be done well. Try to choose to ventilate when children and teenagers go out for activities, or ventilate each room individually.
(3) After family members go out and return home, they should wash their hands, face, and change clothes before coming into contact with their children. If there is a person with respiratory infection at home, they should be isolated from their children and wear a mask.
(4) Guide children and adolescents to develop good hygienic habits, wash hands before and after meals, after sneezing, coughing and cleaning noses, and after going out.
2. Develop good living habits and enhance your own resistance.
(1) Regular work and rest, adequate sleep. Go to bed and get up on time, sleep at least 12 hours a day for children under 1 year old, 11 hours before kindergarten, 10 hours for kindergarten, at least 9 hours a day for elementary school students, and 8 hours for middle school students.
(2) Step by step, exercise. After recovering from COVID-19 infection, it is recommended to gradually increase outdoor activities and physical exercise, and the intensity should be as long as the child has no discomfort.
(3) Regular meals and a balanced diet. No partial eclipse, no picky eaters, cultivate healthy eating habits.
(4) Others: increase or decrease clothing reasonably, and pay attention to mental health.
3. Treat recovery symptoms correctly. Some children and adolescents will continue to cough for a period of time after infection with the new coronavirus. If the general condition is good, does not affect daily life, and does not require special treatment, it is usually not recommended to use antitussives. However, if the child originally has bronchial asthma, allergic rhinitis, etc., and the cough has not recovered for more than 3 weeks, and the cough is mainly at night, it is also necessary to seek medical treatment in time.
4. Congenital heart disease, chronic lung disease, nervous system disease, severe malnutrition, tumor, obesity, diabetes or hereditary disease, immunodeficiency or long-term use of immunosuppressants, premature infants or neonates, etc. Parents should be more vigilant. When the child persists in high fever for more than 3 days, shortness of breath, listlessness, persistent chest tightness or chest pain, or the condition worsens, seek medical treatment in time.
(Editors in charge: Meng Zhu, Gao Xing)
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