Clinic in Germany helps people with persistent COVID-19

Simone Ravera pulls up her pants, takes off her slippers and socks, and cautiously wades into the cold waters of the Baltic Sea.

The 50-year-old rheumatology nurse is slowly recovering her life after contracting COVID-19 last fall, apparently recovering, and relapsing again with severe fatigue and “confusion” four months later.

“The symptoms were almost as bad as in the beginning,” Ravera said.

Near desperation, he found a clinic specializing in patients with what has been called persistent COVID or post-COVID-19 symptoms.

Located in Heiligendamm, a seaside resort on Germany’s north coast popular since the late 18th century, the clinic specializes in helping people with lung diseases such as asthma, chronic bronchitis and cancer.

In the last year, it has become a major rehabilitation center for coronavirus patients, serving 600 people across the country, explained its medical director, Joerdis Frommhold.

Some of his patients were on the brink of death and have to relearn how to breathe properly, regain stamina, and overcome a number of neurological problems associated with serious illness.

But Frommhold also treats a second group of patients who suffered mild or medium symptoms of COVID-19 and who, in the worst case, spent a short stay in hospital.

“These patients have rebound symptoms after one to four months,” said the doctor.

Most are between the ages of 18 and 50 and had no prior health problems, he added. “They are the ones who usually never get sick.”

After recovering from a COVID-19 outbreak, these patients suddenly found themselves short of breath, depressed or having trouble concentrating, Frommhold said. Some suffer from symptoms similar to those of dementia.

A former dialysis nurse found her kitchen flooded because she had forgotten to turn off the tap. “Others are not able to do their homework with their children because they do not understand the questions,” Frommhold said.

Doctors don’t always take your symptoms seriously.

Despite hair loss, muscle and joint pain, irregular blood pressure, and dizziness, routine test results for these patients are usually normal.

“They seem young, dynamic, high achievers, but they can’t do anything they used to do,” Frommhold said.

In the clinic, therapists initially focus on stabilizing patients’ breathing. They then worked to regain stamina and motor coordination with the help of occupational therapy and posture training. Cognitive therapy and psychological support are also part of the program.

In the last year, similar “long-term” clinics have sprung up around the world, including in the United States. In Germany, these treatments are increasingly offered through the national network of more than 1,000 medical rehabilitation centers, of which 50 specialize in lung diseases.

“This doesn’t exist yet in many other countries,” Frommhold added.

How many people have persistent COVID-19 is unknown at this time, in part because the condition is not yet clearly defined. Scientists are still trying to understand what is behind the wide range of symptoms that patients report.

“No two patients have the same experience, and it varies from patient to patient,” said Elizabeth Murray, professor of e-health and primary care at University College London.

“The symptoms they are experiencing this week are not necessarily a guide to the symptoms they will experience the next,” said Murray, who worked as a family physician. “This complicates it for everyone; it makes it very, very difficult for patients. “

Britain’s Office for National Statistics noted that a survey of 9,063 people who tested positive for COVID-19 found that more than 20% reported some persistent symptoms after five weeks. About 10% of the participants suffered from fatigue, while a similar number said they suffered from headaches or loss of smell and taste.

To date, more than 140 million coronavirus infections have been confirmed worldwide, according to the Johns Hopkins University count, which means that even if a small percentage of them suffer from persistent COVID-19, this would affect millions of people.

“This is a lot of extra people to treat and no healthcare system has a lot of capacity to spare,” said Murray, adding that the economic impact of so many people stopping work could be devastating, especially since many of those affected are women who also they bear a disproportionate burden at home.

Murray is developing a digital program, funded by the British National Institute for Health Research, to treat COVID-19 symptoms in the long term and reach more patients and faster than through traditional rehab facilities, ensuring that they do not feel abandoned by the system.

Frommhold noted that a similar program could help Germany cope with the likely increase in patients with persistent coronavirus, but noted that greater acceptance of the condition will also be needed for those who do not fully recover.

“In my opinion, we first need a campaign like the one there was for HIV awareness, which explains that there are different avenues even after recovering from COVID,” he said.

Making patients, their families and their employers understand that they are now chronically ill could prevent those affected from spiraling into depression and anxiety, Frommhold said.

Heike Risch, a 51-year-old kindergarten teacher from the eastern town of Cottbus, could barely walk without assistance after being discharged from the hospital after passing COVID-19.

“I felt like I had aged 30 years in a short period of time,” he said.

At the clinic, Risch couldn’t keep a table tennis ball on a paddle or walk backwards. You still can’t read a watch correctly.

“You no longer trust your own body. You don’t trust your own head anymore, ”Risch said.

However, she hopes to go back to work one day: “I like working with children but I need to be able to concentrate. I need to be able to do two things at the same time ”.

Ravera, the nurse, said that she has come a long way thanks to therapy at Heiligendamm and feels fortunate to have the support of her family and friends.

But he doubts that he will be able to do three shifts again in the same weekend at the Bavarian hospital where he worked.

“You don’t know when you’ll be okay again. The disease comes in waves, ”he said.

But he is considering using what he has learned in rehab to help others with trouble breathing again after COVID-19.

“It is a journey into the unknown,” he said.

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