Survived hospitalization with COVID-19. A great relief for patients and their loved ones. But then … Are ex-patients going back to normal? “We expect that a large group of people will not succeed”, says professor of rehabilitation Rita van den Berg.
‘Ordinary’ patients who have been in an ICU often face problems. They develop physical complaints such as muscle weakness, cognitive problems such as difficulty thinking and speaking, but also mental problems such as depression. “Of all COVID-19 patients who were hospitalized, 26 percent were in the ICU.”
What does the study look like?
“In our study, all patients who leave a hospital in the Rotterdam-Rijnmond region are followed closely for two years. All patients, those who go to a rehabilitation center, a nursing home, but also the people who go home without aftercare. We do that. for two years at all kinds of times, even if they no longer have to come for a check-up. “
In COVID-19 patients, doctors expect the complaints to be even more severe after the hospital period. On average, the patients spent longer in the ICU, under more severe conditions. Many patients have been lying on their stomach for a long time, which is unusual. They have been kept in an artificial sleep for a long time and ventilated in a different way, under high pressure. We are already seeing that ex-patients have to rehabilitate very intensively. For example, they have neck and shoulder complaints, problems with balance, are confused for a long time and suffer from severe fatigue. ”
Patients who have not been in an ICU are also expected to experience other or more frequent problems. “Admitted COVID-19 patients were and are seriously ill, and have been treated under exceptional circumstances. Care workers were anonymous to them, behind those protective masks. And patients could hardly be visited by loved ones. This can cause cognitive and psychological disturbances. Al in all, the COVID treatment for both IC patients and non-IC patients was not comparable to normal hospitalization.
The sudden advance of the unknown pandemic meant that a care program had to be made for these new patients in record time. “That process now consists of rehabilitation, including physiotherapy, psychology, social work and sports therapy. A plan has also been devised to get people back into society as soon as possible, so that they can return to work and participate in social activities. .
Are these treatments (care pathways) correct? And are they given at the right time and in the right place? “That is the big question,” says Van den Berg. We know too little about this virus and its long-term consequences. That is why we want to learn from the first patients. For example, do we provide sufficient aftercare? Do we treat all symptoms? By looking closely at the first group, we can adapt the treatment for future patients, for example if a second wave comes. After all, we don’t know how long this virus will stay with us. ‘
What exactly are you testing?
“We test patients very broadly. For example, we want to know how the muscle strength of patients develops, how the lungs recover, whether they sleep enough, are under stress, but also whether and how quickly they go back to work, visit friends and how. they assess the quality of their life. We also look at whether there are differences in age, whether younger people, for example, recover earlier than older people, whether it matters how heavily a person is ventilated and whether socio-economic status and cultural background have an influence. ”
How do you test that?
“With questionnaires, but also with physical tests, by getting people to walk, for example. We do that 3 months after discharge from the hospital and after 6 months for a year and 2 years.”
What will it ultimately benefit patients?
“We expect that we will be able to better predict how future patients will recover so that we can give them the best care in the right place at the right time.”
For this research, the rehabilitation medicine, lung diseases and IC departments of Erasmus MC are working closely together with the Rijndam rehabilitation center and 6 hospitals in the Rijnmond region.
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