We have all been moved by the photos or videos that circulate these days on social networks. Doctors and nurses applaud as someone who was in intensive care for covid-19 is victorious from the hospital. The odds do not work in favor of these patients with Severe Acute Respiratory Syndrome who must be connected to an artificial respirator: data from the US, China and Italy indicates that half of them die.
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But even for those lucky ones who manage to survive, sometimes the happy ending is neither the end, nor is it so happy. Most of them experience physical, cognitive and emotional consequences to a greater or lesser degree.
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“Total happiness to be back home.”
A few weeks ago, we introduced you to Alfred, a Las Vegas man who was in the ICU on the brink of death due to # COVID_19.
I have survived.
And yesterday – Alfred left @SHHospitalLV & went home to his family.@ News3LV https://t.co/PfjTBBEBx0 pic.twitter.com/6zgIAY8IS8
– Max Darrow (@ MaxNews3LV) April 9, 2020
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Surviving is just the beginning of a long recovery that can take months or years. Many are never completely the same again. ” Unfortunately, often, that person who improves and manages to be disconnected from the ventilator, is not the same as he was at the time of being connected ”, Amy Bellinghausen, a pulmonologist and critical care physician at the University of California, San Diego, tells NPR.
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East dark side of the miracles of modern medicine has a name: post intensive therapy syndrome and it covers a wide range of palpable and non-palpable symptoms with the naked eye that also vary in degree depending on the person.
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Weakness, fatigue, mobility problems, anxiety, depression, sexual dysfunction, sleep problems, intrusive memories, poor concentration and cognitive difficulty are some of them.
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“It took me a while to think the words”
For David Williams, who left the Veterans Hospital in Little Rock to applause after being hooked up to an artificial respirator for 8 days by the covid-19, it was accompanied by muscle weakness to the point of needing a walker to get around.
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He uses an oxygen cannula at home, has trouble remembering the passwords and passwords he has used throughout his life, and has trouble completing sentences. “It takes me a while to think about the words I need to use,” the 54-year-old man tells NPR.
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Although the specific cause of the syndrome in question is not entirely clear, it is believed that this is a consequence of a combination of oxygenation problems, the sedatives used, toxicity caused by kidney problems or simply the result of being on the verge of death. .
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Patients connected to a ventilator need sedation with powerful drugs to avoid succumbing to the natural urge to remove the tube that runs down your throat to your upper chest.
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Most of the time doctors try to use as little as possible to avoid side effects, but in the case of patients with covid-19 lung damage is usually so extensive that deep sedation is required that allows them to be turned upside down to help with their oxygenation levels.
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Some suffer from very disturbing delusions. “I had a patient who told me that he was semi-conscious the whole time and believed that the nurses were putting poisonous snakes in his arms”Bellinghausen tells NBC.
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The trauma can be so strong as to become Post Traumatic Stress Syndrome, which afflicts 1 in 10 patients admitted to intensive care.
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More time, more sequels
The longer you spend on a ventilator under sedation, the greater the risk of side effects, further complicating the picture for covid-19 patients as they typically last two to three weeks – if not longer. – there.
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Another aggravating factor of the pandemic is the total isolation faced by these patients. In their brief moments of lucidity they only see people covered from head to toe in protective suits and they do not have the physical support of their loved ones.
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During his delirium, Jeri Sharp, who was admitted to intensive care for complications from the h1n1 flu in 2016, found comfort in a familiar voice saying, “Jeri, it’s okay, it’s okay,” he tells The Atlantic. It was her mother’s at the foot of her bed in the intensive care room.
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“Those in critical care need to have humans around to calibrate them, touch them, look them in the eye and make them understand what is happening, but that is something that covid-19 patients will not have because they are in isolation,” Wesley Ely, professor of critical medicine at Vanderbilt University, explains to NBC.
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A dangerous illusion
Interventions, rehabilitation sessions and therapy are crucial to help these patients move forward. “The notion that patients requiring critical care and respirators for several weeks can be discharged home without receiving other medical care is a dangerous illusion”Warns the European Rehabilitation Academy in a document entitled ‘Call to Action’.
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They emphasize that the long-term impact affects not only the health of these people, but also society as a whole. A third of patients with this syndrome do not return to the workforce and another third does not return to the same job that I had. “At least 25% of these patients experience a dramatic loss of independence and want care for up to a year after critical care, which poses challenges for their caregivers,” they explain.
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“Now is the time to recognize and take seriously the need to generate an anticipated and coordinated response for this cohort of patients that the pandemic will create,” they emphasize and insist that patients and caregivers “must be informed” about these sequelae that, in order to the bewilderment of many, does not end with the discharge from the hospital.
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