Advice for Covid survivors                                                                      

From Kent & Medway Respiratory Expert Group                                                                                                                                                                     Edited by: Dr N.Banik March 2021

Dear Kent & Medway Patients,

Recovering from Covid: What to know

After a difficult 12 months of the Covid epidemic where millions have fallen ill - our understanding of the long term impact of this disease has rapidly grown. We know that as many as 1 in 10 patients will find the recovery both prolonged and difficult – what has been called Long Covid. While most people affected by Covid-19 will get better in the first 4-6 weeks, some will still be struggling beyond this early phase and even beyond 12 weeks.

The wide ranging symptoms described by Covid survivors include - low energy & intense fatigue, breathlessness, aches and pains in muscles/joints, pains in chest & lungs, palpitations, persistent loss of small; gastric & bowel symptoms like nausea/abdomen pains/ diarrhoea; mental health problems like anxiety-depression; brain fog with sluggish memory and dizziness.

Over 40 symptoms have been described and mental health and neurological problems may appear later on after the first few weeks of infection2. Unfortunately both younger and older patients can get affected by Post-Covid syndrome1 even if the initial illness was mild or severe.

Some ideas we have picked up from UK and International experts:

  • Cough with green phlegm may be a sign of chest infections in weakened lungs.
  • Cough with tightness/wheeze/white phlegm is usually due to airways becoming sensitive from the virus; almost like a temporary asthma and usually will improve over 6-12 weeks.
  • Patients who remain breathless after 4 weeks or who required oxygen in hospital can be referred to local pulmonary rehabilitation teams by their health care professionals.
  • Patients who were diagnosed to have Covid pneumonia in hospital should be getting a 6 week chest x-ray and then a chest clinic specialist team review.
  • Investigations that may help you in Primary Care: In patients who are struggling with physical symptoms 4-6 weeks after Covid your GP clinic can assess you and also arrange investigations; which may include: Chest X-ray; ECG; blood tests based on NICE 2020 guidance.

Post Covid Management Help available:

Up-to date information of Long Covid can be found on the following reliable websites:

Both sites have latest patient guides on symptoms and steps to take to promote a steady recovery. Your-Covid-Recovery is also linked to pulmonary rehabilitation program for patients who are under the rehab teams. They will also be given an app to monitor progress via a web interactive program. This link up will be done by the rehab teams.

Facebook Patient Group: This is a new group created by British Lung Foundation and asthma UK and contains many useful ideas from fellow patients and professionals.

Helping UK Research Teams: Covid-19 and the SARS-2 virus has created an entirely new illness which health care teams around the world are learning about and having to manage as best as they can. However a large number of trials are going on and even reporting your symptoms back to NHS teams like ZOE symptom tracker can help researchers in understanding Covid better. It also wants to know if you have had any side effects from the Covid vaccines. See www.covid.joinzoe.com linked to King’s College London research team.

Referral to specialist led post Covid service

Patients who are not recovering with self-management guidance or have more severe problems; have the Primary Care assessment and should be entered in patient GP records as having post-covid syndrome; and then kept on a waiting list. We expect by end of April expert led clinics will be up and running so these patients can be referred to Long Covid MDT clinic for a virtual/phone assessment by a specialist. This service will cover all areas in Kent/Medway and can be used 10-12 weeks or longer after the acute illness first struck. Outcomes could be:

  1. Consultant clinic specialist review e.g. by chest, cardiology or rheumatology
  2. Pulmonary rehabilitation referral & registering with your-covid-recovery program & App.
  3. Assessment for mental health problems and sign-posting to counselling or other support/measures.

MENTAL Health Support options:

The MIND website3 has good resources for mental health well-being of adults and children [Young-Minds] support; as does the Live-it-well Kent council website and BBC mental health iplayer TV programs. NHS Counselling teams are accepting post Covid mental health self-referrals the usual way.

Encouraging singing for lung health/mental health: Music and singing has proven benefits for mental health/dementia sufferers/ Parkinson’s disease and COPD. Much work has been done by Kent based organisations like the CANTATA trust Canterbury4 and music4wellbeing. They have started a virtual singing group for lung health/post-Covid recovery program which is enrolling patients under the banner ‘sing to beat Covid’. A similar approach is also being organised under English National Opera or ENO with hospital trusts.

Reference:

  1. https://www.nice.org.uk/guidance/ng188
  2. www.guidelines.co.uk/infection/nice-long-covid-guideline/455728.article
  3. https://www.mind.org.uk/information-support/coronavirus/coronavirus-and-your-wellbeing/
  4. www.singtobeat.co.uk/covid-19

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