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Chennai, Tamil Nadu, India (NewsVoir)
• Almost 50% of those who stay in a hospital or in an ICU for a long period of time are known to have complications for up to 1 year after recovery from COVID-19.
• 2 out of 3 patients who are out of ICU face impairment in cognitive ability like memory, attention, planning and execution.
• HAMSA has seen more than 400 patients during the last one and half years affected with COVID-19.
COVID-19 has been a new and strange infectious disease, unlike no other, that came to wage a different kind of war on us. Many of us fell. But an equal number have been left as the ‘Walking Wounded’. They survived COVID, some had only developed mild COVID or even escaped any symptoms at all, but COVID did leave its mark on them, deep, damaging, and disabling.
It was either immediate and Post-COVID, troubling patients during the days, or the weeks after, but it could also be something that lingered, week after week, leaving you with a nagging worry that something was not right. A constellation of symptoms bothered you; you felt fatigued, there were body ache, head ache and joint pains, you felt dizzy and there was a ‘fog’ in the brain all the time which affected sleep, memory and concentration. You felt chest pain, palpitations and breathlessness, appetite was poor and so was smell, and you felt anxious and depressed. It was difficult to make someone, even the near and dear, forget the folks at the place of work, that you had ‘Not got your life back’. The quality of life had gone with the wind! That misery acquired a short name ‘Long COVID!’
In this scenario, HAMSA Rehabilitation Centre which came long before COVID, served with a mission to rehabilitate, or to give the best possible life back, to patients coming to terms with the disabilities from various neurological injuries and diseases of the brain and nervous system. A joint project of Kauvery Hospital Chennai and Dr. G Balamurali, Head of Department Spine Surgery, Kauvery Hospital Chennai and Managing Director, HAMSA Rehab, the centre rose to the challenge and marshalled an army of rehabilitation professionals qualified, trained and experienced in healing a wounded mind and body. In medical words, it re-incarnated as a Post-COVID and Long COVID rehabilitation centre.
"During COVID, we realized that those patients affected with severe COVID, and hospitalized for long duration, required rehabilitation to recover completely. People who have pre-existing medical issues like obesity, multiple organ involvement, those who have a prolonged stay in ICU or a hospital or under mechanical ventilation, may develop consequences in terms of physical, psychological and cognitive disability. Almost 50% of those who stay in a hospital or in an ICU for a long period of time are known to have similar problems for up to 1 year after recovery from COVID," explains Dr. Balamurali Head of Department Spine Surgery, Kauvery Hospital Chennai and Managing Director, HAMSA Rehab.
The team treat patients who suffer from post-COVID illnesses such as difficulty in breathing, fatigue, body aches and joint pains and mental health problems presenting as impairment of speech, memory and attention.
Mr. Santhosh Rajan, (38-year-old) was admitted to the hospital with COVID-19, with the infection involving 80% of lungs. With continuous treatment and rehabilitation that were provided, he is now able to breathe without the help of oxygen cylinders. "He felt the improvement, day by day, once we switched him to nasal cannula from conventional oxygen therapy, and then helped him to breathe normally, but still under oxygen support on and off. We observed that rehabilitation therapies helped him. He was given breathing exercises thrice a day and his breathing patterns were monitored regularly. The blood oxygen levels (SpO2) after rehabilitation exercises improved significantly, thereby increasing his wellbeing. He was completely out of oxygen support in just 5 days after starting his rehabilitation therapies," adds Dr. G Balamurali.
Some of the effects of severe COVID-19, especially in the elderly, the obese and in patients with diabetes, cardiac and lung problems are psychological issues such as stress, anxiety, depression and fear. These can be taken care of by psychological counselling and therapies. Intellectual abilities like memory, attention, and the concentration of the mind required for planning and execution etc. will be impaired in two out of three patients who are out of ICU. These effects may last up to one year. Affected patients may need to be supported with respiratory exercises, and mindfulness and other psycho-social interventions.
Two other patients who illustrate the impact of Long COVID were a 62-year-old and 69-year-old, who had tested positive for COVID-19, with symptoms of fever and breathlessness. "The patients were at hospital for two weeks, and were later shifted to the rehab centre in order to regain their ability to breathe freely and move their hands and legs with ease. The team of physiotherapists gave them respiratory exercises using spirometers. Within a few days they were able to practice all the exercises themselves, achieving a recovery,” says Dr. Balamurali.
There is evidence to show that those who receive early rehabilitation, as they recover from the acute phase, improve better in their physical, mental and social well-being. There is also clear evidence that post-COVID rehabilitation reduces complications, and avoids re-admission to the hospital, thereby aiding better recovery.
"Rehabilitation helps in improving recovery and does not worsen the present condition. It reduces disability, provides early discharge from the hospital and prevents complications which might increase the severity of disability, and other uncontrolled health issues. Apart from these, diet counselling, muscle strengthening and psychological support are also given to make the patient feel healthier mentally and physically," says Dr. Balamurali.
HAMSA has seen more than 400 patients during the last one and half years affected with COVID-19. Physiotherapist, Occupational Therapist, Speech Therapist, Psychologist and Dietician together provide therapies to patients as soon as they are admitted, and until discharge. Some of them continue treatment after discharge as outpatient or at home.
An outcome assessment of these patients showed significant improvement in their physical condition, psychological and cognitive response.
“Any surgery or intense treatment requires a certain level of rehab for the patients, be it psychological or physical. But with COVID-19 affecting an individual in many ways, it has reemphasized the need for careful rehabilitation. An end-to-end treatment helps in faster and better recovery. We have observed this over the last two and a half years in those who have undergone treatments at our hospital and with HAMSA Spine and Brain Rehab. I congratulate the team of doctors, physiotherapists, psychologists and staff at the rehab centre for providing a comprehensive healthcare for our patients, helping them to recover with confidence," says Dr. Aravindan Selvaraj, Co-founder and Executive Director, Kauvery Hospital Chennai.
The state-of-the-art rehab centre also care for pediatric and geriatric patients who need rehabilitation. It offers physiotherapy, occupational therapy, speech Therapy, psychological support and counseling. The Rehab Physician and nurses also continue to serve their original mission, offering a wide range of therapies for neurological injuries and diseases (Stroke, Spinal Cord Injury, Traumatic Brain Injury), orthopedic injury and diseases (Polytrauma, Joint replacement), cardiac ailments and post-surgery rehab.