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What happens after someone has recovered from COVID-19? Gian Marco Frau/EyeEm/Getty Images
  • A new study documents the post-hospitalization health of people who developed COVID-19 in its first wave.
  • The researchers found that nearly half of those who survived COVID-19 experienced lasting damage.
  • In addition, more than 40% of those left in poor health were never assessed for further treatment prior to discharge.

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For many, recovery from COVID-19’s acute phase is just the beginning of the story. COVID-19 can affect the long-term health of a person’s heart, brain, lungs, kidneys, and skin. It can also cause a host of lasting symptoms, referred to collectively as “long COVID.”

A new study has found that 45% of patients hospitalized and treated for COVID-19 were still experiencing related health issues when they were discharged.

The study’s lead author, Dr. Alecia K. Daunter, a clinical assistant professor at the University of Michigan, in Ann Arbor, says, “Physicians and others in the healthcare system were working appropriately to discharge patients.” However, she notes:

“[Patients] survived, but these people left the hospital in worse physical condition than they started. If they needed outpatient therapy or are now walking with a cane, something happened that impacted their discharge plan.”

The researcher explains why this happened so often during the pandemic’s early crisis stage:

“[Doctors and hospitals] needed to keep patients safe while maximizing available beds and minimizing exposure to staff. I think that contributed to many people not being assessed by a therapist or [physical medicine and rehabilitation (PM&R)] physician.”

The new study helmed by Dr. Daunter now appears in the journal PM&R.

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The authors of the study analyzed the medical charts of 288 people hospitalized with COVID-19 at Michigan Medicine, the university’s health system, between March and April 2020, during the pandemic’s first wave.

Of the 45% of COVID-19 patients who were in worse shape after hospitalization than before, 40.6% were not assessed by a PM&R physician, physical therapist, occupational therapist, or speech and language pathologist prior to discharge. This suggests that post-COVID problems have been underreported, notes Dr. Daunter.

Nonetheless, doctors referred 80% of these patients for post-discharge therapy. Durable medical equipment, such as wheelchairs, were necessary for 67.6% of the patients, and 26.7% had ongoing difficulty swallowing, or dysphagia.

The unresolved health issues were so serious that almost 20% of the patients were no longer able to live independently after being discharged from the hospital.

Dr. Daunter explains: “These patients may have needed to move to a subacute facility, or they might have needed to move in with a family member, but they were not able to go home. This has a massive impact on patients and their families — emotionally and physically.”

Medical News Today asked Dr. Daunter what steps should be taken before the next pandemic. She suggested:

  1. Build collaborative relationships between rehabilitation and acute care medical teams to ensure that appropriate screening tools and referral pathways are in place, during and after hospitalization.
  2. Ensure that rehabilitation teams are appropriately staffed to provide optimal care in times of high capacity.
  3. Create programs that address functional decline in patients who have experienced a serious illness, and prioritize access to them in times of crisis.
  4. Continue to research ways to prevent or mitigate functional decline in hospitalized patients.

Speaking with MNT, emergency physician Dr. Joseph Fraiman recalled the critical shortage of nurses during the early days of the pandemic.

He would like to see the federal government develop a flex-staffing system similar to that of the Federal Emergency Management Agency, better known as FEMA. This way, enough staff would be ready for rapid deployment in the event of another pandemic.

Dr. Fraiman explained: “It would be ideal if you had a federal team of nurses. […] You would have sent a bunch of them to New York, a bunch to New Orleans, a bunch to wherever [the disease] was raging.”

The study demonstrates that while much attention is directed toward COVID-19 case numbers and mortality rates, the impact of the disease on individuals extends well beyond these metrics.

Study co-author Dr. Edward Claflin, also a clinical assistant professor at the University of Michigan, is hopeful that the research can bring the complex aftermath of COVID-19 into clearer focus:

“These results help to highlight the true impact of the COVID-19 disease on our patients. They fill in that gap in knowledge about how patients with COVID-19 recover and what kind of rehabilitation needs they have.”

“These problems are frequent, and the stakes are pretty high if we miss them or allow them to progress during hospitalization,” Dr. Daunter adds.

She continues: “Some of these people were working and many were living independently. To lose that level of function is meaningful.”

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