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Lung specialist Dr Helmy Haja Mydin of Pantai Hospital KL shares what to know about Covid-19 aftercare at home and symptoms to look out for

According to a statement by Malaysian health director-general Tan Sri Dr Noor Hisham Abdullah, individuals with Covid-19 who are asymptomatic (Category 1) or with mild symptoms (Category 2A) may undergo home quarantine and are not required to visit a Covid-19 Assessment Centre (CAC). At home, they are required to update their health status twice a day (before 12pm and 6pm) using the Health Assessment Tool on the MySejahtera app.

Do Covid-19 symptoms remain even after a patient has recovered? What exactly is Long Covid and what changes should one be prepared for when recovering from Covid-19?

As daily Covid-19 cases increase in the country with more people than ever waiting out their recovery in home quarantine, Tatler speaks with respiratory physician and Generation T 2019 honouree Dr Helmy Haja Mydin, head of Pantai Hospital Kuala Lumpur’s Lung Centre, on common symptoms to know and what steps to take to improve the health of your lungs after recovering from this disease.

See also: Covid-19 Vaccination: What To Eat, Drink Or Avoid

"The vast majority of patients fully recover within weeks of the illness, especially those who have been fully vaccinated and boosted," shares Helmy, who was recently appointed as a technical advisor to the Ministry of Health. "The risk of prolonged symptoms is higher amongst those who have had Category 4 or 5 Covid-19 and in those who have poorly-controlled co-morbidities. These may include symptoms of fatigue, chest tightness and difficulty breathing. It is more pronounced if the experience with Covid-19 had left the patient with lung fibrosis or scarring," he adds.

What exactly is Long Covid?

Helmy: Long Covid Syndrome is not fully understood. Although it is often described as symptoms that continue for more than 12 weeks after a Covid-19 infection which cannot be explained by another cause, the lack of an internationally-agreed definition makes it difficult to grasp the extent to which it affects society. There is no specific test for it, nor is there a specific cause that we know of. 

What are some typical symptoms that recovered Covid-19 patients may experience?  

A look at Malaysian data revealed these to be the top five symptoms: lethargy (78.9 per cent), breathing difficulties when performing certain tasks (52.9 per cent), coughing (18.1 per cent), insomnia (14.5 per cent) and anxiety (10.4 per cent). The symptoms can be classified into a number of subgroups: 

Respiratory: Symptoms include breathlessness, coughing and the need for supplemental oxygen. These symptoms and the impact on quality of life are higher in those who have significant damage to the lung tissue, whether from Covid-19 or other lung diseases.

Mental health: This includes anxiety, depression, sleep disturbances, post-traumatic stress disorder, headaches and a disturbance or slowing down of cognitive function–also known as 'brain fog'.

Other symptoms:

  • Cardiac, including palpitations and chest pains
  • Blood clots
  • Fatigue
  • Muscle aches
  • Generalised weakness
  • Joint ache and/or hair loss

What are some ways to care effectively for those with co-morbidities who have recovered from Covid-19? 

In terms of aftercare, one key difference is the need to optimise the management of co-morbidities. For example, if a patient has diabetes, there would be a need to adjust medication and diet to ensure optimal blood sugar level control. This is especially true for those who have had Category 4 and 5 of the disease, because the medication that we use to treat these patients may potentially alter the blood sugar control. 

What should patients avoid during and after recovery?

Covid-19 is made worse by co-morbidities, as well as risk factors such as smoking, being overweight or obese and excessive alcohol consumption. Recovering from Covid-19 is an opportunity to reassess the presence of these and take the necessary steps to reduce their impact. 

What treatment options are available for those who experience more severe post-Covid symptoms?

Those with an existing lung disease or those who have damage to the lungs as a result of Covid-19 will benefit from a pulmonary rehabilitation programme. This is a programme that is conducted over a period of up to 12 weeks to gradually improve lung health.

In general, cardiovascular exercises such as running and swimming are good for the lungs, as well as activities that improve breathing such as yoga and pilates. 

Are there any other warning signs that patients should be aware of after recovery? 

I do think that the quarantine period can also have a profound impact on one’s mental health, and patients should be cognisant of this. Some may be depressed, some may be anxious, some suffer from social isolation.

For some, returning to normal interaction is sufficient to allay these concerns but for others, additional support from a therapist may be warranted.

Ultimately, I believe that isolation and quarantine offer one an opportunity to relook at one’s priorities. Although the vast majority of people recover fully, it may take time and one has to be kind to one’s self and be patient whilst simultaneously pushing the boundaries of comfort in a slow but steady fashion. 

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