Patients undergoing intensive care or suffering from severe forms of Covid-19 have major complications from the disease which has shown that it can affect all functions of the body. Are these side effect reversible? Can we expect a patient who has been intubated for a few weeks to return to normal?
As of April, 9th thousands have been hospitalized with coronavirus infections in the US, some of whom were so ill that they required intensive care unit. Fortunately, most of these patients wake up, sometimes even after several weeks of artificial coma. For these patients and for all those severely affected by Covid-19, it proved slow and difficult to return to normality. Although it is still too early to know exactly what the long-term damages of this disease will be, several recent studies have revealed worrying signs.
Intubation and artificial coma: major risks of complications
First of all, the long period of intubation is in itself a cause of complications. The fact that we are intubated, ventilated and sedated causes hyper-metabolism in the body, which causes the muscles to waste away because we consume too many calories. As a result, it can be difficult to walk again. There is also a risk of renal failure and vascular thrombosis due to immobilization.
An excessive immune response can cause systemic inflammation
Many of the side effects of this disease are not caused by the virus itself, but by an overly strong immune response, causing damage not only to the lungs, but also to the heart, kidneys, liver and brain. Acute respiratory distress syndrome (ARDS), which is one of the most serious symptoms caused by Covid-19, can therefore cause pulmonary fibrosis, leading to poor scarring of connective tissue in the lungs and reduced breathing capacity. This could affect about 10% of ARDS patients.
Other organs may be affected. A study published in April in JAMA suggests that myocardial infiltration by inflammatory cells may cause myocarditis. Another study suggests that the virus can affect the central nervous system and manifest in neurological symptoms such as loss of consciousness and acute cerebral vasculitis. We noticed that many patients have delusions during resuscitation, confirmed Wesley Ely, a respiratory physician at the Vanderbilt University Medical Center in the United States, when he told the journal Science. However, these may be due to sedation or the lack of oxygen in the brain that causes nerve cells to die.
Long rehabilitation, but hope for a complete remission
Finally, there are psychological sequelae, which are much more difficult to assess: a 2003 study of SARS patients found that more than one in three patients had depression, anxiety, or post-traumatic symptoms for more than a year. Are all of these consequences transitory or permanent?
What we know about the flu is that in the most severe cases, it takes six to nine months for the respiratory tests to return to normal. However, regardless of the severity of the lung deficiency that the current patients see when they are discharged, there is a high probability they will be able to return to a truly normal life. This however may require a long period of walking and respiratory rehabilitation.