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‘Severe Covid is like being in a car crash: it affects every part of you’

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More than half of Covid-19 patients who were admitted to Beaumont Hospital are still suffering serious medical complications months after being discharged.

Dr Killian Hurley, a respiratory consultant at its post-Covid clinic, says more than half the 120 such patients suffer long-term health problems such as serious fatigue, shortness of breath, inflation of the heart and bad coughs.

Many have been unable to return to work. A proportion are young and did not have any pre-existing health problems, he adds.

Those recuperating from severe Covid are also suffering from a worrying array of memory and cognitive problems, he says.

“Some people have depression and anxiety problems. A lot of them are terrified to go out. There are some people that haven’t left their house since April. They are terrified they are going to pass it on or get it again,” says Dr Hurley.

The leading medic says that as more than half of Beaumont’s hospitalised Covid patients are suffering serious long-term health consequences, the public should not underestimate how debilitating the disease can be.

“Severe Covid is like being in a car crash. It affects every part of your body from your brain to your heart. People should be really careful. It’s not just about the number of people who die. There are many other consequences,” he says.

“There are significant long-term problems for some patients who have been hospitalised. That is maybe something that people are not aware of enough. While we might not be seeing the same number of deaths, each admission to hospital for Covid leads to significant medical problems for that patient.”

The Dublin hospital’s post-Covid clinic is run by a team of medics from the fields of respiratory medicine, intensive-care medicine, infectious diseases, psychiatry, psychology and cardiology.

The clinic reviews each patient two to three months after discharge. “More than half of the patients need to be brought back and treated at the clinic a few months later. Some of these patients are in their 30s and didn’t have any pre-existing health problems or only had minor risk factors such as being overweight,” he says.

Dr Hurley also explained there was a “gender imbalance” among the cohort of severe Covid admissions.

“Three-quarters of the patients attending the clinic are men. For some reason, men who have been hospitalised with Covid are much more likely to suffer long-term problems than women. This could be down to differences in men and women’s immune systems and ability to fight infection.”

The consultant says a lot remains unknown about the lasting health effects for patients who suffered with severe Covid.

“We don’t know the long-term implications of Covid-19 yet. We don’t know what’s down the line in five years’ time. We need to follow these patients for a year.

“In the most severe cases, we are likely looking at some patients still having scarring of the lungs one to five years down the line.”

Dr Hurley says there needed to be “joined-up thinking” across the health service so those who have survived severe Covid get the required follow-up medical care.

“What really needs to happen is that GPs are empowered to refer people who need follow-up to post-Covid clinics that are running in some of the hospitals,” he says.

“We are really stretched already here and post-Covid issues are not being resourced at a national level.

“Patients need reassurance. They are frightened. They need to know that there can be follow-up with specialists if they go to their GP.”

Beaumont is within the Royal College of Surgeons in Ireland hospital group, which transfers Covid-19 patients to rehabilitation beds at nearby Clontarf Hospital, which has established a Covid recovery ward. Dr Jacinta Morgan, a consultant in rehabilitation, spends part of her working week with Covid patients at the Clontarf facility.

Alongside her colleague Dr Carmel Curran, a consultant geriatrician, the two medics have treated around 35 Covid patients at Clontarf Hospital to date.

“I lead a multi-disciplinary team who care holistically for the Covid patients in their recovery. Beaumont needed a release valve,” says Dr Morgan.

While the average Covid patient in recovery spends four to six weeks at Clontarf, some have been released within 10 days – while the less fortunate have spent a number of months recuperating at the facility.

While physical recovery is the primary focus, Dr Morgan has been struck by the psychological impact on her Covid patients.

“The big message I’d like to get across is the psychological effect this has on people. These patients need a lot of psychological support. There are so many aspects to this. There is survivor’s guilt. Why did I survive and so many others die?” she says.

Dr Morgan has been involved in the care of around 10 recovering Covid patients, ranging from a man in his 20s to patients in their 80s.

“This is a disease that essentially takes their lives away. It is very destabilising for them. Survivor’s guilt and post-traumatic stress disorder are part of the psychological trauma for people who had severe Covid.”

Upon admission, recovering coronavirus patients at Clontarf require piped oxygen due to lung damage.

“That’s the first and most immediate thing. The patient then requires less and less oxygen as the recovery process continues,” says Dr Morgan.

The rehab team includes nurses, junior doctors, physical therapists, occupational therapists, medical social workers and dieticians.

The next step is to rebuild the patient’s physical capabilities. Severe Covid patients have often spent a considerable time in intensive care, leading to a loss of muscle mass and strength.

“They have been deconditioned. Some patients can have issues sitting up in bed. Therapists and nurses set goals and challenges for them and programmes of exercise,” says Dr Morgan.

In the most serious cases, around 10pc of recovering Covid patients at Clontarf suffer from critical injury neuropathy, a severe nerve injury.

“These patients can’t move their legs or can do so very minimally. It does come back but it can be slow. That is the extreme end of the scale.

“In Covid recovery, there is more than one issue to deal with,” she says.

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