Friday 5 November 2021

Helping Patients Cope With the Long-Term Effects of COVID-19

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For nearly two years now, the world has been struggling in the grasp of the most devastating pandemic in modern history. To date, the COVID-19 pandemic has claimed almost five million lives worldwide, approximately 700,000 of them American. And the death toll continues to rise. 

Article by Indiana Lee

But it’s not only in the loss of life that the ravages of the novel coronavirus can be felt. For survivors of the virus, the effects of the disease can be both lingering and devastating. Indeed, researchers, clinicians, and patients alike are by now all too familiar with the syndrome now commonly referred to as “long COVID.” The specific manifestations of long COVID, though, can be highly diverse and profoundly unpredictable, making both prognosis and management formidably difficult. This article examines the impacts of long COVID and describes strategies that healthcare providers should know to help patients contend with the disorder. 

What is Long COVID?

Long COVID refers to a panoply of physical, cognitive, and psychiatric symptoms emerging in the aftermath of acute COVID disease and lingering for weeks, months, and, potentially, for years beyond the acute phase of the infection itself. These symptoms may range from mild to severe and may emerge and remit at any stage of the patient’s recovery, both in isolation and in conjunction with other long COVID-related symptoms.

Post-COVID conditions may affect any organ or bodily system and include depression, cognitive impairments, difficulty breathing and shortness of breath, gastrointestinal disorders, changes in the menstrual cycle, and neuralgic and musculoskeletal pain, to name only a few. The sheer diversity, instability, and unpredictability of long COVID symptoms can have a deleterious effect both on the physical and the psychosocial well-being of the patient, amplifying the need for strong, proactive support from healthcare providers. 


Immunological Management

Studies suggest that long COVID can have a particularly detrimental impact on patients’ immune functioning, This not only puts patients at significant risk of acquiring other infections or developing immunological comorbidities, but it also may increase the patient’s risk of COVID reinfection. Current research suggests, for example, that immune resistance to reinfection may only last for around 100 days.

However, it is unclear whether or how long COVID impacts either the duration or the potency of natural immunity. Current research does suggest, though, that the body’s microbiome plays a substantial role in disease severity and mortality risk.

Thus, immune-compromised long COVID patients not only experience a heightened risk of contracting non-COVID illnesses, but they may also be more vulnerable to coronavirus reinfection, as well as more severe coronavirus disease.

In light of this, then, healthcare providers must work with long COVID patients to help them support their immune function and to protect against disease. For example, patients should be educated on the differences between cleaning and disinfecting their homes. This would also include actionable advice for effectively disinfecting each room of the home, noting, in particular, the viral and bacterial risks associated with various rooms, objects, and surfaces of the house. 

Gastrointestinal Effects

In addition to its impacts on immune functioning, long COVID is also strongly associated with significant gastrointestinal effects, ranging from vomiting and diarrhea to the loss of appetite and sense of taste, to the emergence of gastroesophageal reflux disease (GERD). Not only can these disorders contribute to weight loss and the potential for life-threatening GI bleeding, but they can also dramatically reduce the patient’s overall quality of life.

Helping patients to manage long-term COVID, then, will often mean supporting patients in cultivating GI health through diet, supplementation, and, as needed, pharmaceutical or surgical intervention. For example, long COVID patients experiencing GERD can be taught to better recognize and prevent symptoms of the disorder, from making dietary changes to elevating the head of the bed and wearing loose-fitting clothing to reduce acid reflux. 

Emphasizing Education

There is never a “good” time for a pandemic, but COVID-19 has emerged at a particularly challenging moment for the global healthcare system, one already overburdened by a significant and worsening shortage of healthcare providers. Given the reality that the number of COVID survivors is reaching into the tens, possibly the hundreds, of millions worldwide, it can be assumed that a short-staffed healthcare system will soon face an onslaught of long COVID patients.

To attend to their needs, then, it’s not only necessary that healthcare providers understand how to help them manage their present symptoms, but it is also incumbent that current and prospective health workers consider future needs. A key aspect of this is to encourage new and established practitioners alike to pursue advanced training, such as a Director of Nursing Practice (DNP) degree, to increase health system efficacy and capacity for the demand to come. 

The Takeaway

COVID-19 has had a profound impact on patients, families, and healthcare providers the world over. Unfortunately, the battle does not always end once the acute stages of infection have passed. Long-term COVID is detrimentally affecting the health and well-being of untold numbers of coronavirus survivors, and it is incumbent upon healthcare providers to help them manage the diverse and sometimes devastating symptoms of long-term COVID while also cultivating the training and education they need to prepare for future demand.

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