COVID-19. Principles of rehabilitation and therapy for post-COVID syndrome
Introduction
Everyone’s life has changed as a result of the COVID-19 pandemic. We all have friends or close people, who suffered from the corona virus disease. We have heard of vaccines, drugs, their effectiveness. Almost everyone knows about immunity, immunoglobulins G and M, symptoms and consequences — the medical knowledgeability of the population is pleasantly surprising. The purpose of this article is to summarize the information and highlight the problem of post-COVID syndrome and its therapy.
Etiology and pathogenesis
COVID-19 is a corona virus infection caused by a new, pathogenic for humans, strain of corona virus. The first outbreak was resisted in the Chinese city of Wuhan and rapidly spread throughout the world. Due to mutations in the genetic code, new strains have appeared, and the risk of a severe acute disease in younger patients has increased. Vaccination is developing rapidly, but the incidence remains high and the complications can reduce the quality of patients` life for months.
Corona virus is can be spread through airborne contact, as well as through fomites — surfaces on which the viral particles remain viable for several hours. Penetrating into the human body, the virus interacts with the cell by binding to receptors for angiotensin-converting enzyme 2, which normally participates in the processes of vasodilation. This specific feature that causes weakness, lassitude and further complications in the form of impaired cardiac conduction. During the incubation period, which can be from 2 to 14 days, the virus multiplies locally, then the first symptoms begin to appear.
The most often are:
1) lassitude, weakness, increased fatigue
2) high temperature
3) Respiratory disorders — dry cough, shortness of breath, reduced blood saturation with oxygen
4) Loss of smell, weakening of taste
The course of the disease can last from weeks to months, depending on the severity. There are following phases:
1. The acute phase is accompanied by high temperature, cough, shortness of breath. This phase lasts from several days to several weeks.
2. Post-acute phase. Complications can appear for more than three weeks as well as after an asymptomatic course of the disease.
3. Post-COVID syndrome lasts more than 12 weeks and is characterized by chronicity.
Each patient has a risk of complications, and it is important to make a timely decision about the appropriate therapy.
Complications
In the research from Wuhan, China, the long-term effects of acute COVID-19 were assessed by examining 1,733 patients after 6 months symptom onset. For the purpose of examinations the following methods were used: the questionnaires, physical examinations, 6-minute walk tests and blood tests, lung function tests for some cases, high-resolution computed tomography of the chest and ultrasound to assess organ damage after COVID-19.
The majority of patients (76%) noted at least one symptom. As well as another researches the most common symptoms were lassitude / muscle weakness (63%), followed by sleep problems (26%) and anxiety / depression (23%).
· Respiratory system. The affected lung tissue is eventually replaced by non-functional conjunctive scar tissue. Fibrotic scarring can progress without adequate treatment, which reduces the quality and duration of life in general. Shortness of breath is associated with this, even with little physical exertion.
· The cardiovascular system. Anisorhythmia and cardiomyopathy can develop as a result of inflammatory сonditions and an increased risk of thrombus formation can result in thromboembolism (acute blockage of a blood vessel by thrombotic masses, as a result of blood clot detachment) and sudden death.
· Nervous system. Decreased alertness, memory impairment and cognitive deterioration affect the quality of life of patients. The encephalitis, Guillain-Barré syndrome can develop as a collateral damage of inflammation. This leads to muscle weakness and paralysis in especially severe cases.
· Digestive system. The virus can directly infect liver cells, and drug therapy increases the risk of hepatitis. In connection with the thrombolytic therapy the ulcers and erosion of the stomach often develop as well as the intestinal microbial population is inhibited and the risk of developing pseudomembranous colitis increases after antibiotic therapy of concomitant or nosocomial pneumonia..
· Locomotor apparatus. Patients often complain of joint and muscle pain. One of the reasons is the body’s autoimmune response. Development of arthritis and rheumatic joint damage is possible.
· The immune system. The existing avitaminosis and micronutrient malnutrition is aggravated due to the disease and the virus is able to reduce the overall resistance of the body to infections and cause secondary immunodeficiency.
Therapy and recovery
Despite the effectiveness of drug treatment of the acute phase of the disease, the complications remain a vital problem, which for a long time reduces the patients` life quality. Full rehabilitation is a multilateral process that requires special attention and a systematic approach to the problem.
Damage to the lungs, the effect on the cardiovascular system, cognitive impairment and disorder of the digestive system are very dangerous. Very often, despite alloeosis, the depression and psychological problems develop. After illness the immune system needs correction and support
Dr. Choi and his qualified team are medical professionals. With more than 20 years of work experience, numerous scientific works, fundamental Korean and Russian medical education, Dr. Choi does not interrupt the learning process and has extensive knowledge in the field of internal medicine, therapy, gastroenterology, dermatovenerology, gerontology as well as knowledge of traditional oriental medicine — acupuncture, homeopathy and osteopathic manipulative treatment.
The Center for Oriental and European Medicine provides a сomprehensive set of measures against the complications, including consultations of highly specialized doctors, laboratory examinations, a combination of drug treatment and traditional medicine.
The use of infusion therapy for the purpose of detoxification in combination with acupuncture, osteopathy, multivitamins and biostimulants treatment has a positive effect on the cardiovascular, digestive and immune systems and allows patients to recover from a severe disease. In addition to the mentioned above for the nervous system the nootropic therapy is carried out. Physiotherapy exercises, acupuncture and massage have a beneficial effect on the musculoskeletal system, ease of pain and minimize the risk of progression of inflammatory joint lesions.
An individual and comprehensive approach to each patient and supervision of professionals will help overcome the illness and complications.