Brace Yourself for "Post-COVID-19 Condition"
In the ongoing battle against COVID-19, a new challenge is emerging: the long-term effects of the virus on patients. According to data from a major U.S. hospital system, 22% of hospitalized COVID-19 patients required critical care, with 79% needing ventilators and 37% remaining hospitalized for an average of 33 days. This highlights the significant burden on healthcare systems, particularly as the virus continues to spread. One concern is the potential for COVID-19 patients to receive outpatient treatment and home rehabilitation. However, social distancing measures can hamper the ability of home health aides, agencies, family, and friends to provide assistance. The virus could potentially infect as many as 50% of the U.S. population, with 5% requiring ICU beds. This could lead to a surge in demand for ongoing care, both in facilities and at home. Hospitals may struggle to transfer COVID-19 patients requiring ongoing care to other facilities due to limited capacity and concerns about infection risks. This could exacerbate the strain on healthcare systems and leave patients without the care they need. In the U.S., around 5 million have been infected, with approximately 164,000 deaths and 2.5 million recoveries. However, the number of patients requiring ongoing care is currently unknown, but evidence suggests it could be enormous. Governments, healthcare institutions, providers, patients, families, media, and the public need to address these ongoing needs. Policy makers should allocate sufficient resources to meet the growing needs for outpatient services, particularly for uninsured COVID-19 patients and undocumented immigrants. Data collection and reporting have focused on infection rates, hospitalizations, and deaths, but not the quality of survival. A study of patients in Italy hospitalized for COVID-19 found that, on average, 87.4% still had virus-related symptoms 60 days after the onset of symptoms, with 55% having three or more symptoms. Post-COVID-19 syndrome, also known as Long COVID, has been described, with many survivors experiencing ongoing symptoms. Among U.S. COVID-19 patients on ventilators, 31% have needed renal replacement therapy, and 36% have developed neurological problems. 23% of COVID-19 survivors, two years post-discharge, experience moderate to severe depression and anxiety. 73% of COVID-19 patients on ventilators, who survive, develop neurocognitive deficits at hospital discharge, and 47% continue to have these deficits two years later. The COVID-19 pandemic has resulted in ongoing symptoms for many survivors. Governments should begin collecting data on the nature and extent of longer-term COVID-19 problems, including specific kinds of hospital, outpatient, and home services required, and how best to meet these needs. In Germany, several hospitals and institutions are committed to supporting long-term COVID-19 patients. Klinikum Bremerhaven-Reinkenheide offers specialized isolation wards and infection protection concepts, while the Medical University of Hanover is active in lung transplantation and rehabilitation for patients with chronic lung conditions related to COVID-19. Medicare and private insurers in the U.S. have agreed to cover physical and occupational therapy through telehealth during the pandemic, but the duration of such coverage is uncertain. As of August 12, 2020, around 20 million people have been infected worldwide, with almost 740,000 deaths and around 11 million recoveries. The long-term impact of COVID-19 is a growing challenge that requires urgent attention and action from policymakers and healthcare providers alike.
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