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Doctors and patients alike have become accustomed to the conditions dictated by the COVID-19 pandemic for half a year. Doctors from the VUL Santara clinics, who are at the forefront of treating coronavirus patients, spoke in a remote conversation about how the virus has changed the daily work of doctors and who is most at risk.
Specific symptoms of coronavirus
Head of the Hospital for Infectious Diseases, infectologist doc. Ligita Jančorienė first emphasized that the disease has several stages and cannot be limited to its appearance. According to her, the disease begins in the same way as any other respiratory infection, but the specific symptoms would be different.
“First of all, the infection manifests itself in fever, other symptoms: cough, runny nose, sore throat. But it is so nonspecific that it would be difficult to distinguish it from a flu infection. What can be distinguished is one of the more specific signs – Loss of smell and taste, which most patients notice.Later, of course, signs of pneumonia may appear in the lower respiratory tract.
Because the disease is initially more related to the cells of the mucosa, the body’s response remains very important. The cytokine storm has been mentioned many times before, when the body releases a large amount of inflammatory substances in its defense and can cause various other damages to the body ”, explained the director of the Hospital for Infectious.
Named who’s getting harder
Edita Strumilienė, a pulmonologist at the Center for Pneumology and Allergology, added that coughing as a symptom is not much different from other respiratory infections, but other things have been noted.
“Very often, patients who do not yet have significant signs of pneumonia radiologically already experience shortness of breath. And often for a patient, shortness of breath progresses fairly quickly to respiratory failure,” he said.
According to L. Jančorienė, shortness of breath is one of the first symptoms that frightens and forces people to seek medical help.
The doctor recalled that this infection affects not only the lungs, but also the cardiovascular system, and its history can exacerbate existing chronic diseases.
“We see that a much more severe disease occurs in those with diseases of the circulatory system, primary arterial hypertension, lung diseases such as asthma, chronic obstructive pulmonary disease, and we also observe exacerbations of diabetes. Those with impaired immunity are also more seriously ill, ”noted L. Jančorienė.
For some, the consequences last a long time.
The doctor recalled that, on average, hospitalization for COVID-19 takes about two weeks, but this does not mean that the patient will be discharged after recovery.
“We just realized that he didn’t need any specific hospital care. But practice shows that the virus persists in the human nasopharyngeal mucosa for quite a long time, although there may be no clinical symptoms.
PHOTO GALLERY. Exclusive shots from the Santara Clinics Intensive Care Unit and medical records
Not everything is so simple, because the symptoms of the disease can disappear faster, except in severe cases, which are around 10 percent. of all those who need help with resuscitation or intubation, etc., they tend to stay much longer.
But full recovery takes a month and even longer. Also, there is a post-infectious fatigue syndrome, when patients may already be healthy, they no longer have the virus in the nasopharynx, but they complain of fatigue, lack of strength and the like, “he said.
Weakness can be frustrating for 2 months.
E. Strumilienė noted that even 2 months after the patients arrive for the check-up, they have many complaints, despite the fact that there is no virus in the nasopharynx and the blood counts are restored.
“For a long time, two months, the taste disorder persists, for most patients the fatigue syndrome, general weakness and the inability to work remain for the same period of time. In addition, hair loss, various migratory pains such as the jaw, which are rarely seen in other diseases, ”he said, adding that more is said about those patients who were in severe form, had signs of respiratory failure and needed additional oxygen. . and etc.
According to the doctor, these relapsed patients need several consultations, not just a pulmonologist.
“After the illness, patients continue to be monitored by a family doctor, they decide on the continuation of the incapacity for work, more examinations,” he said.
Can the recovered one be reinfected?
When asked if it is realistic for a person who has recovered from the coronavirus to be re-infected and how long the immunity might last, L. Jančorienė said that he still could not give an answer.
“Antibodies generally form within 14 days, but it’s not clear how long they will last, there just wasn’t enough time to collect the necessary data.
So can a person be re-infected? I think this is very questionable in the near future after illness. The question, which was also discussed in the meeting with the Government, is whether the patient needs to be isolated if he has had a severe form of Covid-19 and is now traveling, or if he needs to be isolated.
This has not yet been elucidated in the literature, such data is not yet available, or that person cannot serve as a vector and bring the infection despite being sick. So we don’t have the answers to many questions yet. In my personal opinion, it is very doubtful to be infected again half a year after the disease, ”he said.
The biggest challenge is patient flows
Recalling the start of the pandemic in Lithuania, L. Jančorienė stated that it was an unknown virus and that organizing work in the hospital posed challenges.
“It was a new infection for which there is no approved treatment, information is still being collected. The first task was managing new patient flows that we couldn’t plan in advance. The diagnosis was poorly available and tests could be performed in several major hospitals.
And with the flu itself, the heat of the common cold, everyone who felt these typical symptoms first wanted to know if they had this new infection, so this resulted in difficult-to-control patient flows, “he said.
In addition, he added, the fact that he moved to a new location was also new for the institution’s infectologists.
“I had to invite other doctors and solve problems related to the infrastructure of the premises. However, I am glad that the team is really well played at the moment, ”he said.
According to E. Strumilienė, she and her colleagues were lucky that the infection was well controlled and the flow of patients was not such that they had to participate very actively in the work.
“As a result, we have been able to deal with other illnesses and counsel these patients after they have an active infection,” he said.
Doctors recalled that not everyone needs hospital treatment, but there are also cases where a person discharged for treatment returns home with complications.
“There are patients we let out of the hospital, but then they come back with signs of pneumonia. Of course, they are usually older people with comorbidities, ”said L. Jančorienė.
Opinion expressed on coronavirus skeptics
When asked why, in his opinion, there is such a wave of mistrust, hostility in today’s society, reluctance to wear masks, L. Jančorienė said that apparently there were those who were in the opposition at all times.
“Apparently, they have less information, they do not meet, they have not experienced the disease themselves or among relatives. But we ourselves have met people who have had a negative opinion that there is no such infection. However, when they got sick and they even experienced a more severe form of the disease, they categorically changed their mind, ”noted the doctor.
According to E. Strumilienė, the best counterargument for such people would be the story of the reborn.
“A patient came in and said that his father had died from this disease, his wife was very ill, he couldn’t go back to work for three months at the moment, so talking to those patients could make the situation seem different. I don’t say that it is necessary to intimidate the public, but to say that there is no virus when the entire diagnosis has been confirmed would not be very logical, “said the specialist.
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