As part of Northwell Health Physician Partners, we at Westchester Health would like to share the following article from Northwell Health concerning the COVID-19 outbreak, by Dr. Anita Sadaty, Northwell Health OB/GYN.
In brief, the article discusses:
- Common health issues experienced after ICU discharge
- Secondary health issues associated with COVID-19
- If you can get COVID-19 a second time
- Important questions to ask
- Post-COVID recovery plan
The full article is reproduced below.
I Survived COVID-19. What Does That Mean For My Health In The Future?
A doctor’s recommendations for protecting and strengthening your immune system post-COVID.
There are many questions surrounding the COVID-19 pandemic, but now that the devastating numbers have begun to see a decline, many are turning focus to how coronavirus will affect survivors’ health in the future. And while any potential impacts are not yet clear to health care professionals, there is the potential for long-term effects on the immune system.
Typically, cases of the novel coronavirus are considered either mild or extreme. Mild cases don’t often require a trip to the hospital, whereas severe cases land many patients in the intensive care unit (ICU). If you had a severe case associated with pneumonia, ICU admission, or the need for supplemental oxygen or mechanical ventilation, COVID’s initial assault on your body was likely very extreme. If that’s the case, then you may have some pretty valid concerns about your future health.
COVID-19 aside, ICU survivors most commonly experience some of the following health issues after discharge:
- Lung injury, scarring, and residual breathing problems
- Prolonged inflammation post-pneumonia, which can lay the foundation for future illness risk
- Post-intensive care syndrome. Patients who spend time in an ICU are prone to developing a wide range of deficits including cognitive, physical, and mental issues after discharge. Symptoms can include muscle atrophy and/or weakness, severe fatigue, cognitive deficits like brain fog or memory issues, mood issues like depression and anxiety, and an increased risk for heart disease, stroke, and kidney disease
- Sleep disorders due to circadian rhythm disruption
- Post-traumatic stress disorder (PTSD)
But it’s not just patients who experienced severe cases of COVID that should be on alert for signs of secondary health issues—people with mild cases should also be aware of what to look out for, including:
- Hormone issues, like more severe premenstrual syndrome (PMS), heavy periods, infertility, menopause issues, low libido, acne, and hormonal weight gain
- Stress hormone imbalance, characterized by weight gain, fatigue, hormone issues, mood issues, and intestinal symptoms
- Moderate to severe ongoing fatigue (beyond what you think is reasonable for your level of exertion)
- Moderate to severe joint and muscle aches
- Brain fog, memory issues, and forgetfulness
- Increased autoimmune disease risk due to a combination of inflammation and infection, which are often two drivers of these disorders
- Immune system imbalance and risk of other infections and chronic disease
Will survivors get COVID-19 again, in a different form?
Another question that could take years to answer is whether the SARS-CoV-2 virus may lie dormant in the body and spring back later in a different form. This is not unusual with certain viral infections that we have years of study and data against like chickenpox and Epstein-Barr. Chickenpox can hang out quietly for decades before reappearing as shingles—a more serious version of the original infection that can last longer and is quite painful. Epstein-Barr virus (EBV) is another virus that may be reactivated years after the initial infection. Typically EBV causes “mono” or infectious mononucleosis, and can resurface as chronic fatigue syndrome and fibromyalgia, and may be linked to an increased risk of developing multiple sclerosis. If coronavirus resurfaces later in a survivor’s life, we have yet to be able to record what that looks like and what the symptoms could be.
If you’ve survived coronavirus, there are some things you can do to support your immune system and reset your body to help prevent long-term effects and any potential secondary health issues down the road.
The important questions you should be asking
Ask yourself and a trusted health care professional the important questions about your pre-existing health issues unrelated to coronavirus:
- What health issues do I have? Were they risk factors for developing a severe form of COVID (diabetes, lung disease, heart disease, obesity, immunocompromised)?
- What can I do to make these health issues better beyond taking the prescription medications I have already been given?
- How can I lower my total body inflammation and improve my overall health?
- How do my lifestyle and diet contribute to my level of health or disease?
If your immune system is strong, you likely won’t get these viral reactivations years later. You must, however, control inflammation, clear any underlying chronic infections, and take extra care of your body in order for your immune system to do its job well.
Post-COVID recovery plan
Step One: Practice some self-care. Give yourself a break—you just survived a life-threatening disease caused by a complicated virus. It’s amazing what a haircut or getting dressed up for the day can do for your headspace. A positive outlook is essential to healing your body.
Step Two: Address the four main drivers of inflammation.
- Nix the inflammatory foods. Avoid processed food (Does that food have more than one ingredient in it? If so, put it down, especially if it’s a marshmallow), sugar, alcohol, wheat products, conventional (non-organic) meat, chicken, farmed fish, cow’s milk dairy, and any food that gives you diarrhea, heartburn, or simply makes you feel unwell.
- Balance sugar and insulin. Health issues like prediabetes, diabetes, obesity, hypoglycemia, fatty liver disease, and gout all wreak havoc on your body and cause additional inflammation. To help stave off these issues, make sure to maintain healthy eating habits and exercise routines.
- Address chronic infections and other chronic sources of inflammation. Do you have issues with your sinus, gut, lung, vagina, bladder, or skin in the form of weird rashes? These may include some of the following conditions:
- Irritable bowel syndrome, reflux, inflammatory bowel disease, bloating, alternating diarrhea or constipation
- Chronic urinary tract infections, yeast infections, chronic bacterial vaginosis
- Chronic sinus infections, chronic allergies, frequent colds
- Interstitial cystitis, endometriosis, and other chronic pain syndromes or autoimmune diseases like rheumatoid arthritis, multiple sclerosis, Hashimoto’s thyroiditis, Crohn’s disease, ulcerative colitis
- Anxiety, depression, or any psychiatric disorders—these can be signs of brain inflammation
- Halitosis, toe nail fungus, and itchy butt of unknown origin, as these could be signs of infection.
Step Three: Strengthen your immune system.
- Get your gut right. If you have any intestinal issues that you just assume are normal (they are not), now’s the time to address them. If you need to unbutton and unzip pants following most meals, there’s likely a physical problem. Talk to your physician about getting your gut into a healthy flow, including regular, healthy bowel movements. There are four R’s to “fixing your gut”:
- Remove any foods that cause inflammation from your diet and clear up any infections in your gut that could be causing inflammation
- Replace the things you may be missing, like prebiotics to feed good bacteria and digestive enzymes that deplete with aging
- Reinoculate—or bring good bacteria back into your body—by adding probiotics and prebiotics to your diet
- Restore your gut by fixing your intestinal lining through vitamins and supplements such as glutamine, zinc, and vitamin A
- Get enough sleep. Sleep is a priority for strengthening immune health. Minimally, eight hours a night is enough, but if you don’t feel rested in the morning, your sleep is not restorative and probably could use a make-over.
- Reduce stress. Research has shown that stress weakens our immune systems, so reducing your stress is key to strengthening your body’s immunity.
Learn what Westchester Health is doing to protect our patients and staff against COVID-19
We are here to provide the care you need, when you need it. To learn what smart precautions we’re taking to minimize the spread of COVID-19 and keep you safe, visit our Coronavirus Digital Resource Center. To know how we’re responding to the outbreak and what to do if you’re feeling sick, visit our FAQ page (frequently asked questions). Whenever, wherever you need us, we’re here for you.