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Half of the healed have cardiovascular complications and half have neurological complications. They also have ailments that have not occurred on such a scale so far: chronic fatigue syndrome and symptoms of brain fog – says Dr. Michał Chudzik, initiator and coordinator of “STOP-COVID” – the only program in Poland that provides care for convalescents after a home course of COVID-19.
- Dr. Chudzik lists what convalescents most often complain about
- These are primarily problems with pressure, high sugar levels, chronic fatigue, and neurological disorders
- The doctor points out that people who have had COVID-19 require comprehensive care – often many tests and consultations with various specialists
- – Every day I leave work with a few patients “in my head”, go home, open the internet and look for what may be wrong with them, what else I can do, check if I have missed anything – says the expert
- You can find more about the coronavirus on the TvoiLokony home page
Paulina Wójtowicz, MedTvoiLokony: You are the initiator and manager of the program that provides comprehensive diagnostics and rehabilitation to people who have undergone COVID-19 at home. Where did the idea for such an initiative come from?
Dr. Michał Chudzik: We knew from the beginning that after COVID-19 we were dealing with cardiological complications. We also knew that SARS-CoV-2 infection causes more severe disease in people with heart disease and hypertension, and yet it is also affected by people who undergo COVID-19 at home. We were concerned that they might suffer from disturbances in blood pressure regulation.
The difference was that patients who go to hospital after coronavirus infection are often cardiological patients who already have their own clinic and their own cardiologist. On the other hand, the group of home treatments are mostly people who have never been treated. Therefore, it was necessary to create a facility that would give them quick access to cardiological care in the event of complications or other problems after COVID-19.
internist, cardiologist, currently specializing in geriatrics. Lifestyle and anti-aging medicine specialist. Assistant professor at the Medical University of Lodz. Initiator and coordinator of the stop-covid program.
The first patients reported to the clinic in May 2020.
Yes. The very idea of taking care of patients after a home course of COVID-19 arose in March, when the first case of coronavirus infection was reported in Poland. I needed about two months to prepare everything organizationally. We work as part of the National Health Fund and we did not have a dedicated structure for patients after COVID-19. The first condition for starting the program was to eliminate the queue of people waiting for the cardiology clinic where I worked. It was not possible to create a separate list of patients after coronavirus infection and take them out of sequence, which would be against the regulations.
So how did you manage to get everyone in the queue?
My idea was that with good work organization, you can perform quick and effective cardiological diagnostics in a cardiology clinic. And we managed to do it. The waiting time for a consultation is up to a month – and this is a very good time for Polish realities. Within four weeks, I perform all cardiological diagnostics on the patient and I know whether he or she needs treatment in a hospital, at a cardiology clinic or if he or she can return to the family doctor.
What if you need to consult another specialist?
We also envisage this option. Originally, I assumed that I would only look after my patients with cardiology, but when I started talking to them and examining them, I realized that the problem was not only cardiology or pulmonology.
It turned out that this disease is so complex, so multi-symptomatic and multi-organ, with such consequences that we have to build a very large team of different specialists. It is not easy to find a doctor who wants to consult such a number of patients as part of the NHF clinic, in addition to a new disease about which nothing is known, which you need to know, about which you need to read the latest reports from around the world. It’s not like you leave the clinic and the topic disappears. Every day I leave work with a baggage of experience, with a few patients “in my head”, I go home, open the Internet and look for what may be wrong with them, what else I can do, check if I have missed anything. This is medicine for doctors who want to know more, want to learn, analyze and look for dependencies so as not to miss something in the next patient.
How many people are currently in care?
At the moment, we have 1090 people in the program. We are currently doing a fairly thorough reorganization, which will allow us to hire 200-300 new people a month. We assume that we will have 2 this year. new patients.
Can you distinguish any dominant group among them?
Recently, I participated in a nationwide cardiology conference. Colleagues showed data on patients after hospitalization, and I, in turn, presented data on patients after a home course of COVID-19. This is incredible, but it felt like we were talking about two different diseases. They were dominated by men, in our clinic 2/3 of patients are women, which leads to the conclusion that late symptoms of COVID-19 affect women more often.
- See also: “Long covid” most common in middle-aged women. What are the symptoms?
What it comes from?
We ask ourselves a lot of these questions all the time and we are constantly looking for answers. We have recently received an interesting device from the Lodz University of Technology, used so far to assess complications, including diabetes, but also used by athletes, which checks how our vessels can adapt to stress, exertion, and disease.
We started testing COVID-19 patients with it. It turned out that in women, due to a strongly developed emotional factor, these small vessels constrict more easily, cell hypoxia occurs faster, hence, for example, muscular fatigue syndromes occur in them more often than in men.
What other tests are convalescents subjected to?
We have a standard set of tests that we offer to all patients. First, there is a cardiac evaluation and examination of the patient. It may seem normal to auscultate both the heart and lungs of a sick person, but today it is done less and less frequently.
Then we ask patients to fill in a questionnaire on the course of COVID-19 and the discomforts they are currently experiencing. Later, we have a lifestyle and psychological survey that assesses the level of stress, anxiety, but also the risk of depression.
After that, cardiological tests such as EKG, heart echo, pressure Holter and EKG Holter are performed, as well as basic blood tests. If there are suspicions of other disorders, we refer the patient to more advanced tests: cardiac resonance, coronary angiography, pulmonary tomography, Doppler ultrasound, head resonance imaging.
What is good news is that we don’t have any financial constraints, that we can’t do something. The admission limits for cardiology and diagnostic tests have been lifted. Where there is an indication to perform the test, we can do it there.
What does this research show?
It can be said that half of the survivors have cardiac complications and half have neurological complications. The first group includes diseases known for a long time, ie mainly post-inflammatory changes in the heart – we recognize them in 20-30% of patients. sick. In 6-8 percent there is damage to the heart that qualifies for pharmacotherapy. More rarely, there are dangerous arrhythmias or cardiac arrests that would require the implantation of a pacemaker.
Blood pressure regulation is a very big problem – as much as 80 percent. survivors complain of high blood pressure, even people who have not suffered from hypertension so far. Fortunately, we do not see thromboembolic complications as severe as in hospitalized patients.
The second group includes diseases and ailments that have not occurred on such a scale so far: chronic fatigue syndrome and symptoms of brain fog. They resemble the mild syndromes of cognitive disorders that we observe many years before the onset of Alzheimer’s disease or dementia.
Can you somehow delay them?
At the moment, we know about three factors that can postpone the development of these diseases.
The first is low blood pressure, so we try to lower the pressure, prevent it from spikes, because they have a destructive effect on the vessels of the brain.
The second thing is low glucose levels. 30 percent people after COVID-19 have hyperglycemia, which is a huge predisposing factor to dementia.
The third factor is social and professional activation. This is the most difficult thing, because how can you tell a sick person that he or she has to return to professional activity and meet people when we are locked at home and work largely remotely and alone? However, in order for patients to regenerate, they must return to work, to people, to sports and recreational activities. The latter is also a proven factor that delays the onset of dementia symptoms. For example, dance is great, as it forces the brain to think vividly – you have to move, drive, listen to music. We are talking about it because we believe that when we vaccinate a large number of people, we will slowly return to normalcy and we will be able to efficiently implement these preventive measures.
The health of your lungs, liver and kidneys, and the level of vitamins and minerals in your body after coronavirus infection, can be checked by performing blood tests for COVID-19 survivors. You can buy them on Medonet Market at a favorable price.
Information about the «STOP-COVID» program can be found on the website www.stop-covid.pl.
Do you know that…
are biodegradable face masks available? You can buy at Medonet Market
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