Recovered COVID patients are baffling doctors with complaints of
freak pains, lungs that just won’t get back to normal, and a range of
incapacitating psychological issues.
“What we are seeing is very frightening,” Prof. Gabriel Izbicki
of Jerusalem’s Shaare Zedek Medical Center told The Times of Israel.
“More than half the patients, weeks after testing negative, are still
symptomatic.”
Izbicki is working on a study that involves follow-up with patients
who were in hospitals or coronavirus hotels, looking at the aftereffects
of the virus and trying to understand why patients continue to suffer
long after being confirmed negative. “There is very little research
about the mid-term affect of coronavirus,” he said, adding that it is
much needed to guide doctors.
In Bnei Brak, at Israel’s first community clinic, doctors have been
seeing a spike in recent days in the patients with pains that appear to
come from nowhere.
“It can appear in the arms, legs, or other places where the virus
doesn’t have a direct impact, and if you ask about the pain level on a 1
to 10 scale, can be 10, with people saying they can’t get to sleep,”
said Eran Schenker, director of the month-old clinic in Bnei Brak run by
Maccabi Healthcare Services. “It’s something which we’re starting to
see much more in the last week.”
Man coughing (iStock)
‘Broken’ by the virus
A patient from the clinic spoke to The Times of Israel on condition
that her name is not published. She was diagnosed in March and tested
negative a month ago. But the woman, a Bnei Brak resident in her 40s,
still has severe fatigue and anxiety, and can only walk for a few
minutes at a time.
Her husband, who also caught
coronavirus in March and tested negative last month, now “feels like
he’s broken,” she said. “He’s actually worse than he was when he was
hospitalized.”
Her
husband, 55, had some health problems before contracting coronavirus in
March, but was active “from morning until night,” with plenty of
energy. He is now extremely lethargic, can hardly walk, and has heart
problems, she said.
This came as a particular shock to the
family, as during his initial hospitalization in March and early April
he did not require oxygen and X-rays showed no damage to his lungs. He
was hospitalized again during April with pneumonia-like symptoms, and
declared negative in May. But the man then developed pains and
significant breathing problems, and has seen cardiologists, neurology
experts, rehabilitation teams, and other professionals at the clinic.
This man was “one of the hard cases, but he’s not the worst and we have patients who suffer more,” according to Schenker.
He said that with all illnesses patients
can be left reeling from long hospitalizations, and ventilators use can
slow full recuperation — but COVID-19 is causing patterns that are not
usually seen.
“We’re amazed that people aren’t just
suffering from the things we expected, but things we just weren’t aware
would have relevance,” he told The Times of Israel. “It’s not textbook.”
He stressed that his patients are not all
newly recovered. “Some of them had coronavirus in March, so they may
have been recovered for months,” he said.
Gabriel Izbicki, head of the Pulmonary Institute at Jerusalem’s Shaare Zedek Medical Center (Shaare Zedek Medical Center)
Izbicki, director of Shaare Zedek’s Pulmonary Institute, also
emphasized that many of his patients have long been declared
coronavirus-free. One of the biggest surprises, he said, is that there
is no predicting which patients will find the disease hard to shake, and
which will not.
“There is no correlation between seriousness of disease during
hospitalization and extent of symptoms afterwards,” he said, discussing
preliminary results from his study on recovered patients who were
treated in hospitals and coronavirus hotels.
“Within the symptoms that we checked for, we revealed general
weakness among the majority of patients alongside shortness of breath,
sustained cough, and other complex breathing and pulmonary issues,” he
said, adding that he is also familiar with the freak pains that Schenker
discussed.
These pains — seen in young patients and old
alike — have doctors scratching their heads. Schenker said:
“Painkillers block the pain but don’t relieve the source, but we don’t
know how to address the source and you can’t be on painkillers the rest
of your life.”
While the pains are excruciating for some,
others describe the pains more as a major discomfort: burning
sensations, tingling, or just a hard-to-place sense that a limb does not
feel normal.
The patients with these pains do not
normally raise red flags during the main medical examinations. Schenker
said: “We check their lung and hearts and they have no disease, and they
have no neurological issues. We do scans and can’t see anything, but
they have this pain — we’re told about it again and again.”
Dan Oyero, deputy director of medicine in
central Israel for Maccabi Healthcare Services (courtesy of Maccabi
Healthcare Services)
Dan Oyero, Maccabi’s deputy director of medicine in central Israel,
said that the overarching issue doctors are dealing with is the
far-reaching change in people’s lives, for which doctors cannot predict
an end point.
“The most distressing thing is that people compare how they feel now
compared to how they were a few weeks ago before they were infected,” he
said. “And they say they just can’t do the things they used to do.”
The sense of taste and smell, lost during the illness, sometimes does
not return. When patients ask if it will come back, given that doctors
have such limited experience of the disease, they cannot give a clear
answer. “We just don’t know,” said Oyero.
When doctors can invoke a precedent from other illnesses, it can be bad news.
Elderly patients who were badly stricken by
the coronavirus, even if they had no previous respiratory issues, can
find their lungs working at half capacity, long after testing negative,
said Schenker.
Eran Schenker, director of the clinic for
recovered COVID patients in Bnei Brak run by Maccabi Healthcare
Services (courtesy of Maccabi Healthcare Services)
“They have two lungs, but they are the equivalent of one, because
each lung is working at 50% — and it could be like this for the rest of
their lives,” he said. He draws this conclusion from the pattern of lung
damage that is seen from some other diseases — but normally only
affecting patients who had previous lung complications.
“The damage was not done by the virus, but by an inflammation process
which, we know from other diseases, will not leave lungs with the
capacity to exchange oxygen as before,” Schenker commented.
Izbicki said that in his experience, COVID-related lung damage can
affect patients of all ages, and said he shares the concern that people
will not regain full lung performance. “We don’t know if the lung
function tests will become normal,” he said.
Some patients require physical therapy. Schenker said: “We’ve seen
cases of weight loss that have been so extreme that people find it hard
to walk.” Meanwhile, some who are physically able to move around just
don’t have the energy or motivation to do so.
A recovered coronavirus patient sees a
cardiologist at the special clinic in Bnei Brak run by Maccabi
Healthcare Services (courtesy of Maccabi Healthcare Services)
Some of these patients are young and normally energetic, Schenker said.
“It’s amazing how many people went back to work — they can be
educators, lawyers and in other professions — but when they sit for an
hour they feel anxiety, feel insecure, and sometimes the people suffer
from depression beyond what we expected.”
Oyero said:“The main complaints are actually
fatigue, compacts [intense periods] of low energy — nothing we can give
a name to. Many people say that they don’t have the energy they had
before. They are more tired. Some say they don’t have the drive to do
things. We can’t give the complaints a name or tell them they have a
particular syndrome, but we’re trying to help them.”
