Post-Intensive Care Syndrome: What COVID-19 Survivors Could Face after Hospitalization

May 12, 2020recovering

When a COVID-19 survivor leaves the hospital, recovering physically may not be the only feat they’re faced with overcoming. For many patients who have undergone intensive care, studies have shown that there is also a likelihood for cognitive and psychological complications, which can linger for months, or even years.

The health impacts that result from an ICU stay – physical, cognitive, and psychological – all contribute to what is known as post-intensive care syndrome. While there’s currently no clear-cut definition or diagnosis, Dr. Jay Kirkham, Critical Care Pulmonologist at Jefferson Washington Township Hospital, explains that these symptoms are something he’s seen many times throughout his career.

“People have observed health complications post-ICU for years and years,” said Dr. Kirkham. “During the COVID-19 pandemic, this is especially important for us to be aware of, as we see an influx of patients. As caretakers and family members, we need to know how to help them recover.”

A number of stressors may lead to post-intensive care syndrome, but the most prominent risk factors include the intensity of therapy (i.e., the amount of medications/sedatives needed, as well as devices needed, such as a ventilator) and the longevity of care; however, it all depends on the individual.

Common physical complications include critical care myopathy (extreme muscle weakness) and neuropathy (nerve weakness causing numbness/tingling), and for COVID-19 patients specifically, impaired lung function, explains Dr. Kirkham. These are addressed through rehabilitation.

The mental health impacts, unfortunately, aren’t addressed as often as the physical; however, more health experts are starting to understand the extent of emotional trauma that can result from intensive care, as it can be a near-death experience, says Dr. Kirkham.

“Studies show that patients in the ICU can experience some level of delirium, often due to medication. They recount having lucid and frightening dreams,” said Dr. Kirkham. “Recollections of these nightmares, along with pain and fear, can cause anxiety, depression, and even PTSD.”

While the ICU team works diligently to make patients as comfortable as possible to help minimize these effects, proper follow-up is also key, explains Dr. Kirkham. In addition to physical therapy, occupational therapy, and other therapies needed depending on the patient’s condition, psychological care should also be sought. In some cases, family members may suffer similar mental health detriments and could benefit from seeking help as well.

If you have a loved one in the ICU, and they’re conscious and aware enough to do so, it can be beneficial to keep a journal detailing their experiences, thoughts, and emotions, to help them cope after the fact, adds Dr. Kirkham.

Once discharged, patients may feel like they’re in a “daze,” unable to remember and comprehend what they’ve been through. They may also have difficulty concentrating and communicating.

It can take months of rehab for patients to regain around 80 percent of the functionality they had prior to their hospitalization, explains Dr. Kirkham. The first step, for patients and family members alike, is coming to terms with what happened. From there, you can speak to your doctor about finding the right mental or behavioral health professional for you.

Survivors of COVID-19 won’t walk away from the hospital the same as they were upon entering it, and that’s okay, says Dr. Kirkham. “When patients are discharged, I tell family members that this is the start of a marathon, and they just left the starting line. While it may not be an easy road ahead, there are ways we can help support them.”