More than 1,900 coronavirus patients are currently lying in hospital beds in LA County. More than 500 of them are in the intensive care unit.
Their family members and friends are hoping and praying they’ll survive. But surviving is only the first step. After leaving the ICU, many seriously ill COVID-19 patients begin a long, difficult path to recovery.
“I think of critical illness as a war that your body is waging against,” says Dr. Isabel Pedraza, the director of Cedars-Sinai’s Medical Intensive Care Unit. “You have survived, thankfully. But you can be left with a lot of residual effects of fighting that battle.”
Within days of being in the ICU, she says patients can start to dissolve muscle and become incredibly weak. The longer someone stays in the ICU and the more severe their disease is, the more likely they’ll have trouble with daily activities after getting discharged.
“This can be things as mundane as getting dressed in the morning, being able to shower, being able to feed oneself, being able to swallow. All these things can be affected,” says Pedraza. “This can often take a year or sometimes years to recover fully, if at all.”
Some patients are left with permanent muscular deficits. In addition, they can develop problems with mental processing speed.
“They'll have difficulty driving, going shopping, cooking for themselves, being able to manage medications, being able to manage their finances. ... Things that they were doing in their work can be very difficult because of this cognitive impairment that they're left with,” she says.
On top of all that, Pedraza says a significant portion of ICU patients develop PTSD.
“In studies looking at critically ill patients, the incidence of PTSD is on par with that of combat veterans,” she says. “We're worried about this with COVID-19 patients because this virus may affect the brain in ways that we don't yet understand, and that may lead both to worsening cognition as well as worsening PTSD, anxiety, and depression.”
People with certain chronic conditions like diabetes, coronary artery disease, hypertension, and obesity are more at risk of ending up in the ICU and taking longer to recover.
Pedraza says staying at home as much as possible and wearing a mask when you’re around others can prevent debilitating consequences for not just the person who contracts the virus, but the family members tasked with caring for them afterward.
“It doesn't just affect the patient. It affects the caregiver. They are having to often give up jobs. There's financial stress. And there's a higher risk of depression in caregivers. Wearing a mask seems like a relatively small price to pay to protect others or even yourself from a lifetime of problems, disability, and impairment.”