When patients are discharged from the hospital after being treated for COVID-19, the recovery usually is far from over. Some are diagnosed with Post Intensive Care Syndrome, also known as PICS. It is a condition separate from the illness that causes that patient to be in the ICU.
The symptoms can be physical and emotional and are caused by the intensive level of care they received. For COVID patients, the isolation from family is hard mentally and the treatments, like being placed on a ventilator, take a physical toll.
“These patients when they leave the intensive care unit can have organ dysfunction, changing in their heart, their kidneys, their liver, they can have bed sores from being in bed for a long period of time, even with excellent medical care,” explained Leslie Schlachter, Physician Assistant and Chief Advanced Practice Provider at the Department of Neurosurgery at Mount Sinai Health Systems.
“But sometimes what people don’t realize is the emotional, cognitive, behavioral changes these patients have from having a very traumatic experience,” she explained.
Schlachter works with the Critical Care Resilience Program at Mount Sinai. It was formed before the coronavirus crisis and became an important part of patient care since March, Schlachter explained. The team includes nurses, nurse practitioners, physician assistants, and spiritual counselors. They follow up with every patient who stays in the ICU for more than seven days after discharge. There is a weekly phone call to make sure the patient is adjusting at home and the patient also has a follow up telehealth appointment with a doctor about a month after discharge.
Schlachter said sometimes the patients don’t remember their hospital stay at all because they were unconscious.
“A lot of us have to explain what is COVID, what happened to them,” explained Schlachter. “We have to walk through the medicines they were prescribed because maybe now they have high blood pressure or kidney disease,” she said.
Other patients are recovering alone at home, managing new routines like use of an oxygen tank or walker.
Maritza Plasencia was hospitalized for nearly a month in her battle against the coronavirus. She was in the ICU on a ventilator for part of that time. Now at home with her daughter, Plasencia says the follow up calls have helped her manage anxiety.
“I don’t want to sleep at night because I was scared to fall asleep and not wake up,” Plasencia said.
“They told me to think of better things, and write it down, and speak with people about what happened with me. It made me realize that I’m not alone. It’s not only me; it’s not only me that thinks that way. The people that had that experience, they have those feelings,” she said.
Schlachter said people caring for a discharged COVID patient at home should encourage conversation about how they are doing physically and emotionally. For those who need assistance, the caregiver should follow up with the hospital.