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  • Pinay Doctor Explains How A COVID-19 Patient In The ICU Can Still Recover

    Chances of survival are slim, but many have won the battle.
    by Dahl D. Bennett .
Pinay Doctor Explains How A COVID-19 Patient In The ICU Can Still Recover
PHOTO BY Shutterstock/CGN089
  • The Intensive Care Unit (ICU) occupancy in this time of pandemic is a strong indication of how the country is faring in its battle against COVID-19. According to an October 4, 2021 report from Rappler, despite the decline in COVID infections, ICU occupancy was still at a 73% nationally, a trend that has not changed since August when the country imposed a hard lockdown.

    The ICU is the last place anyone with COVID-19 wants to end up in, but more often than not, many patients who are rushed to the hospital for the disease are already in critical condition and only the facilities in an ICU can possibly save them.

    Why some COVID patients are admitted to the ICU

    SmartParenting.com.ph asked internist Dr. Pia Hugo, who has been on the frontlines since the pandemic broke in March 2020, to make us understand the conditions that require a COVID-19 patient to be brought to the ICU and, once, there, what can a patient expect.

    “Even before the pandemic, the ICU is specifically indicated for critical patients needing close monitoring and at least hourly assessment,” explains Dr. Hugo, who is currently under the Post-Residency Deployment Program of the Department of Health (DOH) and is assigned as a Medical Officer at RPHS Antipolo Annex II, which is a COVID hospital.

    Patients who are admitted to the ICU are those who have existing comorbidities and are in need of specific medical care and procedures. They are those who: 

    • Need mechanical ventilators and intubation to support breathing
    • Need high flow nasal cannula device to deliver oxygen better into the lungs
    • Are on inotropic support to stabilize circulation and to optimize oxygen supply
    • Have severely depressed sensorium where the patient cannot think clearly
    • Have severely unstable comorbidities and are at high risk for morbidity and mortality (i.e. acute stroke, suffered heart attacks, or are on insulin drip for uncontrolled diabetes)

    Once admitted in the ICU, a COVID-19 patient will undergo a standard process of being hooked to a cardiac monitor, an automatic BP apparatus, and a pulse oximeter. These devices are only the minimum requirements, points out Dr. Hugo.

    Readings for these devices are displayed on a monitor or telemetry at the nurses’ station and always in view of the duty physician. “This enables us to respond real time to any sudden changes in a patient’s status, like sudden drop of BP, oxygen level or cardiac arrest,” says Dr. Hugo.

    Can a COVID-19 patient in the ICU recover?

    For COVID-19 patients, the most significant marker of recovery for us is really the oxygen requirement of the patient, explains Dr. Hugo. “Once the patient is able to tolerate lower levels of oxygen support, we can prime for discharge or transfer to a regular room.”

    Other factors doctors have to consider are stable vital signs and controlled comorbidities. “Once a patient no longer needs hourly monitoring and assessment, we also consider them as candidates to be transferred out,” she says.

    The unpredictable nature of COVID-19 and how differently individuals are able to respond to the virus makes it hard for those in the medical field to predict recovery time of patients who have been brought to the ICU. Based on her experience, Dr. Hugo says that recovery for most ICU patients can be very low.

    “Once a patient is admitted at the ICU and mechanically ventilated, chances of survival are slim, but there a lot of variables that contribute to this, so it cannot be purely attributed to the disease progression alone,” she points out.

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    Among these variables are the ability of the patient to afford well-equipped hospitals with better life-saving devices and the late stage at which the patient was brought hospital. 

    Long-haul effects of COVID-19

    For those who make a recovery at the ICU, the battle may not be over for some time, according to Dr. Hugo. “Patients could probably still suffer from significant symptoms at the 14th day to as long as 3 to 6 months after admission,” she says. Patients who experience this are often referred to as ‘long haulers.’

    Dr. Hugo also adds that more and more studies are surfacing with regard to the long-lasting effects of COVID-19 in multiple organ systems, not just to the lungs, but also to the heart and kidneys. “By experience, a lot of patients still suffer from easy fatiguability, shortness of breath after exertion and fatigue after recovering from a severe infection.”

    Get vaccinated

    Despite this grim outlook, the COVID-19 vaccine has proven to be the population’s best weapon in avoiding admission to the ICU and to the hospital in general. Even if no vaccine is 100% effective, there is one assuring phenomenon that those in the frontlines like Dr. Hugo can be certain of: Vaccines work.

    “One thing does still remain certain — we have more unvaccinated patients who are diagnosed with critical disease than vaccinated ones,” says Dr. Hugo. “So, we really advocate everyone to be vaccinated, no matter the brand of vaccine,” she concludes.

    Managing COVID at home? Click here for tips from a doctor if you have mild to severe symptoms.

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