ABSTRACT
Human beings prefer a predictable and certain environment over an unpredictable and uncertain environment. No one predicted the coronavirus pandemic and it is not certain when the pandemic will come to an end. Pandemics not only affect the physical health but also the mental health of the public. An increase in anxiety and suicide rates has been reported during the previous pandemics and the same trend is also being observed in this current pandemic as well. Pandemics inevitably result in unpredictable and uncertain environments. Many studies have proven that unpredictability and uncertainty increase the levels of stress and anxiety in animals and humans. Coronavirus pandemic has caused many unpredictable and uncertain events resulting in increased confusion, frustration, stress and anxiety among the public. For instance, the institution of lockdowns was unpredictable and it was uncertain when the lockdowns will be unlocked. Similarly, events that unfolded around the initial touting of chloroquine and hydroxychloroquine as a possible therapeutic agent and later lack of evidence in support of these drugs resulted in extreme confusion and frustration. The uncertainty around if a vaccine for coronavirus will be developed and when it will become available for public use has also caused stress and anxiety. Current studies indicate that coronavirus is not just a respiratory virus but it also affects the kidneys, brain, heart and blood vessels. This unpredictable nature of the virus has caused further confusion and frustration. These unpredictable and uncertain events around the current pandemic might have increased the levels of stress and anxiety among the public.
ABSTRACT
Introduction: A significant proportion of patients who had COVID-19 have experienced symptoms persisting even weeks after recovery from the acute phase of infection. For some patients the symptoms were mild but few have experienced moderate to severe symptoms hampering their daily routine. Studies to know the long term effects of COVID-19 are needed to effectively plan healthcare delivery. Aim: To know the persistent symptoms in patients who were discharged from a dedicated COVIDhospital's intensive care unit (ICU). Materials and Methods: In this cohort studyfour hundred and forty six patients with laboratory confirmed COVID 19, who were treated and discharged from intensive care unit(ICU) between April 2019 to Nov 2019 were included. The telephonic survey was done four times in three months after being discharged. First follow up was on the15th day of discharge, second on the first month of discharge, third follow up on the second month of discharge and the fourth at the end of third month. Patients were asked to retrospectively recollect the symptoms which were present during the acute phase of the disease and if those symptoms or any new symptoms are present now. Results: Tiredness(fatigue), dyspnea, cough and chest pain were the common symptoms observed. Among 446 patients followed up, 37.4% had no symptoms at the first follow up and 87% were symptom free by the end of third month. 26.09% complained of tiredness at the 15th day of discharge, but only 4.4% of them complained of this symptom at the end of third month. Dyspnea was seen in 21.5% of patients in the first follow up and by the end of third month none of them had dyspnea. There was a gradual decline in number of patients having cough from 19.5% in the first follow up to 0.24% in the last follow up. Chest pain was seen in 7% of the patients on the 15th day of discharge and was seen only in 0.24% of them at the end of third month. Out of 446 patients followed up for a period of three months we observed a mortality of 6.27%. Conclusion: Patients experience persistent symptoms even after recovering from COVID 19infection and getting discharged from intensive care unit. There is a need for follow up and assessment of discharged patients to know to what extent these symptoms have affected them physically and mentally.