Role of the Multidisciplinary Team in the Management of the Patient after SARS-COV 2 Severe Infection

ABSTRACT

SARS-COV2 infection is a challenge for the clinician, not only in the acute phase, in which the impairment of the patient's respiratory function can occur and evolve surprisingly quickly, but also in the post-acute phase, when the patient, especially the one who needed support long-term ventilator, requires complex recovery of respiratory, motor, neurological and cardiac functions. We present the case of a 60-year-old patient, diagnosed with a severe form of SARS COV2 infection for which he needed ventilatory support for 20 days, as well as antiviral treatment, systemic corticosteroid, anticoagulant and antibiotic. After 20 days from the first positive RT-PCR test, the patient is considered cured in terms of SARS COV2 infection, but severe respiratory failure requires transfer to the Pulmonology Department of the Marius Nasta Institute for further treatment. Upon admission to the ward, the patient has hypotrophy and hypotonia in the limb muscles, resting dyspnea, bilaterally diminished vesicular murmur, bilateral subcrepitant rales, SaO2 = 72% in aa and rest, 90% with oxygen supplement 8/min. Starting with the 10th day of hospitalization respiratory physiotherapy is initiated. The rehabilitation of the patient is also supported through exercises for the upper limbs with dumbbells, walking with frame support and breathing exercises with incentive spirometers. After 30 days of systemic corticosteroid therapy, anticoagulant treatment and respiratory physiotherapy, the patient was able to make the daily activities, the spirometry reveals a moderate restrictive syndrom;after 60 days the respiratory function was normal. Conclusion: The management of patients after severe SARS-COV 2 infection in order to improve and maintain the quality of life requires a long time care and multidisciplinary team consisting in pulmonologist, respiratory therapist, nurse, cardiology specialist.