On March 16, Wu Jing went for a follow-up at the rehab clinic of Hubei Provincial Hospital of TCM. Her husband kept her company as she walked on a treadmill for six minutes.
By the third minute, her oxygen saturation dropped to 90 percent and her average respiratory rate was 25 breaths per minute. The normal rate of an adult is 12 to 20.
“I was so exhausted that I was panting like mad. It felt like I had just ran an 800-meter race,” Wu said.
But after 15 days of physical rehab, a second walking test did not show any improvement in her endurance.
“The virus has caused lung structure damage, which is very difficult to recover from fully,” Ke Jia, senior pulmonologist at the Hubei Provincial Hospital of TCM, told NewsChina.
“But since the lesions on her lungs are not large, there’s a chance that her lung function would mostly return to normal if she continues with rehab.”
The Shanghai Public Health Clinic Center has discharged 370 Covid-19 patients. The center opened a rehab clinic after its first patient left hospital. Most discharged patients have visited the clinic for follow-up treatment.
Lu Hongzhou, Party Secretary of the Shanghai Public Health Clinic Center, points out that most patients with milder symptoms recover quickly and those with moderate symptoms recover within weeks. However, severe patients, who account for 5 percent of the total, have developed pulmonary fibrosis and could take years to heal.
Besides pulmonary dysfunction, many discharged patients reported changes in their senses of smell and taste and showed abnormal blood glucose levels.
“Normally, we can use medications to restore the patient’s blood glucose levels, but now even after four or more medications, they still don’t work,” Xiao Mingzhong, a physician at the department of infectious diseases, Hubei Provincial Hospital of TCM and head of the hospital’s rehab center, told NewsChina.
“Our solution is to adopt multi-disciplinary treatment - apart from letting our patients undergo rehab treatment, we enlist an endocrinologist to bring their blood glucose levels under control,” Xiao told NewsChina.
Kidney dysfunction is also a common symptom among many Covid-19 patients.
Zheng Xia, an ICU physician at the First Affiliated Hospital of Zhejiang Medical College, was transferred to Wuhan Jinyintan Hospital as part of the Zhejiang medical team on January 23. She returned to Zhejiang on April 3.
During her first days at Wuhan Jinyintan Hospital in January, Zheng found that four out of the six patients in her care showed a conspicuous spike in serum creatinine, an indicator of kidney dysfunction.
In the early phases of the disease, pulmonary dysfunction and metabolic acidosis (acid accumulation in the body) from kidney lesions could be fatal. In later phases, however, many patients recovered from kidney dysfunction with treatments such as hormone therapy.
“But we’re still uncertain whether it is the virus or the lack of oxygen that causes the kidney damage,” she said.
“Our current understanding of Covid-19 is still superficial. There are too many unknowns,” Zheng told NewsChina. “Hormone treatments for Covid-19 patients haven’t been as widely adopted as they were during SARS in 2003. But there are many patients undergoing long-term hormone therapy, the side effects of which still need observation,” she added.