The sequelae of COVID-19 are becoming a hidden pain for some discharged patients. During the recovery process, my mother suffered from diarrhea, abdominal distension, and lost weight to a handful of bones. My father also had headaches and felt weak from time to time.

Introduction

The sequelae of COVID-19 are becoming a secret pain for some discharged patients.

Source: "Eight Points News" WeChat public account

Special author: Xie Haitao

html On June 25, the Dragon Boat Festival, Li Hua (pseudonym) took his parents out to play.

Amidst the green mountains and green waters, the family picked mugwort and admired the ancient ruins. The parents, who are nearly seventy years old, are as happy as children.

A few days ago, my mother was still crying. She wanted to go back to her hometown no matter what, and did not want to stay in Wuhan. Li Hua tried to persuade her for a long time, feeling very uncomfortable. It was not easy for my parents either. Both of them were infected with COVID-19 at the end of January and were hospitalized for several months. During the recovery process, my mother suffered from diarrhea and bloating, and was reduced to a bone. My father also had headaches from time to time and felt weak.

Li Hua has invited many doctors to treat his mother, but the effect has not been obvious. His mother lost control of her emotions several times, and Li Hua was very heartbroken. lamented that modern medicine is powerless to deal with some of the sequelae of COVID-19. As a doctor in a tertiary hospital, there is almost nothing he can do.

A doctor in Wuhan told 8:00 News that the new coronavirus is known as a "perfect" virus. It attacks a very wide range, from the brain nerves to all tissues and organs in the body. The official account of Beijing Ditan Hospital once announced that patients with COVID-19 may suffer from multiple organ damage such as ARDS, myocardial damage, abnormal coagulation function, kidney damage, and liver damage. Some COVID-19 patients will inevitably experience sequelae during their recovery, depending on the severity of the disease and the location of the infection.

html On March 4, in order to improve the respiratory function, physical function, psychological function, daily living activity ability and social participation ability of patients discharged from COVID-19, the National Health Commission organized experts to formulate guidelines on rehabilitation operation techniques and procedures, and further promote their full recovery. The "Rehabilitation Plan for Patients Discharged from COVID-19 (Trial)" was formulated.

As the number of discharged patients with COVID-19 gradually increases, the multi-level and multi-type rehabilitation medical needs of discharged patients have become increasingly prominent. In order to further strengthen the rehabilitation treatment of major functional impairments in discharged patients, on May 13, the National Health Commission, the Ministry of Civil Affairs and other four departments jointly formulated the "Rehabilitation Treatment Plan for Main Functional Disorders in Discharged Patients with COVID-19".

Currently, there are few reports on the sequelae of discharged patients with COVID-19 in China. For fear of being discriminated against or for privacy reasons, some patients hide their COVID-19 medical history and are even more secretive about the sequelae of COVID-19. There are also some patients and family members who do not know enough about the sequelae of COVID-19. Eight O'clock News has called dozens of critically ill patients or their family members, and a considerable number of them said that they or their family members had no sequelae.

A clinic doctor once served as a medical volunteer and participated in the care of COVID-19 patients at the rehabilitation station. After the patients left the station, many people still kept in contact with him and conducted medical consultations from time to time. He told 8:00 News that some patients still have sequelae, but he refused to disclose more detailed information.

The sequelae of COVID-19 are becoming a secret pain for some discharged patients.

April 4, a community in Wuhan. The pictures in this article were all taken by Xie Haitao.

Weird abdominal distension

Li Hua’s mother is 65 years old. When she was infected with the new coronavirus, her illness was mild, but her symptoms were very weird.

htmlOn November 26, she suspected that she had a neurological problem. Her whole body was numb, she was sweating, and her body was wrinkled. A CT examination was performed on January 31 and it was found that there was inflammation in the lungs. He was admitted to the hospital on February 2. During 's illness, his body temperature was normal, but he had diarrhea and abdominal distension.

html When I got home in early April, my mother still had diarrhea. Li Hua consulted a traditional Chinese medicine doctor and prescribed prescriptions to improve his immunity. The prescription contains ginseng slices, the amount is not large. After taking it for a week, the diarrhea stopped and became bloating and constipation instead.

My mother has severe abdominal bloating. She will become bloated after eating and cannot be relieved by taking a walk. "Seeing her stomach growling and bulging, she felt uncomfortable holding it in. She thought she was sick again, so she became very nervous." My mother massaged her abdomen upwards. Within a few days, her entire mouth smelled bad and her tongue was coated so thickly that she didn’t even dare to take off the mask.

The mother did not dare to eat. Li Hua asked her daughter to supervise her eating. The daughter was only 9 years old and said that she could not control her grandma because she was afraid that she would feel uncomfortable after eating.My mother is very picky about what she eats. Li Hua said, you can eat whatever we can eat, and we can take care of the bloating slowly.

Mom can eat breaded steamed buns, but only a little. Li Hua asked her to drink porridge, "try to make it thinner, easier to digest, more nutritious and with more protein content."

A colleague told Li Hua that he could not give his mother milk but milk powder. Li Hua bought high-protein milk powder and made two spoonfuls of it. After drinking it, his mother said that the milk had increased again. The belly rose up little by little. "When it swells, you can see the shape of the stomach." After the belly swelled and the chest was squeezed, the mother felt suffocated and even had trouble breathing. She panicked. Li Hua quickly massaged her abdomen.

A colleague said that eat small meals frequently, preferably five or six meals a day. So, my mother ate six meals a day, a little each time, and exercised more, but she still had bloating.

Starting from April 12, Li Hua gave his mother the traditional Chinese medicine rhubarb to help with exhaust. Rhubarb can purge heat and relieve constipation, cool blood and detoxify. It is often used to treat constipation due to excess heat and abdominal pain due to stagnation. Ordinary people take rhubarb, one bag a day, but my mother gets two or three bags, and she eats it whenever she feels bloated. I took rhubarb for more than two months and spent more than 6,000 yuan.

Colleagues told Li Hua that rhubarb is toxic and should not be eaten in large quantities. Li Hua gradually reduced the dosage for his mother, asking her to go out for walks more during the day to maintain a good mood, and take a bag of rhubarb to sleep at night.

In addition to abdominal distension, my mother is also constipated. When the condition is severe, glycerin enema may also be used. Li Hua bought glycerin and a syringe from the hospital. He would usually get home from get off work at six or seven in the evening. After his mother had finished her sixth meal, he would give her an enema, draw out the glycerin with a syringe, and push it in. She took the medicine and went to sleep.

html At the end of June, Li Hua took his mother to the hospital for a check-up. The doctor said that she should no longer take rhubarb or enema, as this would make her dependent on herself. In early July, Li Hua asked his mother to stop taking rhubarb, but she was still taking it secretly.

did not find anything during this inspection. The doctor said that the gastrointestinal tract is controlled by the sympathetic nervous system. My mother’s symptoms were caused by sympathetic nervous system disorder. The new coronavirus attacked the nervous system and affected a number of peripheral nerve functions. Li Hua recalled that when her mother first became ill, her whole body felt tight, which was a sign of autonomic nerve disorder.

html From January to early July, my mother’s abdominal distension was relieving, but it still appeared from time to time. During the day, it would be better to go for a walk. In the middle of the night, I would sometimes feel bloated, so I would rub my belly and take some Dingzhu and Huoxiang Zhengqi Pills.

After several months of hard work, the 1.7-meter-tall mother's weight shrank from 120 kilograms to more than 90 kilograms, and she became a skeleton.

April 8 is the day some patients leave the rehabilitation station.

Regular headaches

Compared with mother, father’s recovery condition is better.

Dad was found to have lung inflammation during a CT examination on January 31. I was hospitalized on February 2 and complained of headaches. By March 5, Dad had a headache that made him want to hit the wall and could not breathe, so he was transferred to the intensive care unit.

htmlOn March 8, my father suddenly became critically ill. His normal body temperature reached 37.8℃ and he had difficulty breathing. The examination revealed that he had diffuse infiltrative lesions in both lungs, which turned into white lungs. His immune system was almost destroyed, and his lymphocyte subpopulations were reduced across the board. The doctor gave him high-dose hormone shock, albumin, chloroquine phosphate and other drugs, and it took two days for him to be in danger.

When I got home on April 12, my father still had a headache. It usually hurt in the afternoon and evening, and he was so painful that he dared not sleep.

In Li Hua’s impression, his father had never had any head injuries and was always in good health. However, his head was mainly attacked by the virus. He used to have pain all day long. “It was like an explosion, from the inside to the outside. The pain is radiating, and it hurts even when I touch my scalp.”

When my father was seriously ill, Beijing Ditan Hospital detected the new coronavirus in the cerebrospinal fluid of COVID-19 patients, confirming that the new coronavirus can attack the brain. My father then underwent a head MRI, but no problem was found.

In the new coronavirus epidemic, patients whose brains are attacked are not alone.

Dr. Fu, a retired doctor in Wuhan, said that when she was infected, although the CT scan of her lungs was a little bad, she did not feel respiratory distress, but just felt a bit blocked. Her discomfort was in her gastrointestinal and head areas.For 10 days, she felt like vomiting, couldn't eat, her legs were weak, and later she had a headache. "It was like a hole was drilled into her head, lead was filled in the hole, and there was a tightening spell on the outside. It hurt like hell."

When Dr. Fu was young, he was constructing water conservancy projects in the countryside and contracted cerebrospinal meningitis. He was later cured in the county hospital. She felt that the attack of the new coronavirus focused on her head and gastrointestinal tract. Fortunately, she no longer had headaches after being discharged from the hospital.

The headaches experienced by COVID-19 patients once led researchers to focus on the attack of the COVID-19 on the nervous system.

According to China Business News, in early March, Hu Bo’s team, director of the Department of Neurology at Union Hospital Affiliated to Huazhong University of Science and Technology, conducted a neurological study on patients hospitalized with COVID-19 and found that more than 30% of the 214 patients had neurological symptoms, with three specific manifestations: Category: first, central nervous system symptoms such as headache, dizziness, disturbance of consciousness, acute cerebrovascular disease, epilepsy, etc.; second, peripheral nervous system symptoms such as loss of taste, loss of smell, loss of appetite, neuralgia, etc.; third, skeletal muscle injury.

Dad couldn’t sleep at night because of his headache. In the past, he was physically strong and liked to do physical work, tending the vegetable garden, digging in the ground, and would fall asleep quickly.

When he was hospitalized, like many COVID-19 patients, my father had been taking sleeping pills, and so had my mother. After he was discharged from the hospital, he couldn't live without sleeping pills. Sleeping pills have an analgesic effect. After Dad took them, his headache was gone and he could fall asleep.

After the Wuhan community was liberalized, Li Hua often took his father out. Dad went out for a walk and felt better. He was tired at night and fell asleep. The next day, I asked him again if he had a headache. He said it didn't seem to hurt.

html From January to early July, my father said that he no longer had headaches in the past week.

"If you work harder, you will be tired"

Dad gradually returned to normal, but he still felt tired from time to time.

He took off the small bicycle his granddaughter was riding, and went to a bicycle repair stall on the street to inflate it. The stall owner inflated it. He pressed the valve core, supported the bicycle, and occasionally put in some effort, but he was out of breath.

When I went to a scenic spot, after climbing a few stairs, I felt out of breath and very short of breath. Mom also gets tired easily. Li Hua believes that this is related to their immunity being attacked and not fully recovered.

Li Hua said that when many elderly patients get sick, their immune cells drop to a very low level and they do not recognize foreign viruses and do not form antibodies. When my father was seriously ill, his immunity collapsed and all immune cells were reduced across the board. Li Hua once suspected that he had AIDS, but later he learned that the new coronavirus has the characteristics of both AIDS and SARS, and it itself destroys immunity. The recovery of immunity takes some time, depending on the age of the patient and the degree of attack.

Eight Points News learned that fatigue is quite common among COVID-19 patients during their recovery process.

In the "Rehabilitation Treatment Plan for Main Functional Disorders of Patients Discharged from COVID-19", the National Health Commission mentioned physical dysfunction, which mainly manifests as general weakness, easy fatigue, muscle soreness, and some may be accompanied by muscle atrophy, decreased muscle strength, etc. It is more common in critically ill and severe patients who are discharged from hospital. It is a secondary physical dysfunction caused by long-term bed rest and immobilization.

Mr. Liu, who lives in Ganghua Street, Qingshan District, has been home for more than two months and still feels weak from time to time. Mr. Liu, 67, became ill in February with dry cough, fatigue, chest tightness and shortness of breath, no fever, and both lungs were infected. He was admitted to Leishenshan Hospital on February 14 and returned home in early April. By the end of June, he felt that his recovery was generally okay, but his knee joints often felt weak, his legs and feet were not as strong, and he would sweat even if he moved a little. Experts from a nearby hospital organized rehabilitation exercises, and he practiced Baduanjin and felt better.

Ms. Chen from Minquan Street, Jianghan District has been home for more than three months and often feels tired. Ms. Chen, 59 years old, suffers from high blood pressure. She was hospitalized with COVID-19 on February 5 and returned home on March 12. She felt that her back was sore when doing some housework. When she went to bed at night, her waist was always sore and she seemed tired. My sleep is not as good as before, I wake up two or three times a night.

Mr. Zhang from Tongfu Community in Jiang'an District is over 60 years old. He used to be a veteran. His health is not bad and he has to exercise every day. He can also take care of his 7-year-old grandson and cook. But when he returned home after being discharged from the hospital in March, if he works a little harder, If you feel tired, you should take oxygen once every day before going to bed to relieve fatigue.

March 25, Wuhan Tongji Hospital. During the epidemic, many patients' lives were saved here, but some of them still have to face the sequelae.

Pulmonary fibrosis

The headaches have subsided, and my father's mental state has improved. The doctor who treats him often calls and says, old man, nothing is wrong with you.

Dad thought he was better, and he spoke with great enthusiasm. Sometimes he joked with Li Hua, saying that this time he was sick, and he ate more than before.

Li Hua did not dare to tell his father that in fact he still had sequelae. His father was a seriously ill patient. When he was about to be discharged from the hospital, Li Hua learned about the fibrosis in his lungs. "The space between the alveoli and the alveoli is filled with fibrous tissue. When you inhale air, it cannot expand; when you want to exhale, it cannot compress and loses its elasticity."

My mother’s illness is mild, and her lungs also have a little fibrosis. Her mother had been inhaling oxygen since she was sick. After returning home, Li Hua was worried that her lungs had not recovered well, so he kept her on oxygen for a while. However, long-term oxygen inhalation will not easily restore its own functions, and will also aggravate pulmonary fibrosis, so it is stopped.

Li Hua said that if pulmonary fibrosis is a localized lesion, it is considered cured and becomes a scar there. If fibrosis occurs on a large scale, it will affect the function. There is no treatment for pulmonary fibrosis. It can only be temporarily relieved to slow down its progression.

According to Li Hua’s understanding, during the SARS epidemic, some patients had pulmonary fibrosis. This time around, some severely ill elderly patients with COVID-19 also have fibrosis in their lungs, which can be seen through CT images.

According to Guangming Daily, Wang Guiqiang, director of the Department of Infectious Diseases at Peking University First Hospital, pointed out at the press conference of the Joint Prevention and Control Mechanism of the State Council on April 21 that from the perspective of the cause of pulmonary fibrosis, chronic injury is more likely to lead to pulmonary fibrosis, and COVID-19 It is an acute viral infectious disease with a short course and a low probability of pulmonary fibrosis. Most patients with mild symptoms will not develop pulmonary fibrosis.

"However, severe and critically ill patients may develop pulmonary fibrosis." Wang Guiqiang said that new coronavirus pneumonia causes serious damage to the lungs, with obvious inflammation and damage. There is repair after inflammatory damage, and the repair process is the stage of fibrous tissue proliferation. Repair and fibroplasia is a dynamic process, and if the condition is not severe, it may be absorbed quickly. But in severe cases, some fibrosis may remain. "It can be seen from the autopsy of the patients who died that there were some signs of consolidation and fibrosis."

html When Mr. Fan from Hongshan District was discharged from Wuhan No. 3 Hospital in March, the doctor told him that it would take a long time. " Even within a year or two, the lungs will be like normal people.

htmlIn December, Mr. Fan suffered from fever for more than ten days, cough, chills, and fatigue. He was first isolated in a hotel, reported to the community many times, and tried various methods before he was admitted to the hospital. After being discharged from the hospital, he felt well, did not cough, and walked for an hour every night. When you feel tired, take a nap at noon and get used to it.

html applied for resumption of work in May, and his employer arranged for him to undergo an examination. After a CT examination, the doctor said that his lungs had not fully absorbed the disease. The employer is a large state-owned enterprise and does not allow him to resume work. Mr. Fan had no choice but to stay at home. He found that the neighbors and former friends in the community no longer interacted with his family. Some people even told him that if he gets COVID-19, he will not be able to have contact with him for two years.

Mr. Fan doesn’t know where the above information comes from. They are circulated in WeChat groups. Although medical experts have not said this, his friends basically do not interact with him. All this makes Mr. Fan worried, "Will our infected people relapse in the future?"

Mr. Zhang from Tongfu Community in Jiang'an District also found that his lungs have not fully recovered during the examination. In the impression of his son, Mr. Zhang, his father started to have a high fever and difficulty breathing on January 26. During the infusion treatment at Wuhan Central Hospital on February 3, he suffered from tremors and coma. He was hospitalized and returned home in March.Mr. Zhang felt that his father was in his 60s, had underlying diseases, and had generally recovered well. His lung function was fine before, but after he came back he had asthma, chest tightness, and lung damage. My father goes to the hospital one or two days a week for some examinations and various rehabilitation treatments. My mother is also a patient, her recovery is slightly better, and she also suffers from chest tightness.

Ms. Xiang from Heping Street, Hongshan District, felt at the end of June that her "resistance was quite poor and she kept having a cough." When she became ill in February, she had "viral infection in both lungs and fibrosis in both lower lungs" and was a mild patient.

Mr. He from Jiang'an District, 68 years old, originally had basic diseases such as "three highs", but he had no symptoms in the lungs and was seriously ill when infected. He was admitted to Wuhan No. 1 Hospital in early February and returned home in late May. By late June, he was still often out of breath, fatigued and coughing. In about half a month, I will go to the hospital for a checkup.

In a report by Guangming Daily, Wang Guiqiang said that in response to the problem of pulmonary fibrosis in patients with new coronavirus pneumonia, the National Health Commission has issued relevant regulations requiring good health management of discharged patients. After patients are discharged from the hospital, they should be intervened through rehabilitation methods to avoid the occurrence and development of pulmonary fibrosis, and long-term follow-up of severe and critically ill patients should be carried out. Wang Guiqiang explained that the development of pulmonary fibrosis does not occur in a short period of time. It may not appear until one month, two months or even longer after discharge. Therefore, long-term follow-up is required to observe possible problems and intervene in a timely manner.

The attacked heart

html In late June, Li Hua took his mother for a magnetic resonance imaging and found that the new coronavirus had also attacked her heart. Although her heart function had recovered, she could not feel any abnormalities. From the CT images, her heart had morphological changes, and the outer layer of the myocardium became fatty.

When a mother is sick, she behaves strangely, with numbness and tightening all over her body. This symptom can also be caused when the nerves and heart are attacked. Li Hua believed that his mother's symptoms were caused by an attack on her heart.

Low potassium in the heart can also cause general numbness. Li Hua gave his mother potassium supplements for a period of time. The use of potassium is particularly strict. A slight overdose can cause sudden death. Li Hua first gave his mother potassium supplements under the guidance of a professional doctor, and then asked her to eat oranges to supplement potassium. Oranges are high in potassium. You can get potassium from food and it is not easy to overdose.

According to a report compiled by China Youth Daily, a small study published in the Journal of the American Medical Association Cardiology showed that more than one-fifth of the new coronavirus patients in Wuhan suffered heart damage, and some of them did not have a heart. Medical history.

Cardiology experts believe that the following conditions may cause damage to the patient's heart: it is difficult for the heart to pump blood when there is a lack of oxygen; the virus invades heart cells; the human body causes an immune storm in the process of trying to eliminate the virus, causing myocardial damage.

Dr. Mohammed Maijid, an assistant professor at McGovern Medical School at the University of Texas Health Science Center at Houston, said the new coronavirus is more likely to cause heart damage than other viruses. Erin Mizios, deputy director of preventive cardiology at the Johns Hopkins University School of Medicine, pointed out that the new coronavirus attacks organs, including the heart, "which is more likely to occur in severely ill patients."

Promotional materials for smell, taste and brain cognitive function examinations carried out by a hospital in Wuhan for discharged patients.

Hearing, smell, taste, and temperature sensations were impaired

In addition, after his mother came home, Li Hua found that her various senses were very dull.

Before, my mother had very good hearing and vision, but now I have to say several words to her before she can hear her. I have to shout loudly, and even if she hears it, I don’t know what it means. It was a very simple thing. After talking about it for a long time, she said, "Ah, what did you say?"

's memory also declined. His hands sometimes shook and his mouth twitched subconsciously, as if he was suffering from the sequelae of a cerebral infarction.

Sometimes she is busy in the kitchen alone, talking to herself, saying various things, her voice is quite loud, as if she is chatting with others, which was not the case before.

Sometimes what she said was related to life, sometimes not. One day, Li Hua heard her say, "Look at this land, it's like this, why don't you dig it up?"

As soon as Li Hua entered the kitchen, she stopped talking. Li Hua asked, Mom, what did you say? She said I didn't speak.

Li Hua judged that this was a problem with his mother's nervous system. If he were not a doctor, he would probably wonder if his mother was mentally disturbed? In fact, she didn't. Many elderly people will have this symptom, but their family members often don't understand it and think that the above symptoms are caused by aging and do not think that they are related to the nervous system.

Li Hua remembered that his mother had bloating and diarrhea when she was hospitalized. She said it was stomachache. Li Hua thought she had caught a cold, so he asked a colleague from the traditional Chinese medicine department for moxibustion. Apply to uncomfortable areas. At 7 o'clock in the evening, my mother was watching TV and doing moxibustion, which caused a big blister on her body.

Li Hua asked his mother, if it’s so uncomfortable, wouldn’t you move it away? Mom said, I don’t feel anything.

A normal person, with hearing and vision, wearing long clothes and long sleeves, carrying moxibustion in a thick purse, how could he get blisters from burning through the clothes? How come you don't feel anything? Li Hua felt strange at the time.

COVID-19 patients are not alone in their inability to feel temperature. During the examination of discharged COVID-19 patients at a hospital in Wuhan since April, staff found that some patients did not know how to boil the water when drinking it, causing bubbles to form on the oral mucosa.

This examination is used to check the sense of smell, taste and brain perception of discharged patients.

html In March, among some COVID-19 patients in Europe and the United States, many suddenly lost their sense of taste and smell, which attracted the attention of countries around the world.

According to The Paper, on March 21, Hopkins, chairman of the British Rhinological Society, and Kumar, chairman of the British Association of Otolaryngology (ENT UK), issued a document on the official website of the association stating that there is new evidence that loss of smell is a cause of the new coronavirus. One of the symptoms of infection. The

article stated that evidence from South Korea, China and Italy shows that a considerable number of COVID-19 patients experience symptoms of anosmia or decline. According to reports, more than two-thirds of confirmed cases in Germany have anosmia. South Korea's testing scope is wider, and about 30% of mild cases mainly show loss of smell.

There are not many reports of olfactory impairment in COVID-19 patients in China, but it is not unheard of.

According to a report on May 18th by the Shanghai Science and Technology News official account Science and Technology Living Room, the Shanghai Public Health Clinical Center took the lead in completing an international collaborative study, and conducted smell and taste questionnaires or questionnaires on 394 patients from 5 hospitals in China, France, and Germany. detection. The study showed that 161 patients had abnormal sense of smell or taste, 48% of whom had mild symptoms. 93 patients had simultaneous olfactory and taste dysfunction.

6 On June 24, at the Beijing New Crown Pneumonia Epidemic Prevention and Control Press Conference, Wu Guoan, deputy director of Beijing Ditan Hospital, said that among the recent cases in Beijing, 33 people had changes in their sense of smell and 21 people had changes in their sense of taste.

Test project of a hospital in Wuhan.

In the above-mentioned survey conducted by the Wuhan hospital, insiders told 8:00 News that among the discharged patients with new coronavirus pneumonia, it was indeed found that some people have olfactory impairment and "do not know the smell of things when they smell them." This affects both the elderly and young people. .

The above-mentioned insider said that in the early days of the outbreak of COVID-19 in China, the typical symptoms were fever, fatigue, and cough. At that time, everyone was treating patients and saving people, and everyone focused their attention on this aspect. Relatively speaking, the damage to the sense of smell and taste is atypical and less noticeable; moreover, Chinese people have always ignored the sense of smell, and patients wearing masks were not aware of the loss of smell at first. The patient's sense of smell disappears quickly and recovers slowly.

Loss of taste is easier to identify because you will taste the food when you eat. Ms. Liu from Keyuan Community in Jiang'an District started having a low fever, diarrhea, vomiting gradually, general weakness, and difficulty breathing on January 26. She was admitted to Wuhan No. 6 Hospital on February 8 and returned home on March 10. She felt that for a few months, she had "no taste in her mouth, as if she had no feeling." Later, she gradually got better.

Lu Hongzhou, Secretary of the Party Committee of Shanghai Public Health Clinical Center, said in an interview with Shanghai Science and Technology News that the reason why COVID-19 patients develop smell and taste disorders is closely related to the ACE2 and TMPRSS2 genes. The former mainly expresses the host cell receptor of the new coronavirus. The latter expresses surface proteases that mediate the entry of the new coronavirus into cells. They are highly expressed in a variety of olfactory epithelial cell types. It is the expression of these two genes that promotes the virus to enter the cells, thereby causing olfactory disorders in the human body.In addition, the ACE2 gene is highly expressed not only in the lungs, but also in the oral mucosa and tongue, so the new coronavirus can also easily affect taste.

"Another possibility is to infect the olfactory pathway through ACE2 receptors, which may also lead to olfactory dysfunction." Lu Hongzhou said.

In addition to physical illness, some patients also need to get over the shadow of psychological trauma as soon as possible.

Painful psychological healing

What Li Hua is more worried about is his mother's psychological problems.

html At the beginning of April, my mother was quarantined at home. After 14 days, she was still in quarantine because she was afraid of affecting her family. The bedroom is not big, so when she needs to move around, she walks around in it.

On April 12, my father returned home and was also in quarantine. Each of them had a room, and the door was shut tightly. They had to shout through the door before they could say a few words. When eating, family members bring the rice to the door of the room, pour it into their own bowls, and say the food is here, and they come and get it themselves.

The quarantine period is over, and my parents are wearing masks at home. Li Hua asked his father to take off the mask. As soon as he entered the living room and saw his granddaughter taking online classes there, he immediately put it on and took it off only when he returned to his room.

html In mid-May, all people in Wuhan were tested for nucleic acid, and the community gradually opened up. Parents brought their ID cards and hospital certificates to the community to register. The community reported the information. After approval by superiors, the community reviewed it again and arranged for parents to undergo CT examinations and nucleic acid tests. . In June, my parents’ health code was converted to a green code. They can walk around the community and go to the wet market to buy food.

Mom wears a mask and cooks for everyone, but she still goes back to her room after eating. When she feels unwell, her mother loses control of her emotions. Seeing that the epidemic in Beijing was serious, she was also affected. She suddenly burst into tears and wanted to go back to her hometown. Li Hua comforted her, and occasionally lost his temper, and his mother would talk back. After both parties vented, they both felt better.

My parents often talk to my hometown on the phone, and my younger brother often tries to persuade my mother, but she is still depressed. In the past, my mother was more reasonable, but after she got sick, she often lost her temper. Li Hua felt that even if she couldn't bear it mentally, you had to let her vent, let her cry and make trouble, it would be better.

On the morning of June 20, my mother was crying again and wanted to go back no matter what. Li Hua persuaded her for a long time. It's really difficult. It was not easy for her to think about the elderly. The tall man, who was over 1.7 meters tall, was so skinny that he had only a handful of bones left and was still stooped.

After the COVID-19 epidemic, Wuhan citizens generally suffered psychological trauma, and COVID-19 patients felt it especially deeply.

According to a report by The Paper on June 9, many psychology-related doctors in Wuhan said that most of the new patients in the recent outpatient clinics have psychological problems due to the impact of the epidemic. According to Mei Junhua, deputy chief physician of the Sleep Medicine Center of Wuhan First Hospital, there are three main categories of outpatients at the hospital: patients recovering from COVID-19 and their families, patients with a history of sleep disorders but not suffering from COVID-19, and those on the front lines of the fight against the epidemic. staff member.

Mei Junhua said that many COVID-19 patients were under great mental stress during treatment, or were left with psychological shadows due to isolation, or encountered some social factors after being discharged from the hospital. After recovery and returning home, they still felt unwell and would come to the outpatient clinic to repeatedly complain about their panic. Chest tightness, insomnia, nervousness and other symptoms.

The Paper reported that even after being discharged from the hospital, some patients had always suspected that they had returned positive and had taken nucleic acid tests ten times. Even though they were negative every time, they still could not get rid of their inner troubles. After drug treatment and psychological counseling, they gradually recovered. Rehabilitation. This situation is not unique in Wuhan.

In addition, the pain of bereavement is also hitting some COVID-19 patients hard. Ms. Chen from Minquan Street in Jianghan District feels sad when she thinks of her sister. On February 3, she and her sister were diagnosed and were sent to the Wuhan Red Cross Hospital by the community. They sat in the corridor for two days and two nights, and it became increasingly difficult to breathe before they were admitted to the hospital. On March 17, my sister passed away. My sister is 66 years old, has underlying diseases, and has three stents installed in her heart.

html In late June, when Ms. Chen was called by 8:00 Jianwen, she burst into tears when she mentioned her sister. Usually, the children don't let her cry, and she knows it's not good to cry, but she can't control it. Sometimes she cries for a while and comforts herself. Children say that those who are alive should live well. She thought that she still had children and grandchildren to take care of.

Introduction

The sequelae of COVID-19 are becoming a secret pain for some discharged patients.

Source: "Eight Points News" WeChat public account

Special author: Xie Haitao

html On June 25, the Dragon Boat Festival, Li Hua (pseudonym) took his parents out to play.

Amidst the green mountains and green waters, the family picked mugwort and admired the ancient ruins. The parents, who are nearly seventy years old, are as happy as children.

A few days ago, my mother was still crying. She wanted to go back to her hometown no matter what, and did not want to stay in Wuhan. Li Hua tried to persuade her for a long time, feeling very uncomfortable. It was not easy for my parents either. Both of them were infected with COVID-19 at the end of January and were hospitalized for several months. During the recovery process, my mother suffered from diarrhea and bloating, and was reduced to a bone. My father also had headaches from time to time and felt weak.

Li Hua has invited many doctors to treat his mother, but the effect has not been obvious. His mother lost control of her emotions several times, and Li Hua was very heartbroken. lamented that modern medicine is powerless to deal with some of the sequelae of COVID-19. As a doctor in a tertiary hospital, there is almost nothing he can do.

A doctor in Wuhan told 8:00 News that the new coronavirus is known as a "perfect" virus. It attacks a very wide range, from the brain nerves to all tissues and organs in the body. The official account of Beijing Ditan Hospital once announced that patients with COVID-19 may suffer from multiple organ damage such as ARDS, myocardial damage, abnormal coagulation function, kidney damage, and liver damage. Some COVID-19 patients will inevitably experience sequelae during their recovery, depending on the severity of the disease and the location of the infection.

html On March 4, in order to improve the respiratory function, physical function, psychological function, daily living activity ability and social participation ability of patients discharged from COVID-19, the National Health Commission organized experts to formulate guidelines on rehabilitation operation techniques and procedures, and further promote their full recovery. The "Rehabilitation Plan for Patients Discharged from COVID-19 (Trial)" was formulated.

As the number of discharged patients with COVID-19 gradually increases, the multi-level and multi-type rehabilitation medical needs of discharged patients have become increasingly prominent. In order to further strengthen the rehabilitation treatment of major functional impairments in discharged patients, on May 13, the National Health Commission, the Ministry of Civil Affairs and other four departments jointly formulated the "Rehabilitation Treatment Plan for Main Functional Disorders in Discharged Patients with COVID-19".

Currently, there are few reports on the sequelae of discharged patients with COVID-19 in China. For fear of being discriminated against or for privacy reasons, some patients hide their COVID-19 medical history and are even more secretive about the sequelae of COVID-19. There are also some patients and family members who do not know enough about the sequelae of COVID-19. Eight O'clock News has called dozens of critically ill patients or their family members, and a considerable number of them said that they or their family members had no sequelae.

A clinic doctor once served as a medical volunteer and participated in the care of COVID-19 patients at the rehabilitation station. After the patients left the station, many people still kept in contact with him and conducted medical consultations from time to time. He told 8:00 News that some patients still have sequelae, but he refused to disclose more detailed information.

The sequelae of COVID-19 are becoming a secret pain for some discharged patients.

April 4, a community in Wuhan. The pictures in this article were all taken by Xie Haitao.

Weird abdominal distension

Li Hua’s mother is 65 years old. When she was infected with the new coronavirus, her illness was mild, but her symptoms were very weird.

htmlOn November 26, she suspected that she had a neurological problem. Her whole body was numb, she was sweating, and her body was wrinkled. A CT examination was performed on January 31 and it was found that there was inflammation in the lungs. He was admitted to the hospital on February 2. During 's illness, his body temperature was normal, but he had diarrhea and abdominal distension.

html When I got home in early April, my mother still had diarrhea. Li Hua consulted a traditional Chinese medicine doctor and prescribed prescriptions to improve his immunity. The prescription contains ginseng slices, the amount is not large. After taking it for a week, the diarrhea stopped and became bloating and constipation instead.

My mother has severe abdominal bloating. She will become bloated after eating and cannot be relieved by taking a walk. "Seeing her stomach growling and bulging, she felt uncomfortable holding it in. She thought she was sick again, so she became very nervous." My mother massaged her abdomen upwards. Within a few days, her entire mouth smelled bad and her tongue was coated so thickly that she didn’t even dare to take off the mask.

The mother did not dare to eat. Li Hua asked her daughter to supervise her eating. The daughter was only 9 years old and said that she could not control her grandma because she was afraid that she would feel uncomfortable after eating.My mother is very picky about what she eats. Li Hua said, you can eat whatever we can eat, and we can take care of the bloating slowly.

Mom can eat breaded steamed buns, but only a little. Li Hua asked her to drink porridge, "try to make it thinner, easier to digest, more nutritious and with more protein content."

A colleague told Li Hua that he could not give his mother milk but milk powder. Li Hua bought high-protein milk powder and made two spoonfuls of it. After drinking it, his mother said that the milk had increased again. The belly rose up little by little. "When it swells, you can see the shape of the stomach." After the belly swelled and the chest was squeezed, the mother felt suffocated and even had trouble breathing. She panicked. Li Hua quickly massaged her abdomen.

A colleague said that eat small meals frequently, preferably five or six meals a day. So, my mother ate six meals a day, a little each time, and exercised more, but she still had bloating.

Starting from April 12, Li Hua gave his mother the traditional Chinese medicine rhubarb to help with exhaust. Rhubarb can purge heat and relieve constipation, cool blood and detoxify. It is often used to treat constipation due to excess heat and abdominal pain due to stagnation. Ordinary people take rhubarb, one bag a day, but my mother gets two or three bags, and she eats it whenever she feels bloated. I took rhubarb for more than two months and spent more than 6,000 yuan.

Colleagues told Li Hua that rhubarb is toxic and should not be eaten in large quantities. Li Hua gradually reduced the dosage for his mother, asking her to go out for walks more during the day to maintain a good mood, and take a bag of rhubarb to sleep at night.

In addition to abdominal distension, my mother is also constipated. When the condition is severe, glycerin enema may also be used. Li Hua bought glycerin and a syringe from the hospital. He would usually get home from get off work at six or seven in the evening. After his mother had finished her sixth meal, he would give her an enema, draw out the glycerin with a syringe, and push it in. She took the medicine and went to sleep.

html At the end of June, Li Hua took his mother to the hospital for a check-up. The doctor said that she should no longer take rhubarb or enema, as this would make her dependent on herself. In early July, Li Hua asked his mother to stop taking rhubarb, but she was still taking it secretly.

did not find anything during this inspection. The doctor said that the gastrointestinal tract is controlled by the sympathetic nervous system. My mother’s symptoms were caused by sympathetic nervous system disorder. The new coronavirus attacked the nervous system and affected a number of peripheral nerve functions. Li Hua recalled that when her mother first became ill, her whole body felt tight, which was a sign of autonomic nerve disorder.

html From January to early July, my mother’s abdominal distension was relieving, but it still appeared from time to time. During the day, it would be better to go for a walk. In the middle of the night, I would sometimes feel bloated, so I would rub my belly and take some Dingzhu and Huoxiang Zhengqi Pills.

After several months of hard work, the 1.7-meter-tall mother's weight shrank from 120 kilograms to more than 90 kilograms, and she became a skeleton.

April 8 is the day some patients leave the rehabilitation station.

Regular headaches

Compared with mother, father's recovery condition is better.

Dad was found to have lung inflammation during a CT examination on January 31. I was hospitalized on February 2 and complained of headaches. By March 5, Dad had a headache that made him want to hit the wall and could not breathe, so he was transferred to the intensive care unit.

htmlOn March 8, my father suddenly became critically ill. His normal body temperature reached 37.8℃ and he had difficulty breathing. The examination revealed that he had diffuse infiltrative lesions in both lungs, which turned into white lungs. His immune system was almost destroyed, and his lymphocyte subpopulations were reduced across the board. The doctor gave him high-dose hormone shock, albumin, chloroquine phosphate and other drugs, and it took two days for him to be in danger.

When I got home on April 12, my father still had a headache. It usually hurt in the afternoon and evening, and he was so painful that he dared not sleep.

In Li Hua’s impression, his father had never had any head injuries and was always in good health. However, his head was mainly attacked by the virus. He used to have pain all day long. “It was like an explosion, from the inside to the outside. The pain is radiating, and it hurts even when I touch my scalp.”

When my father was seriously ill, Beijing Ditan Hospital detected the new coronavirus in the cerebrospinal fluid of COVID-19 patients, confirming that the new coronavirus can attack the brain. My father then underwent a head MRI, but no problem was found.

In the new coronavirus epidemic, patients whose brains are attacked are not alone.

Dr. Fu, a retired doctor in Wuhan, said that when she was infected, although the CT scan of her lungs was a little bad, she did not feel respiratory distress, but just felt a bit blocked. Her discomfort was in her gastrointestinal and head areas.For 10 days, she felt like vomiting, couldn't eat, her legs were weak, and later she had a headache. "It was like a hole was drilled into her head, lead was filled in the hole, and there was a tightening spell on the outside. It hurt like hell."

When Dr. Fu was young, he was constructing water conservancy projects in the countryside and contracted cerebrospinal meningitis. He was later cured in the county hospital. She felt that the attack of the new coronavirus focused on her head and gastrointestinal tract. Fortunately, she no longer had headaches after being discharged from the hospital.

The headaches experienced by COVID-19 patients once led researchers to focus on the attack of the COVID-19 on the nervous system.

According to China Business News, in early March, Hu Bo's team, director of the Department of Neurology at Union Hospital Affiliated to Huazhong University of Science and Technology, conducted a neurological study on patients hospitalized with COVID-19 and found that more than 30% of the 214 patients had neurological symptoms, with three specific manifestations: Category: first, central nervous system symptoms such as headache, dizziness, disturbance of consciousness, acute cerebrovascular disease, epilepsy, etc.; second, peripheral nervous system symptoms such as loss of taste, loss of smell, loss of appetite, neuralgia, etc.; third, skeletal muscle injury.

Dad couldn’t sleep at night because of his headache. In the past, he was physically strong and liked to do physical work, tending the vegetable garden, digging in the ground, and would fall asleep quickly.

When he was hospitalized, like many COVID-19 patients, my father had been taking sleeping pills, and so had my mother. After he was discharged from the hospital, he couldn't live without sleeping pills. Sleeping pills have an analgesic effect. After Dad took them, his headache was gone and he could fall asleep.

After the Wuhan community was liberalized, Li Hua often took his father out. Dad went out for a walk and felt better. He was tired at night and fell asleep. The next day, I asked him again if he had a headache. He said it didn't seem to hurt.

html From January to early July, my father said that he no longer had headaches in the past week.

"If you work harder, you will be tired"

Dad gradually returned to normal, but he still felt tired from time to time.

He took off the small bicycle his granddaughter was riding, and went to a bicycle repair stall on the street to inflate it. The stall owner inflated it. He pressed the valve core, supported the bicycle, and occasionally put in some effort, but he was out of breath.

When I went to a scenic spot, after climbing a few stairs, I felt out of breath and very short of breath. Mom also gets tired easily. Li Hua believes that this is related to their immunity being attacked and not fully recovered.

Li Hua said that when many elderly patients get sick, their immune cells drop to a very low level and they do not recognize foreign viruses and do not form antibodies. When my father was seriously ill, his immunity collapsed and all immune cells were reduced across the board. Li Hua once suspected that he had AIDS, but later he learned that the new coronavirus has the characteristics of both AIDS and SARS, and it itself destroys immunity. The recovery of immunity takes some time, depending on the age of the patient and the degree of attack.

Eight Points News learned that fatigue is quite common among COVID-19 patients during their recovery process.

In the "Rehabilitation Treatment Plan for Main Functional Disorders of Patients Discharged from COVID-19", the National Health Commission mentioned physical dysfunction, which mainly manifests as general weakness, easy fatigue, muscle soreness, and some may be accompanied by muscle atrophy, decreased muscle strength, etc. It is more common in critically ill and severe patients who are discharged from hospital. It is a secondary physical dysfunction caused by long-term bed rest and immobilization.

Mr. Liu, who lives in Ganghua Street, Qingshan District, has been home for more than two months and still feels weak from time to time. Mr. Liu, 67, became ill in February with dry cough, fatigue, chest tightness and shortness of breath, no fever, and both lungs were infected. He was admitted to Leishenshan Hospital on February 14 and returned home in early April. By the end of June, he felt that his recovery was generally okay, but his knee joints often felt weak, his legs and feet were not as strong, and he would sweat even if he moved a little. Experts from a nearby hospital organized rehabilitation exercises, and he practiced Baduanjin and felt better.

Ms. Chen from Minquan Street, Jianghan District has been home for more than three months and often feels tired. Ms. Chen, 59 years old, suffers from high blood pressure. She was hospitalized with COVID-19 on February 5 and returned home on March 12. She felt that her back was sore when doing some housework. When she went to bed at night, her waist was always sore and she seemed tired. My sleep is not as good as before, I wake up two or three times a night.

Mr. Zhang from Tongfu Community in Jiang'an District is over 60 years old. He used to be a veteran. His health is not bad and he has to exercise every day. He can also take care of his 7-year-old grandson and cook. But when he returned home after being discharged from the hospital in March, if he works a little harder, If you feel tired, you should take oxygen once every day before going to bed to relieve fatigue.

March 25, Wuhan Tongji Hospital. During the epidemic, many patients' lives were saved here, but some of them still have to face the sequelae.

Pulmonary fibrosis

The headaches have subsided, and my father's mental state has improved. The doctor who treats him often calls and says, old man, nothing is wrong with you.

Dad thought he was better, and he spoke with great enthusiasm. Sometimes he joked with Li Hua, saying that this time he was sick, and he ate more than before.

Li Hua did not dare to tell his father that in fact he still had sequelae. His father was a seriously ill patient. When he was about to be discharged from the hospital, Li Hua learned about the fibrosis in his lungs. "The space between the alveoli and the alveoli is filled with fibrous tissue. When you inhale air, it cannot expand; when you want to exhale, it cannot compress and loses its elasticity."

My mother’s illness is mild, and her lungs also have a little fibrosis. Her mother had been inhaling oxygen since she was sick. After returning home, Li Hua was worried that her lungs had not recovered well, so he kept her on oxygen for a while. However, long-term oxygen inhalation will not easily restore its own functions, and will also aggravate pulmonary fibrosis, so it is stopped.

Li Hua said that if pulmonary fibrosis is a localized lesion, it is considered cured and becomes a scar there. If fibrosis occurs on a large scale, it will affect the function. There is no treatment for pulmonary fibrosis. It can only be temporarily relieved to slow down its progression.

According to Li Hua’s understanding, during the SARS epidemic, some patients had pulmonary fibrosis. This time around, some severely ill elderly patients with COVID-19 also have fibrosis in their lungs, which can be seen through CT images.

According to Guangming Daily, Wang Guiqiang, director of the Department of Infectious Diseases at Peking University First Hospital, pointed out at the press conference of the Joint Prevention and Control Mechanism of the State Council on April 21 that from the perspective of the cause of pulmonary fibrosis, chronic injury is more likely to lead to pulmonary fibrosis, and COVID-19 It is an acute viral infectious disease with a short course and a low probability of pulmonary fibrosis. Most patients with mild symptoms will not develop pulmonary fibrosis.

"However, severe and critically ill patients may develop pulmonary fibrosis." Wang Guiqiang said that new coronavirus pneumonia causes serious damage to the lungs, with obvious inflammation and damage. There is repair after inflammatory damage, and the repair process is the stage of fibrous tissue proliferation. Repair and fibroplasia is a dynamic process, and if the condition is not severe, it may be absorbed quickly. But in severe cases, some fibrosis may remain. "It can be seen from the autopsy of the patients who died that there were some signs of consolidation and fibrosis."

html When Mr. Fan from Hongshan District was discharged from Wuhan No. 3 Hospital in March, the doctor told him that it would take a long time. " Even within a year or two, the lungs will be like normal people.

htmlIn December, Mr. Fan suffered from fever for more than ten days, cough, chills, and fatigue. He was first isolated in a hotel, reported to the community many times, and tried various methods before he was admitted to the hospital. After being discharged from the hospital, he felt well, did not cough, and walked for an hour every night. When you feel tired, take a nap at noon and get used to it.

html applied for resumption of work in May, and his employer arranged for him to undergo an examination. After a CT examination, the doctor said that his lungs had not fully absorbed the disease. The employer is a large state-owned enterprise and does not allow him to resume work. Mr. Fan had no choice but to stay at home. He found that the neighbors and former friends in the community no longer interacted with his family. Some people even told him that if he gets COVID-19, he will not be able to have contact with him for two years.

Mr. Fan doesn’t know where the above information comes from. They are circulated in WeChat groups. Although medical experts have not said this, his friends basically do not interact with him. All this makes Mr. Fan worried, "Will our infected people relapse in the future?"

Mr. Zhang from Tongfu Community in Jiang'an District also found that his lungs have not fully recovered during the examination. In the impression of his son, Mr. Zhang, his father started to have a high fever and difficulty breathing on January 26. During the infusion treatment at Wuhan Central Hospital on February 3, he suffered from tremors and coma. He was hospitalized and returned home in March.Mr. Zhang felt that his father was in his 60s, had underlying diseases, and had generally recovered well. His lung function was fine before, but after he came back he had asthma, chest tightness, and lung damage. My father goes to the hospital one or two days a week for some examinations and various rehabilitation treatments. My mother is also a patient, her recovery is slightly better, and she also suffers from chest tightness.

Ms. Xiang from Heping Street, Hongshan District, felt at the end of June that her "resistance was quite poor and she kept having a cough." When she became ill in February, she had "viral infection in both lungs and fibrosis in both lower lungs" and was a mild patient.

Mr. He from Jiang'an District, 68 years old, originally had basic diseases such as "three highs", but he had no symptoms in the lungs and was seriously ill when infected. He was admitted to Wuhan No. 1 Hospital in early February and returned home in late May. By late June, he was still often out of breath, fatigued and coughing. In about half a month, I will go to the hospital for a checkup.

In a report by Guangming Daily, Wang Guiqiang said that in response to the problem of pulmonary fibrosis in patients with new coronavirus pneumonia, the National Health Commission has issued relevant regulations requiring good health management of discharged patients. After patients are discharged from the hospital, they should be intervened through rehabilitation methods to avoid the occurrence and development of pulmonary fibrosis, and long-term follow-up of severe and critically ill patients should be carried out. Wang Guiqiang explained that the development of pulmonary fibrosis does not occur in a short period of time. It may not appear until one month, two months or even longer after discharge. Therefore, long-term follow-up is required to observe possible problems and intervene in a timely manner.

The attacked heart

html In late June, Li Hua took his mother for a magnetic resonance imaging and found that the new coronavirus had also attacked her heart. Although her heart function had recovered, she could not feel any abnormalities. From the CT images, her heart had morphological changes, and the outer layer of the myocardium became fatty.

When a mother is sick, she behaves strangely, with numbness and tightening all over her body. This symptom can also be caused when the nerves and heart are attacked. Li Hua believed that his mother's symptoms were caused by an attack on her heart.

Low potassium in the heart can also cause general numbness. Li Hua gave his mother potassium supplements for a period of time. The use of potassium is particularly strict. A slight overdose can cause sudden death. Li Hua first gave his mother potassium supplements under the guidance of a professional doctor, and then asked her to eat oranges to supplement potassium. Oranges are high in potassium. You can get potassium from food and it is not easy to overdose.

According to a report compiled by China Youth Daily, a small study published in the Journal of the American Medical Association Cardiology showed that more than one-fifth of the new coronavirus patients in Wuhan suffered heart damage, and some of them did not have a heart. Medical history.

Cardiology experts believe that the following conditions may cause damage to the patient's heart: it is difficult for the heart to pump blood when there is a lack of oxygen; the virus invades heart cells; the human body causes an immune storm in the process of trying to eliminate the virus, causing myocardial damage.

Dr. Mohammed Maijid, an assistant professor at McGovern Medical School at the University of Texas Health Science Center at Houston, said the new coronavirus is more likely to cause heart damage than other viruses. Erin Mizios, deputy director of preventive cardiology at the Johns Hopkins University School of Medicine, pointed out that the new coronavirus attacks organs, including the heart, "which is more likely to occur in severely ill patients."

Promotional materials for smell, taste and brain cognitive function examinations carried out by a hospital in Wuhan for discharged patients.

Hearing, smell, taste, and temperature sensations were impaired

In addition, after his mother came home, Li Hua found that her various senses were very dull.

Before, my mother had very good hearing and vision, but now I have to say several words to her before she can hear her. I have to shout loudly, and even if she hears it, I don’t know what it means. It was a very simple thing. After talking about it for a long time, she said, "Ah, what did you say?"

's memory also declined. His hands sometimes shook and his mouth twitched subconsciously, as if he was suffering from the sequelae of a cerebral infarction.

Sometimes she is busy in the kitchen alone, talking to herself, saying various things, her voice is quite loud, as if she is chatting with others, which was not the case before.

Sometimes what she said was related to life, sometimes not. One day, Li Hua heard her say, "Look at this land, it's like this, why don't you dig it up?"

As soon as Li Hua entered the kitchen, she stopped talking. Li Hua asked, Mom, what did you say? She said I didn't speak.

Li Hua judged that this was a problem with his mother's nervous system. If he were not a doctor, he would probably wonder if his mother was mentally disturbed? In fact, she didn't. Many elderly people will have this symptom, but their family members often don't understand it and think that the above symptoms are caused by aging and do not think that they are related to the nervous system.

Li Hua remembered that his mother had bloating and diarrhea when she was hospitalized. She said it was stomachache. Li Hua thought she had caught a cold, so he asked a colleague from the traditional Chinese medicine department for moxibustion. Apply to uncomfortable areas. At 7 o'clock in the evening, my mother was watching TV and doing moxibustion, which caused a big blister on her body.

Li Hua asked his mother, if it’s so uncomfortable, wouldn’t you move it away? Mom said, I don’t feel anything.

A normal person, with hearing and vision, wearing long clothes and long sleeves, carrying moxibustion in a thick purse, how could he get blisters from burning through the clothes? How come you don't feel anything? Li Hua felt strange at the time.

COVID-19 patients are not alone in their inability to feel temperature. During the examination of discharged COVID-19 patients at a hospital in Wuhan since April, staff found that some patients did not know how to boil the water when drinking it, causing bubbles to form on the oral mucosa.

This examination is used to check the sense of smell, taste and brain perception of discharged patients.

html In March, among some COVID-19 patients in Europe and the United States, many suddenly lost their sense of taste and smell, which attracted the attention of countries around the world.

According to The Paper, on March 21, Hopkins, chairman of the British Rhinological Society, and Kumar, chairman of the British Association of Otolaryngology (ENT UK), issued a document on the official website of the association stating that there is new evidence that loss of smell is a cause of the new coronavirus. One of the symptoms of infection. The

article stated that evidence from South Korea, China and Italy shows that a considerable number of COVID-19 patients experience symptoms of anosmia or decline. According to reports, more than two-thirds of confirmed cases in Germany have anosmia. South Korea's testing scope is wider, and about 30% of mild cases mainly show loss of smell.

There are not many reports of olfactory impairment in COVID-19 patients in China, but it is not unheard of.

According to a report on May 18th by the Shanghai Science and Technology News official account Science and Technology Living Room, the Shanghai Public Health Clinical Center took the lead in completing an international collaborative study, and conducted smell and taste questionnaires or questionnaires on 394 patients from 5 hospitals in China, France, and Germany. detection. The study showed that 161 patients had abnormal sense of smell or taste, 48% of whom had mild symptoms. 93 patients had simultaneous olfactory and taste dysfunction.

6 On June 24, at the Beijing New Crown Pneumonia Epidemic Prevention and Control Press Conference, Wu Guoan, deputy director of Beijing Ditan Hospital, said that among the recent cases in Beijing, 33 people had changes in their sense of smell and 21 people had changes in their sense of taste.

Test project of a hospital in Wuhan.

In the above-mentioned survey conducted by the Wuhan hospital, insiders told 8:00 News that among the discharged patients with new coronavirus pneumonia, it was indeed found that some people have olfactory impairment and "do not know the smell of things when they smell them." This affects both the elderly and young people. .

The above-mentioned insider said that in the early days of the outbreak of COVID-19 in China, the typical symptoms were fever, fatigue, and cough. At that time, everyone was treating patients and saving people, and everyone focused their attention on this aspect. Relatively speaking, the damage to the sense of smell and taste is atypical and less noticeable; moreover, Chinese people have always ignored the sense of smell, and patients wearing masks were not aware of the loss of smell at first. The patient's sense of smell disappears quickly and recovers slowly.

Loss of taste is easier to identify because you will taste the food when you eat. Ms. Liu from Keyuan Community in Jiang'an District started having a low fever, diarrhea, vomiting gradually, general weakness, and difficulty breathing on January 26. She was admitted to Wuhan No. 6 Hospital on February 8 and returned home on March 10. She felt that for a few months, she had "no taste in her mouth, as if she had no feeling." Later, she gradually got better.

Lu Hongzhou, Secretary of the Party Committee of Shanghai Public Health Clinical Center, said in an interview with Shanghai Science and Technology News that the reason why COVID-19 patients develop smell and taste disorders is closely related to the ACE2 and TMPRSS2 genes. The former mainly expresses the host cell receptor of the new coronavirus. The latter expresses surface proteases that mediate the entry of the new coronavirus into cells. They are highly expressed in a variety of olfactory epithelial cell types. It is the expression of these two genes that promotes the virus to enter the cells, thereby causing olfactory disorders in the human body.In addition, the ACE2 gene is highly expressed not only in the lungs, but also in the oral mucosa and tongue, so the new coronavirus can also easily affect taste.

"Another possibility is to infect the olfactory pathway through ACE2 receptors, which may also lead to olfactory dysfunction." Lu Hongzhou said.

In addition to physical illness, some patients also need to get over the shadow of psychological trauma as soon as possible.

Painful psychological healing

What Li Hua is more worried about is his mother's psychological problems.

html At the beginning of April, my mother was quarantined at home. After 14 days, she was still in quarantine because she was afraid of affecting her family. The bedroom is not big, so when she needs to move around, she walks around in it.

On April 12, my father returned home and was also in quarantine. Each of them had a room, and the door was shut tightly. They had to shout through the door before they could say a few words. When eating, family members bring the rice to the door of the room, pour it into their own bowls, and say the food is here, and they come and get it themselves.

The quarantine period is over, and my parents are wearing masks at home. Li Hua asked his father to take off the mask. As soon as he entered the living room and saw his granddaughter taking online classes there, he immediately put it on and took it off only when he returned to his room.

html In mid-May, all people in Wuhan were tested for nucleic acid, and the community gradually opened up. Parents brought their ID cards and hospital certificates to the community to register. The community reported the information. After approval by superiors, the community reviewed it again and arranged for parents to undergo CT examinations and nucleic acid tests. . In June, my parents’ health code was converted to a green code. They can walk around the community and go to the wet market to buy food.

Mom wears a mask and cooks for everyone, but she still goes back to her room after eating. When she feels unwell, her mother loses control of her emotions. Seeing that the epidemic in Beijing was serious, she was also affected. She suddenly burst into tears and wanted to go back to her hometown. Li Hua comforted her, and occasionally lost his temper, and his mother would talk back. After both parties vented, they both felt better.

My parents often talk to my hometown on the phone, and my younger brother often tries to persuade my mother, but she is still depressed. In the past, my mother was more reasonable, but after she got sick, she often lost her temper. Li Hua felt that even if she couldn't bear it mentally, you had to let her vent, let her cry and make trouble, it would be better.

On the morning of June 20, my mother was crying again and wanted to go back no matter what. Li Hua persuaded her for a long time. It's really difficult. It was not easy for her to think about the elderly. The tall man, who was over 1.7 meters tall, was so skinny that he had only a handful of bones left and was still stooped.

After the COVID-19 epidemic, Wuhan citizens generally suffered psychological trauma, and COVID-19 patients felt it especially deeply.

According to a report by The Paper on June 9, many psychology-related doctors in Wuhan said that most of the new patients in the recent outpatient clinics have psychological problems due to the impact of the epidemic. According to Mei Junhua, deputy chief physician of the Sleep Medicine Center of Wuhan First Hospital, there are three main categories of outpatients at the hospital: patients recovering from COVID-19 and their families, patients with a history of sleep disorders but not suffering from COVID-19, and those on the front lines of the fight against the epidemic. staff member.

Mei Junhua said that many COVID-19 patients were under great mental stress during treatment, or were left with psychological shadows due to isolation, or encountered some social factors after being discharged from the hospital. After recovery and returning home, they still felt unwell and would come to the outpatient clinic to repeatedly complain about their panic. Chest tightness, insomnia, nervousness and other symptoms.

The Paper reported that even after being discharged from the hospital, some patients had always suspected that they had returned positive and had taken nucleic acid tests ten times. Even though they were negative every time, they still could not get rid of their inner troubles. After drug treatment and psychological counseling, they gradually recovered. Rehabilitation. This situation is not unique in Wuhan.

In addition, the pain of bereavement is also hitting some COVID-19 patients hard. Ms. Chen from Minquan Street in Jianghan District feels sad when she thinks of her sister. On February 3, she and her sister were diagnosed and were sent to the Wuhan Red Cross Hospital by the community. They sat in the corridor for two days and two nights, and it became increasingly difficult to breathe before they were admitted to the hospital. On March 17, my sister passed away. My sister is 66 years old, has underlying diseases, and has three stents installed in her heart.

html In late June, when Ms. Chen was called by 8:00 Jianwen, she burst into tears when she mentioned her sister. Usually, the children don't let her cry, and she knows it's not good to cry, but she can't control it. Sometimes she cries for a while and comforts herself. Children say that those who are alive should live well. She thought that she still had children and grandchildren to take care of.

As a front-line medical staff in the fight against the epidemic and a family member of a patient, Li Hua often feels psychologically traumatized. There are many things at work, parents are in bad condition, and all kinds of things are added to it, and sometimes people almost collapse. She often feels lazy, her mind goes blank, and she doesn't want to do anything. She just wants to let her family spend this time safely.

Li Hua studied psychology and was a member of a hospital's psychological counseling team. She tried to provide psychological counseling to her mother.

’s mother has a strong “anti-detection” ability, doesn’t trust psychiatrists, and doesn’t like others to induce or “design” her. Li Hua felt that if he directly told his mother that she was sick and offered her psychological counseling, she would resist.

"It's actually about design, how to help mothers recover," Li Hua said. She started after dinner, starting from a certain topic, discussing the matter, and providing psychological counseling to her mother. Mom didn't notice it and thought it was just chatting.

Sometimes, Li Hua asked his daughter to cooperate. The mother used to dote on her granddaughter, but after she fell ill, she gradually became indifferent and paid less attention to the child because she was afraid of infecting the child. Li Hua wanted to stimulate his mother to return to normal cognition. Li Hua sometimes scolds his daughter and pretends to hit her. When her daughter is crying and making trouble, her mother comes over, holds the child in her arms, and angrily says to Li Hua, "How dare you? If you do this again, I will scold you and beat you." ”.

Li Hua tried to use this method, to let the mother vent her bad emotions, burst out her protective desire, and stimulate her normal reaction to return her to a normal state.

Dad’s mental state is relatively good. Li Hua also prescribed the right medicine to adjust his father's condition.

html In May, Li Hua received a letter from an old calligrapher in Fujian. The letter came with two calligraphy works. Li Hua took them home and showed them to his father, saying that they were the calligrapher's calligraphy and they were well written. Dad said he can also write. Dad likes calligraphy and has been practicing calligraphy for decades.

Li Hua said, if you can write it like this, you should do it too. Li Hua bought ink for his father and several rolls of 1-meter-wide rice paper.

Dad lives in the study, practices calligraphy every day, and plans to go out and sell calligraphy after he has finished it. He was so enthusiastic that he had to write at least two to three thousand words every day. He was reluctant to use rice paper. He first wrote on water writing cloth and then wrote on the newspaper. He wrote small characters first, then wrote the front and back, and then wrote large characters until the entire newspaper was almost Only when it was completely dark did I let go. By early July, he had written more than 30 kilograms of newspapers. When he got tired of writing, he played the flute and the melody flowed in the room.

Dad practices calligraphy during the day and his mental state is better. One day, my father said that he couldn't write well and the rice paper was too hard, so he might not be able to sell it. Li Hua encouraged his father, how good you are at writing, better than calligraphers, and I will change the paper for you later.

Li Hua also wanted to find something to do for his mother. The new home is still being renovated, and Li Hua wants to clear out the first floor first so that his parents can live there. There is a vegetable patch in front of the house, and my mother likes to grow vegetables.

The night before the Dragon Boat Festival, Li Hua said to his parents, let’s go out to play tomorrow morning. Dad said "Wow", just like a child, he really wanted to jump up. Mom said, okay, I'll make the dough right away, and we'll bring some food tomorrow.

Li Hua felt that he had to suddenly stimulate them and create a scene for them. Psychotherapy is not just a few questions. Different scenarios must be set up. The closer they are to life, the less likely they are to notice, and the better the effect.

In response to her mother’s slow reaction and talking to herself, Li Hua also wanted to stimulate her normal reactions through the stimulation of various life scenes, so that she could gradually eliminate the malignant memories and subconscious anxieties and fears in her mind. Lose. "But there is a process, and I don't know what the effect will be."

During the Dragon Boat Festival, Li Hua took his parents out to play. They were very happy, but insisted on wearing masks. When we arrived at the scenic spot, Li Hua said, there are not many people here, and the air is so good, you should take off your masks. When

took the photo, his parents were far away. When he pulled down his mask, he asked whether this would be passed on to his granddaughter. After taking the photo, the parents immediately put on the masks. "They are still very fragile psychologically." Li Hua said.

Editor in Charge | Su Mu

There is another important thing to tell you

Recently, WeChat articles are no longer arranged in chronological order.

This may prevent you from seeing our articles in time.

In order that we can meet at 6:30 every night in the future, I would like to invite you

and see you there!

In order that we can meet at 6:30 every night in the future, I would like to invite you

and see you there!