Post-COVID-19 Complications, Recommended Diet And Physiotherapy Regime

India is currently facing a second wave of the Covid-19 infection and it has been observed that the increased pathogenicity of the current viral strain has increased. Consequently, India is seeing an increased mortality rate and post-recovery complications in survivors of the Covid-19 infection.

When patients who have recuperated from COVID-19 infection continue to experience symptoms of the disease even after four weeks after initial recovery, they are exhibiting post-COVID complications. This condition is referred to as ”long Covid” or ”long-haul Covid”. Since COVID-19 infection can affect your vital health in the long run, a healthy diet must be followed post-recovery.

Post-Covid-19 Complications

Long Covid symptoms can persist long after recovery. These symptoms should be medically addressed to ensure restoration of complete health.

Following is a list of post-Covid-19 symptoms experienced by survivors:

• Shortness of breath
• Dizziness
• Joint pain
• The reappearance of fever.
• Breathing problem
• Fatigue
• Chest pain
• Difficulty in swallowing.

Apart from these, the survivors of the second wave of Covid-19 infection experience lung issues, renal malfunction and fungal infection. 

Older people and people with pre-existing medical complications (diabetes, hypertension, etc.) are more susceptible to experiencing these lingering symptoms. However, it does not mean that young people are not affected by them.

It is advised that those who experience these symptoms should get in touch with their doctors urgently.

Post Covid-19 Care

Recovery from Covid-19 is a long journey. A positive mind, proper diet and moderate exercise are the keys to beating the Covid-19 infection.

The Ministry of Health & Family Welfare, in its Post Covid Management Protocol, advises maintaining for Covid-19 behaviour – social distance, practising hygiene and the use of masks. It also advises that survivors should follow a nutritious diet, get adequate sleep, drink sufficient water and moderate exercise. Most importantly, the protocol recommends self-monitoring at home post recovery and immediate medical consultation on noticing any post-Covid-19 complications to ensure timely treatment.

Post-Recovery Diet

A balanced diet is crucial to regaining health after recovery from Covid-19 infection. You should consume freshly cooked and easily digestible food.

Survivors should include a wide range of fruits and vegetables, preferably seasonal, in their diet. Alternatively, they can consume fruit and/or vegetable juices to overcome weakness. These are high in minerals and vitamins, making one feel more energized.

A common myth currently being propagated is that consumption of meat, seafood and poultry products worsens Covid-19 symptoms. However, consumption of these products is recommended because a high protein diet is essential for post-Covid-19 management for immunity and to overcome weakness. Consume a high-protein diet with 75-100 grams of protein each day. Include as many eggs, lentils, legumes, milk products, soy, seeds and nuts in your diet as possible. Non-vegetarians can incorporate animal products such as lean meat, poultry, fish and eggs.

As per the Ministry of AYUSH, people can prepare and drink immunity-boosting beverages, such as warm turmeric milk. Milk provides the calcium necessary for strengthening the bones, while turmeric has antibiotic effects; this will aid elimination of physical weakness.

To improve energy requirements and further boost immunity, people can consume herbal teas like kadha (an indigenous drink prepared from a mix of spices and herbs), ginger tea, green tea and other herbal teas.

It is advisable to reduce salt and sugar intake. Use of iodized salt is recommended. Choose fruits and nuts instead of sugary treats such as cookies, cakes and chocolates to limit sugar intake.

The survivor must continue to take multivitamins (vitamins B, C, and D), zinc, iron and selenium pills as directed by the doctor. Daily intake of multivitamins is essential to aid the removal of toxins from the body.

One of the post COVID-19 complications is blood clotting. To keep yourself safe from such conditions, you can include Amla in your diet. Many studies show that Amla fruit extracts might be effective as an anticoagulant. Thus including it in your diet might be quite useful to avoid post COVID-19 complications.

Dr. Siddharth Gupta, B.A.M.S, M.D (Ayu)

Post Covid-19 Rehabilitation

Apart from a proper diet and adequate sleep, people who experience severe symptoms post recovery from Covid-19 infection may require rehabilitative support, such as physiotherapy, chest therapy, mental health support, etc.

The current strain of Covid-19 badly affects the lungs and the heart. People experiencing lung and cardiac issues could benefit from respiratory/chest physiotherapy from a qualified practitioner. Chest therapy – involving a set of breathing exercises using a respirometer – is especially helpful in releasing fluids trapped in the lungs. It aids the lung to regain its capacity and mitigate breathing issues. 

For improving breathing, people can also practice yoga asana, pranayama and meditation (Ministry of Health & Welfare). Walking is also a good exercise.

Additionally, with the support of physiotherapists, practising a set of activities – such as transitioning from a lying to a sitting posture, bedside ADLs (Active Daily Living Exercises), prone positioning – can significantly benefit the recovering patients.

But the following things can be kept in the mind: 

• Patients with heart conditions such as myocarditis and pericarditis should avoid vigorous aerobic exercise for three months.
• The painful respiratory disease might progress to respiratory failure. So, once you’ve recovered from COVID-19, you’ll need to get essential rest, chest inspection and oxygen monitoring.
• Patients who have a history of depression, demyelination, seizures, ischemic stroke or encephalitis after recovering from COVID-19 should see a neurologist.
• For post-covid-Syndrom in older adults and children, personalized care with a multi-professional healthcare team monitors multisystem inflammatory syndrome and depression.

The following clinical outcome metrics are recommended for evaluating existing treatment objectives and setting new or changed treatment objectives for post-Covid-19 patients with chronic lung diseases:

• To measure physical activity, use a pedometer or accelerometer.
• The 6-minute walk test (6MWT) is used to determine exercise tolerance.
• Before, during and after exercise, use the Borg Scale CR10 for shortness of breath and fatigue.
• Before, during and after exercise, measure oxygen saturation (SpO2) and heart rate frequency (HR).
• Dynamometer: To measure the isometric strength of legs. 
• Patient-Specific Functional Scale (PSFS) score.
• Short Physical Performance Battery (SPPB) for the elderly patient.

People who do not exhibit severe long Covid-19 symptoms can undertake simple exercises that require less strength, such as deep breathing, knee lifts, side bends, etc.

In my opinion, including jaggery in your post COVID-19 diet can be beneficial. According to studies, jaggery has multiple benefits. It might help in reducing cold and cough-like conditions. It may also help in promoting relaxation of muscles to prevent fatigue. Due to its strong antioxidant properties, it may act as a blood purifier and might help in boosting immunity.

Dr. Rajeev Singh, BAMS

Conclusion

It is vital to keep in mind that most COVID-19 patients recover rapidly. However, because of the long-term consequences of the infection, it is even more critical to prevent the spread of COVID-19 by taking measures outlined by the government. Wearing masks, maintaining social distance, avoiding crowds, getting vaccinated as soon as possible and keeping hands clean are important yet simple precautions to take.

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

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