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Health Dept Issues Advisory On Post COVID Follow Up

Bhubaneswar: The Health and Family Welfare (H&FW) Department today issued an advisory on post COVID follo up and management of patients. A letter from Additional Chief Secretary (H&FW) Pradipta Kumar Mohapatra to Collectors, Municipal Commissioners, Chief District Medical & Public Health Officers (CDM & PHOs) and Superintendents of all Government Medical Colleges and Hospitals (MCHs) stated that the advisory needs to be followed across the State. “A holistic approach is required for follow up care and well-being of all patients post COVID,” the Additional CS’ letter read.

Below are the excerpts from mentioned in the Post COVID advisory:

At the present stage of COVID-19 pandemic, there are few studies examining the occurrence or prevalence of long-term sequelae associated with COVID-19. Cardiovascular, pulmonary and other neurological and endocrinological sequelae may be expected.

After acute COVID-19 illness, recovered patients may continue to report wide variety of signs and symptoms including fatigue, body ache, cough, sore throat, difficulty in breathing, increased incidence / worsening of Coronary Artery disease, acute myocardial infarction, heart failure, myocarditis, stroke, impaired cognitive function, persistence of taste and smell abnormality, besides occurrence of depression, anxiety and fear.

Further, the instability in the course of diabetes, asthma and COPD are frequently reported.

Post COVID Follow Up:

At Individual Level:

Continue COVID appropriate behaviour (use of mask, hand and respiratory hygiene, physical distancing);

Drink adequate amount of warm water;

If health permits, regular household work to be done. Professional work to be resumed in graded manner;

Mild / moderate exercise;

Balanced diet;

Avoid smoking and alcohol;

Take regular medications; and

Look for signs like fever, breathlessness and chest pain.

At Community Level:

Recovered individuals share positive experiences with friends and family using social media and create awareness, dispelling myths and stigma;

Take support of community for recovery and rehabilitation;

Seek psycho-social support from peers and community health workers; and

Participate in yoga and meditation.

At Health Care facility setting:

The first follow up visit should be within 7 days of discharge. Thereafter, it should be done in 4 weeks and 12 weeks of discharge;

The patients who had undergone home isolation, if they complain of symptoms, will visit nearest health facility; and

Severe cases requiring critical care support will require more stringent follow up.

During Hospital Follow Up:

Chest X-Ray, pulmonary function test, measurement of oxygen saturation and echo cardiography should be done at 12 weeks of discharge.

“If the findings of any of these tests are abnormal then high resolution CT thorax, CT pulmonary angiography shall be done to detect any evidence of ILD or PVD. If noted, it should be managed by appropriate health care institution. During the follow up period the status of co-morbidities must be monitored and appropriate steps shall be taken for its management.”

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