Ashwini HJ, Chief Psychologist, Pro Physio

Ashwini HJ, a Clinical Psychology postgraduate passed out from Manipal University, Manipal currently pursuing a doctoral degree in Psychology from Christ University, Bangalore. She has extensively worked in the clinical settings especially with children and parent population. She is a trained Cognitive Behaviour Therapist trained from Beck Institute (USA) and Swati Institute (Pune). She extensively uses techniques such as CBT, Mindfulness Cognitive Therapy, Positive Psychology Therapy etc exclusively with adults. Her passion lies in creating awareness about mental health through illustrations.

A majority of people who tested positive for the Novel Coronavirus (Covid-19) regardless of age, sex or severity of illness are showing residual symptoms which could impact the physiological, physical and mental health of an individual. Even after testing negative for Covid-19 and decline in the viral load, experts have pointed to a sustained inflammatory response in the body which may have a residual effect. This evidently impairs an individual to function at their optimal functioning capacities. And hence, post-Covid rehabilitation becomes vital.

Covid-19 impacts internal systems and organs. The Cardiovascular System and the Heart shows damage to the heart muscles and causes heart failure leading to heart attack; in the Respiratory System and Lungs, there is damage to the lung tissue and restrictive lung failure which may lead to pulmonary embolism; and the Nervous System and the Brain can be affected and the indications are loss of sense of smell (anosmia), cognitive impairments (e.g. memory and concentration) and thromboembolic events such as stroke, impacts of the gastrointestinal tract, kidneys, or leg.

There is also an impact on mental health and mind which cause anxiety, depression, anger, delusion (in severe cases) post-traumatic stress disorder and sleep disturbances. Eighty percent of the patients have presented with psychotic symptoms which occurred for more than two weeks after the first manifestation of bodily symptoms associated with Covid-19. Nonetheless, this was resolved in less than two weeks; and finally, musculoskeletal troubles can crop up with indications of pain in the joints and muscles. Covid-19 has challenged all healthcare, including rehabilitation, and will continue to do so for at least a few years.

According to the Union Ministry of Health and Family Welfare (MohFW), around 80% of people recover from Covid-19 without any special treatment. Around 1 in 6 Covid-19 patients get a severe infection and have difficulty in breathing, with senior citizens and those with comorbidities particularly at risk. As per a recent US study, only 65% of those who had recovered from Covid-19 returned to their pre-Covid health levels after 14 to 21 days of contracting the infection. With less than a year’s worth of research on this virus, several long-term effects of it still remain unknown to us. However, there is increasing evidence about symptom profiles and rehabilitation needs of Covid-19 survivors in the initial months of their recovery. Therefore, it is critical to understand the course of patients’ recovery from Covid-19 for appropriate measures to address associated health implications post-Covid.

It is crucial for individuals who tested positive for Covid-19, an illness caused by the Novel Coronavirus to consider post-Covid rehabilitation as an essential aspect of their recovery which eases the process of “getting better”. A team of specialists i.e., the treating doctor, a physiotherapist, a psychologist and a nutritionist are to be consulted just about 14 – 21 days after recovering from Covid-19. These group specialists can enable the post-Covid recovery in a slow, consistent, adequate and appropriate manner.

A physiotherapist steps in to develop a tailor-made exercise program based on an initial assessment, on how badly the patients were impacted because of the inflammatory response and the Novel Coronavirus itself. Patients are handheld into structured and supervised exercise programs. Evidently, in some cases, it is also reported by the health care workers that there are indications of post-viral fatigue syndrome, the kind of patients who have to be evaluated with a separate and distinctive protocol. They would require a completely different approach on curating an exercise program by the physiotherapist vs a regular approach (for other Covid-19 survivors).

A clinical psychologist, psychologist, counsellor or a psychiatrist on the post-Covid rehab team exclusively works on the aspects of mind and its effects on the somatic symptoms. It is imperative and equally important to understand that mind-body dualism is crucial in the recovery of post-Covid-19 symptoms.

The various neural pathways may be impacted by the virus and hence even if there were psychological symptoms pre-Covid, it is seen that the patients are experiencing difficulties to cope mentally because they have been experiencing symptoms of depression, anxiety, impaired cognitive functions such as loss of memory, clouded thinking, brain fog, difficulties in concentration and attention etc. A mental health specialist is the one who could help them recover better in addressing these symptoms by providing better tools to cope and manage. Mind Matters! Sometimes the mind can be the root cause of many problems that we don’t anticipate.

Nutrition is yet another aspect of post-Covid rehabilitation. A nutritionist aids in the appropriate nutrient intake and an adequate/appropriate diet plan especially after being infected by the Novel Coronavirus leading to severe malnutrition and nutritional deficiencies, in turn, prolonging the post-Covid recovery. Additionally, good nutritional status is very important in maintaining a strong immune system against the virus.

A fulfilled life comes from positive health. Post-Covid Rehab includes integrated nutrition, exercise, genetics and gut analysis to positively influence the health of individuals. Many non-specific issues like fatigue, fluctuation of moods, reduced stamina, frequent aches and pain are symptoms of certain deficiencies caused by improper nutrition and activity. Post-Covid rehab experts will recommend the right personalised lifestyle solution to improve your life and help you be the best version of yourself.

Post-Covid recovery has to be addressed holistically vis-a-via physiologically, physically, mentally and nutritionally. Since the Novel Coronavirus is causing harmful effects on multi-systems of the body, post-Covid rehab plays a pivotal role, whether asymptomatic or symptomatic. And hence reaching out to a team of health care workers who exclusively provide services for post-Covid rehabilitation is crucial in the complete recovery from Covid-19. Rehabilitation care is vitally important for patients who experience any type of debilitating illness, and it’s important that patients receive the physical aspects of rehabilitation care, as well as cognitive rehabilitation care, to ensure their health and wellbeing is being addressed comprehensively.

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