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Post-COVID-19 illness
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==Severe COVID-19 survivors== ===<span id="pics">Post-Intensive Care Syndrome</span>=== [[File:Post-COVID-19 ventilators.png|alt=Post-COVID-19 illness. The notion that patients surviving intensive care and mechanical ventilation for several weeks can be discharged home without further medical attention is a dangerous illusion." - Stam, Stucki & Bickenbach (2020)|left|frameless]] {{Clear|both}} [[File:Post intensive care syndrome.png|thumb|Post Intensive Care Syndrome symptoms. Source: [https://medicaljournals.se/jrm/content/html/10.2340/16501977-2677 J Rehabil Med 2020; 52: jrm00044]. License: CC-BY NC.]] <br />Long term physical, cognitive and mental health problems have also been found to be relatively common in patients discharged from intensive care from illnesses other than COVID-19, with the length of time in intensive care influencing the long term health impacts.<ref name="nbc28032020" /> Post Intensive Care Syndrome (PICS) is one of several conditions that can result, including Critical Illness Polyneuropathy (CIP) and Critical Illness Myopathy (CIM), and requires both short and medium term rehabilitation treatments.<ref name="Stam2020">{{Cite web|url=https://medicaljournals.se/jrm/content/html/10.2340/16501977-2677| title = Covid-19 and Post Intensive Care Syndrome: A Call for Action | first = H J | last = Stam | authorlink= | first2 = G | last2 = Stucki | authorlink2 = | date = 2020-04-15 | website = Journal of rehabilitation medicine|language=en|doi=10.2340/16501977-2677|pmid=32286675|archive-url=|archive-date=|url-status=|access-date=2020-04-23 | last3 = J | first3 = Bickenbach|volume=52|issue=4}}</ref> ===COVID-19 pneumonia and SARI=== Moderately ill patients with COVID-19 may develop mild viral pneumonia.<ref name="CDC-clinicalguide">{{Cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html| title = Coronavirus Disease 2019 (COVID-19) | last = CDC | first = | authorlink = Centers for Disease Control and Prevention | date = 2020-02-11 | website = Centers for Disease Control and Prevention|language=en-us|archive-url=|archive-date=|url-status=|access-date=2020-04-22}}</ref> Severe acute respiratory infection (SARI) is known to develop in some people severely ill with COVID-19. SARI resulting from other illnesses has been studied.<ref>{{Cite journal | last = Zhang | first = Chen | last2 = Zhu | first2 = Na | last3 = Xie | first3 = Zhengde | last4 = Lu | first4 = Roujian | last5 = He | first5 = Bin | last6 = Liu | first6 = Chunyan | last7 = Ma | first7 = Xuejun | last8 = Tan | first8 = Wenjie | date = 2013-08-22| title = Viral Etiology and Clinical Profiles of Children with Severe Acute Respiratory Infections in China|url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0072606|journal=PLOS ONE|language=en|volume=8|issue=8| pages = e72606|doi=10.1371/journal.pone.0072606|issn=1932-6203|pmc=PMC3750056|pmid=23991128}}</ref> ===Acute respiratory distress syndrome=== Acute respiratory distress syndrome (ARDS) is a life-threatening condition that involves the patient's lungs becoming inflamed, and being unable to produce enough oxygen for the body's vital organs.<ref name="ARDS-NHS">{{Cite web|url=https://www.nhs.uk/conditions/acute-respiratory-distress-syndrome/| title = Acute respiratory distress syndrome (ARDS) | last = National Health Service | first = | authorlink = National Health Service | date = 2017-10-17 | website = nhs.uk|language=en|archive-url=|archive-date=|url-status=|access-date=2020-04-01}}</ref> ARDS develops in 17-29% of ''hospitalized'' COVID-19 patients and is known to have long term effects.<ref name="JH-ABX-540747">{{Cite web| title = Coronavirus COVID-19 (SARS-CoV-2) | first = Paul G. | last1 = Auwaerter | date = Apr 8, 2020|access-date=Apr 17, 2020|url=https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540747/all/Coronavirus_COVID_19__SARS_CoV_2_}}</ref><ref name="MMW-27Mar2020">{{Citation| title = Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) β United States, February 12βMarch 16, 2020 | last = CDC COVID-19 Response Team | date = Mar 27, 2020|journal=MMWR Morb Mortal Wkly Rep 2020|volume=69|issue=12|pages=343-346|doi=10.15585/mmwr.mm6912e2|url=http://dx.doi.org/10.15585/mmwr.mm6912e2|pmid=32214079}}</ref><ref name="CDC-clinicalguide" /> ARDS can cause nerve and muscle damage, which causes [[chronic pain|pain]] and weakness.<ref name="ARDS-NHS" /> ===Mechanical ventilator effects=== Invasive ventilation using a mechanical ventilator was needed by 47-71% of patients admitted to Intensive Care Units.<ref name="JH-ABX-540747" /> ===COVID-19 complications=== These include: *Anecdotal reports of DVT and pulmonary embolism in critically ill patients *Central nervous system [[encephalitis]] and [[encephalomyelitis]] *anecdotal evidence of pulmonary aspergillosis *pneumonia *hypoxemic respiratory failure/ARDS *[[sepsis]] and septic shock *cardiomyopathy and [[arrhythmia]] *acute kidney injury *complications from prolonged hospitalization including: **secondary infections including [[bacteria]]l and [[fungal infection]]s **thromboembolism **gastrointestinal bleeding **critical illness polyneuropathy/myopathy.<ref name="JH-ABX-540747" /><ref name="CDC-clinicalguide" /><ref name="Varatharaj2020a" />
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