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From breathlessness to lacking sense of smell, COVID-19 full recovery a long road for some Indonesians

From breathlessness to lacking sense of smell, COVID-19 full recovery a long road for some Indonesians

Health workers wearing protective suits gesture from the isolation room for the coronavirus disease (COVID-19) patients after taking swab samples, at the emergency unit at Persahabatan Hospital in Jakarta, Indonesia, May 13, 2020. REUTERS/Willy Kurniawan

JAKARTA: More than a month ago, Lilis felt unwell. She had a sudden headache and was nauseous.

Lilis, not her real name, initially thought she was simply tired and regarded the symptoms as signs she was near her menstrual cycle.

But after three days, the 37-year-old Jakarta-based housewife did not feel better.

She visited several doctors. A computed tomography (CT) scan, X-Ray scan and polymerase chain reaction (PCR) test showed that she had meningitis and COVID-19.

The doctors assumed the meningitis was a result of the Sars-COV-2 virus, which they say is very rare but has been identified before in a patient in Wuhan.

Lilis was hospitalised at a private hospital in Jakarta, as the COVID-19 referral hospitals were unavailable amid a surge in infections in the capital.

She received several medications, including dexamethasone, the steroid which American President Donald Trump also received.

After having tested negative twice for COVID-19 and given 10 doses of antiviral drugs, Lilis was discharged.

A health worker wearing protective suit and patients exercise at the Patriot Chandrabhaga Stadium which has been converted into a quarantine house amid the coronavirus disease (COVID-19) outbreak, in Bekasi, on the outskirts of Jakarta, Indonesia, September 28, 2020. REUTERS/Ajeng Dinar Ulfiana

However, the two weeks of hospitalisation did not mean she was 100 per cent fit and healthy.

"I still have recurrent headaches, and if I perform certain activities for too long, I will feel tired. I also feel short of breath,” Lilis told CNA.

For example, she has to lie down for two hours after doing chores for three hours before she feels better.

Her doctor told her: “This will persist for the next nine months.”

READ: Six months after COVID-19 strikes Indonesia, questions linger over healthcare capacity and equipment

Other COVID-19 patients who have tested negative told CNA they still feel a bit unwell, even though they have been declared free from the disease.

Doctors noted that COVID-19 can have a long impact on patients' health and cannot be taken lightly.

LACKING SENSE OF SMELL

Another COVID-19 survivor, who only wanted to be known by her first name Ika, also told CNA she is not completely well after testing negative for the disease on Oct 7.

Prior to being tested positive, Ika had a fever for two days, a sore throat and bodyaches. She also felt dizzy, lost appetite and suffered from a loss of smell known as anosmia. 

While she has now been declared COVID-19 free, her sense of smell is still not 100 per cent back. Sometimes, she feels easily tired if she has performed certain activities like household chores and looking after her children.

“I am not as strong as I was before having COVID-19,” the 31-year-old housewife said.

FILE PHOTO: A medical worker wearing personal protective equipment (PPE) collects a swab sample from a woman to be tested for the coronavirus disease (COVID-19), as the outbreak continues in Jakarta, Indonesia, September 29, 2020. REUTERS/Willy Kurniawan

Her doctor told her it is normal since she is in her post-viral infection period.

“I just have to continue to maintain and increase my immunity so that I can recover quickly. I can recover from the anosmia 100 per cent, but it takes time and the nose must continuously smell all kinds of odours to get itself used to,” she said.

According to her doctor, the time needed to fully recover varies from one patient to the other.

Some can fully recover two weeks after having tested negative, and there are others who need about a month, she was told.

While she does not know for sure how she contracted the disease, four people in her household of six tested positive.

READ: Indonesia aims to produce 70% of required medical supplies as part of self-reliance efforts: Coordinating minister

They have all been declared COVID-19 free and are now on their way to a full recovery.

Her live-in maid, who was most affected by the symptoms, currently has the most complaints. She still suffers from a cough, is easily tired and occasionally feels dizzy.

SHORTNESS OF BREATH

A Tangerang resident who only wanted to be known as Joni, tested positive for COVID-19 early September.

Prior to getting himself tested for the disease, he displayed some symptoms such as a fever, chills and inflammation in the throat.

He believed the virus may have originated from his neighbours who were diagnosed with COVID-19 a few days before him.

As all hospitals he contacted were full, Joni had to undergo home quarantine while displaying symptoms.

READ: Premature reopening, gatherings among factors that led to COVID-19 clusters in Jakarta workplaces

When he was quarantined at home with his wife who also had the disease, three people in his family passed away due to COVID-19.

Joni had not seen them for a while and knowing what had happened was tough psychologically for him.

After three PCR tests in one month, Joni tested negative in early October.

However, the 36-year-old entrepreneur still complains about shortness of breath after attempting simple sporting activities. This is something he has never experienced before.

“I’ve tried to do sports a couple of times and I felt a bit out of breath. I felt a shortness of breath,” he said.

Joni noted that prior to COVID-19, he was in good shape and he had no comorbidity.

An Indonesian nurse takes a blood sample from a woman during a mass rapid test amid the COVID-19 coronavirus pandemic in Jakarta on April 23, 2020. (Photo: AFP/Adek Berry)

Marine Affairs and Fisheries Minister Edhy Prabowo, who tested positive for COVID-19 in early September, has a similar experience. 

The 47-year-old was warded in an Intensive Care Unit (ICU) room at a Jakarta COVID-19 referral hospital. He was declared free from the disease at the end of September and started working again early this month.

In a video posted on his instagram account last week, he said: "I haven't fully recovered yet. Frankly speaking, I still have to practice breathing."

"That's why I said: Don't get COVID-19. Especially (so severe) that you must be treated in an ICU room. Why? Because afterwards, it is not good. My lungs are not so normal yet."

The minister added: “If I walk for a long time, I gasp. If I climb the stairs, I also gasp."

READ: Why Indonesia has the highest COVID-19 fatality rate in Asia

He said that he was in good physical shape prior to contracting the disease, citing his ability to ride a bike for three hours or about 100km non-stop.

Mr Prabowo also said he was able to play football as well as two straight sets of badminton.

POSSIBLE PERMANENT DAMAGE TO BODY ORGANS: EXPERTS

What do medical experts know about the COVID-19 post-recovery process?

Pulmonologist Dwi Bambang said that COVID-19 can cause permanent damage to many organs.

He further noted that there are different cases because not every COVID-19 patient has the same viral load and immunity.

“Sometimes patients will still feel sick even though they have recovered or tested negative because there is damage at the alveoli (tiny air sacs in the lungs which regulate the oxygen one breathes and the carbon dioxide one expels) – there is fibrosis,” he explained. 

The time needed to fully recover from COVID-19 depends on how damaged the organs of the patients are and their nutritional intake, Bambang noted.

READ: 'We are worried,' say Indonesian healthcare workers as COVID-19 takes toll on medical system

READ: Indonesians seek to get tested for COVID-19 as tally rises; govt says unnecessary to test everyone

Internist and cardiologist Eka Ginanjar concurred.

“COVID-19 can cause damage to several important organs such as the lungs and heart… It takes time to restore their functions ranging from a month until even nine months, depending on the damage or the response of the body,” he said.

He revealed that a longer full recovery period is quite common, especially among those who suffered severely or were in a critical condition.

But the doctor, who is also a member of the Indonesian Medical Association risk mitigation team, believed a full recovery is possible.

“Get enough rest, perform physiotherapy (light physical exercise), consume healthy food, think positively, and if the doctor prescribes some medicine, consume them according to the prescription,” advised Ginanjar.

Indonesian medical staff prepare a room for patients at the 2018 Asian Games athlete's village which has been converted into a hospital for COVID-19 coronavirus patients in Jakarta on Mar 23, 2020. (Photo: Hafidz Mubarak A/Pool/AFP)

Furthermore, the head of the Indonesian Association of Pulmonologists Agus Dwi Susanto asserted that being able to recover from COVID-19 is an achievement. But recovery sometimes also means the beginning of a long-term health problem, said Susanto.

“For some people, especially those who were warded in an ICU room, lung problems, kidney and heart damage are what they need to deal with,” he said.

He highlighted that the lungs must receive extra attention because a number of patients will have chronic lung disease as a result of COVID-19 and will require further treatment.

“Viral infection can cause persistent symptoms like coughing for a few weeks to several months or having persistent symptoms of shortness of breath as if one is wheezing or has asthma,” he said.

He also acknowledged that recovered patients can experience a decrease in their lung function by 20 to 30 per cent which will result in breathing difficulty when walking.

“Patients with mild symptoms can recover more quickly and not need extra oxygen but usually will become weak and easily fatigued,” he noted.

Those interviewed by CNA said they wanted to send the message that everyone must always follow the COVID-19 health protocols and stay at home as much as possible.

Joni especially added: “Don’t be selfish. Perhaps you’re fine, but you can be a carrier. And it can be deadly.”

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Source: CNA/ks(aw)

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