Practical information for people who have been treated in hospital with Covid 19

This information has been designed to help you with your recovery. It contains facts about the COVID 19 infection and also suggests where you can find further help and support.

Everyone’s COVID 19 journey is different so please avoid comparing yourself with others. This document provides general information which we hope you will adapt for your personal needs.

COVID-19 is an infectious disease caused by a new virus called SARS-CoV-2. Many people who are infected with the virus experience breathing difficulties but the virus can also affect other parts of your body.

All viral illnesses cause a few people to feel a weakness and tiredness they struggle to shake off. This fatigue is a normal part of the body’s response to recovering from a viral infection, or critical illness that requires being admitted to hospital.

Fatigue is likely to continue for some time after the infection has cleared. It can make you sleep more, feel unsteady on your feet, make standing for long periods difficult, as well as affecting your ability to concentrate and your memory. This can lead to feelings of anxiety or depression but can be avoided or less severe with the suggestions later.

As COVID-19 is a new disease we do not know exactly how long it will take for most people to get better. In similar severe viral diseases, we have found that you may experience:

• Less aches and pains in your joints and muscles after 4 weeks.
• Between 4 and 6 weeks the productive cough will gradually reduce and you will feel less short of breath.
• After 3 months you may still feel tired but all other symptoms are beginning to settle.
• For a small number of people it may take up to six months before you begin to feel your normal pre-COVID self, and for those who required intensive care treatment it may be even longer.

Usually, we expect symptoms to slowly improve over several weeks. If after building up the pacing of your daily activities, you don’t see any improvement in what you can do, then you should ask your GP for advice.

If you have any other concerns about your health after COVID-19 infection, we recommend that you call either your GP’s practice or ring NHS 111 (even when you hear the health service is busy) for advice.

Call 999 or 111 for further advice if you are:

• Coughing up blood.
• Feeling severe chest pain.
• Getting more breathless.

Call your GP or 111 for other new symptoms such as:

• Swelling of a leg or arm.
• Chest pain.
• Losing more weight or not wanting to eat anything.
• A racing heart.
• Muscle aches.

We would recommend that you have a look at the NHS ‘Your Covid Recovery’ website for information to help as you get better from your illness.

Rest.

This is very important for your body as it fights off the infection. Rest for both your body and mind are best achieved by keeping television, phones and social media to a minimum. Relaxation, breathing and meditation can all support quality rest.

The NHS Apps Library has free tools you can try. Sensory relaxation tools such as calming music can also help. If a strategy does not work for you, do not give up try an alternative.

Sleep.

You may find that you need more sleep during recovery. Hospitals are often noisy and bright environments. Eye masks and ear plugs may help both in hospital and at home.

Eating and drinking.

Some people may find their ability to taste remains limited for some time. Cold foods are often easier to tolerate when struggling with taste. Try keeping to your normal routine for eating and drinking. If your appetite is low, eat little and often instead of big meals. A little of what you fancy is fine in the first few days but try to include foods which are high in protein because they will help your body recover and maintain muscles.

Cream and cheese is useful to add to dishes to make them higher in protein and calories, provided these fit within any dietary restrictions you may have. Protein is found in all dairy products such as cheese, yoghurts, meat or fish, nuts, eggs, beans and pulses such as kidney beans, chickpeas, and lentils. If your diet is restricted for medical reasons please discuss options with your GP or dietitian.

Being ill with a raised temperature can cause dehydration so it is very important that you drink often (not alcohol) throughout the day so that you pass urine with normal frequency and volume.

Contact your GP or NHS 111 for medical advice if you continue to lose weight after a couple of weeks.

Movement and exercise.

Where possible, get up and move around slowly and gently a few times each day. Exercise could lead to risk of physical injury, especially if you are feeling short of breath or dizzy. Keep your activity levels low and gradually build them up over time. To begin with try to do only a small number of activities each day, including basic activities such as washing and other self-care.

By being active and starting some exercise you become stronger and fitter. You may notice your tiredness increase and some breathlessness at first, but these should improve the stronger you get.

Exercise is vital to your mental health and will enable you to do more of the things that are important to you. Regular activity will help to reduce pain and stiffness in joints and regain muscle strength. Being active during the day may help you sleep better. The more time spent being physically active, the greater the health benefits.

Set yourself small goals that you can do in the day. You can start with small tasks such as making a drink or something to eat. Aim for a daily walk. Walk with someone until you are confident to go out on your own. Try making a walk part of your daily routine to give your day structure. Don’t worry if you need to stop and rest, that is a normal part of recovering and getting strong again.

Allow time.

COVID-19 affects people differently, so give yourself the time to recover. You may feel pressure to resume your usual activities quickly, but don’t rush. People often increase their activity levels too quickly, which can set them back. So, go slow and steady and avoid pushing through fatigue.

Daily routine.

Slowly resume your usual daily activities. If this is not possible create a realistic list to follow and then add to it as you are able. Continue to limit everyday ‘thinking’ activities, such as emails, planning shopping, making decisions, as these all use energy. Try to do them only for set times with regular rests in between. By taking these steps, your body will be able to re programme itself to improve your thinking and memory.

Have fun.

Do some low energy activities that you enjoy, like reading or watching the television for short periods. Enjoy some sunshine whenever you can.

You may have heard of Long Covid (also known as Post-COVID-19 Syndrome) which is the term used to describe when someone has symptoms which continue for more than 12 weeks and are not explained by an alternative diagnosis.

The likelihood of developing Long Covid symptoms is not thought to be linked to the severity of your initial COVID-19 infection. If you are concerned about your recovery, please speak to your GP.

Employment.

You may need longer off work than initially anticipated. A phased return works best and should be planned with your manager and, if you have one, your occupational health department. You may also need a fit note from your GP. Try to avoid returning to work too soon and without the adjustments you need to manage fatigue.

Breathing Support:

• Asthma UK and British Lung Foundation Website.

Mental Health Website:

• One You.

Stay at home guidance:

• Gov.uk guidelines.

Covid Patient Support:

• An interactive course from the Lancashire Teaching Hospitals.

Diet:

• British Dietetic Association (BDA).

Supporting your recovery after COVID-19:

• Includes topics such as nutritional advice and exercising.

For recovery after Intensive Care:

• ICU Steps.

Long Covid Support Website:

• Longcovid.org.

Apps:

•  The NHS Apps Library

How to manage post-viral fatigue after COVID-19:

• Royal College of Occupational Therapists.