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Life After Intubation: People Face Physical, Cognitive Issues


For someone with a life-threatening case of COVID-19, survival is just the first step. NPR's Jon Hamilton reports that the process of recovery can be long and grueling.


JON HAMILTON, BYLINE: At a veterans hospital in Little Rock, Ark., a big man in a wheelchair is gliding toward the exit. The man is David Williams, a former Marine who spent a week on a ventilator after getting COVID-19, and hospital staff have lined up to give him a big sendoff.


HAMILTON: That was more than two weeks ago, and Williams, who is 54, is home now with his wife. But he's still tethered to an oxygen machine.

DAVID WILLIAMS: I just wear my - actually, I have, like, a hundred-foot cord. And so I wear my oxygen on my nose, and I'm still able to travel all over the house.

HAMILTON: Also, he still depends on a walker.

WILLIAMS: So I need it when I have to wake up in the middle night or something and go to bathroom because, you know, trying to get the feet going again is a little rough.

HAMILTON: Even so, Williams says he's improved a lot, especially since he was overweight and out of shape when he got sick. When Williams first woke up, he had almost no control of his arms and legs, and like most patients on a ventilator, he felt parched pretty much all the time. He couldn't drink, so a nurse left him a damp swab to suck on.

WILLIAMS: It took me, like, five or six minutes just to pick that thing up, to get my fingers actually on it and my brain telling my hand to lift it up and, you know, to put it in my mouth.

HAMILTON: Williams can feed himself now, but he's still having problems with memory and thinking.

WILLIAMS: It was hard for me to try and recall things or - because, like - right now it takes me a while to think about the words I need to be able to say now, but I'm slowly getting it back.

HAMILTON: If Williams makes a full recovery, he can count himself among the fortunate. Dr. Amy Bellinghausen of the University of California San Diego says some COVID-19 survivors will never recover completely.

AMY BELLINGHAUSEN: Unfortunately, oftentimes, when they're coming off the ventilator, it's not the same person as who went on the ventilator.

HAMILTON: The condition is known as post-ICU syndrome. Bellinghausen says most patients start out so weak they are nearly helpless.

BELLINGHAUSEN: That whole time in the ICU, they're losing muscle mass. People lose 20, 30, 40 pounds over a week or two in the ICU.

HAMILTON: And for many, she says, there's been organ damage.

BELLINGHAUSEN: People can have injuries to their lungs or scarring in their lungs. Sometimes kidneys are impacted, but really, any organ can suffer injury in the ICU.

HAMILTON: Including the brain - Bellinghausen says one reason is the drugs used to paralyze and sedate patients while they're on a ventilator.

BELLINGHAUSEN: Some of those medications can have long-lasting impact on the brain. The other thing is that patients who have bad lung disease often have times when their oxygen level is very low, and that also causes damage to the brain.

HAMILTON: Then there's the emotional impact. Bellinghausen says patients who may be delirious from fever or sedatives find themselves trapped in a scary, noisy place, connected to machines that have taken control of their bodily functions. And if someone resists, they may be forcibly restrained.

BELLINGHAUSEN: They really think that all these efforts that we're doing in the ICU to try to save their life may be trying to harm them, and so people come out of the ICU with pretty profound symptoms of PTSD sometimes - post-traumatic stress disorder.

HAMILTON: Bellinghausen says COVID-19 survivors do improve over time, and a few bounce back quickly. Matthew Robertson is 28. He's a tech worker who lives near Seattle.

MATTHEW ROBERTSON: I got to the hospital on February 29, and then when I woke up, I was looking at the date on the chart that was on my window. And it already said, like, March 7.

HAMILTON: Six weeks later, though, he's pretty much back to normal.

ROBERTSON: I think the only thing that still hasn't properly recovered is the vocal range of my voice.

HAMILTON: So no karaoke clubs yet, but they're all closed anyway.

Jon Hamilton, NPR News.


Jon Hamilton is a correspondent for NPR's Science Desk. Currently he focuses on neuroscience and health risks.

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