As the new coronavirus continues to spread across the United States, some areas of the country are at or near the peak of new infections, according to many health experts. But wide areas of the country are predicted to see new infections continue to grow for quite some time, with a corresponding increase in hospitalizations, admission to hospital intensive care units (ICUs) and fatalities.
There’s strong evidence that people with diabetes are more likely to develop severe symptoms and complications of COVID-19 (the disease caused by the virus). According to the Centers for Disease Control and Prevention (CDC), this higher risk applies to people with both type 1 and type 2 diabetes. That’s especially true if your blood glucose levels are frequently higher than levels in people without diabetes, or if you’ve developed certain diabetes-related health problems like heart disease or kidney disease.
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If you’re at higher risk for severe COVID-19, it’s especially important to protect yourself from exposure to the coronavirus, and to have critical supplies on hand in case you get sick and can’t leave your house for the duration. But it’s also important to know what to expect if you develop symptoms that are severe enough to require hospitalization and admission to the ICU.
What intensive care for COVID-19 involves
Most people who develop COVID-19 won’t need to be hospitalized. Overall, the CDC estimates that 81% of people with the illness have mild to moderate symptoms, which includes mild pneumonia (with less than 50% of lung involvement on imaging).
The remaining 19% develop severe or critical illness that requires hospitalization, with symptoms like extreme difficulty breathing, low blood oxygen levels or severe pneumonia. In critical cases, the illness may cause respiratory failure, shock (a sudden, life-threatening drop in blood flow) or dysfunction in multiple organ systems. About 6% of all people with COVID-19 will require care in a hospital’s ICU, which can involve a range of treatments. In the most severe cases, if you can’t breathe on your own, you may need to be put on a mechanical ventilator (breathing machine).
It’s unclear how likely people admitted to an ICU for COVID-19 are to survive, with estimated mortality rates ranging from 39% to 72% depending on the study, according to the CDC. Among people who survive, the median length of the hospital stay is estimated as 10 to 13 days.
It’s worth noting that the hospitalization rate for COVID-19 increases with age among adults. The CDC estimates that people ages 75 to 84, for example, are more than twice as likely to require hospitalization for the disease than people ages 50 to 64 and more than six times as likely as people ages 18 to 49.
Recovering after intensive care for COVID-19
While many people discharged from the hospital after ICU admission due to COVID-19 experience steady improvement, that’s not the case for everyone.
Post-intensive care syndrome is defined as “new or worsening impairments in physical, cognitive or mental health status” after discharge from a hospital due to a critical illness. While there isn’t reliable data on how common it is for COVID-19, it can affect anyone who was in an ICU — or a family member experiencing trauma as a result.
“Most patients, regardless of their age or medical background, experience some type of problem after the ICU,” explains Dale M. Needham, MD, medical director of the Critical Care Physical Medicine & Rehabilitation Program at Johns Hopkins Medicine in Baltimore. “Problems may be more common in those who are older or have more medical or psychological problems before being admitted to the hospital.”
To help reduce the risk of problems after discharge, says Needham, it’s important for people to receive care related to physical rehabilitation and mobility — even while they’re still in the ICU or hospital. But, he notes, “hospitals have varying abilities to implement physical rehabilitation and mobility in the ICU, depending on the availability of equipment and staff.” And in some hospitals, resources may be strained due to the large number of patients with COVID-19.
Still, “screening patients for early rehabilitation and mobility interventions on a daily basis is important to ensure the early start of intervention to prevent muscle weakness” and post-intensive care syndrome, says Needham. Ideally, nursing and rehabilitation staff will collaborate to make sure people get the right exercises and training both during and after their hospital stay.
After you’re discharged, says Needham, “it’s important to engage in mobility activities, within safety limits, outside of rehabilitation sessions, to improve endurance and strength.” That may include walking or light strength and flexibility exercises, as recommended by your healthcare team.
And even though coronavirus-related social distancing may make it more difficult to interact with other people, “family and friends can have a great impact on helping with patient mobility,” says Needham, including by helping you follow through with “specific exercises and other tasks learned during rehabilitation sessions, in order to speed the recovery process.”
If you’re interested in connecting with other ICU survivors online or looking for other resources for post-intensive care syndrome, you can visit the web page of THRIVE, an initiative by the Society of Critical Care Medicine to help people and their families after an ICU discharge.
Want to learn more about coronavirus and diabetes? Read “Coronavirus and Diabetes: What You Need to Know,” “Healthy Eating During Hard Times” and “Avoiding Coronavirus With Diabetes: Stock Up and Stay Home, CDC Says.”