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Severe COVID-19 - discharge

Severe coronavirus 2019 - discharge; Severe SARS-CoV-2 - discharge

You have been in the hospital with COVID-19, which causes an infection in your lungs and may cause problems with other organs, including the kidneys, heart, and liver. Most often it causes a respiratory illness that causes fever, coughing, and shortness of breath. Now that you are going home, follow your health care provider's instructions on taking care of yourself at home. Use the information below as a reminder.

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COVID-19

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When You're in the Hospital

In the hospital, your health care providers help you breathe better. They may give you oxygen and IV fluids (given through a vein) and nutrients. You may be intubated and on a ventilator. If your kidneys are injured, you may have dialysis. You also may receive medicines to help you recover.

Once you can breathe on your own and your symptoms improve, you may spend time in a rehabilitation facility to build up your strength before going home. Or you may go directly home.

What to Expect at Home

Once at home, your health care providers will continue to work with you to help your recovery.

You will likely still have symptoms of COVID-19 even after you leave the hospital.

Recovery may take weeks or even months. Some people will have ongoing symptoms.

Be sure to follow your provider's instructions for self-care at home. They may include some of the following recommendations.

MEDICINES

Your provider may prescribe medicines to help in your recovery, such as antibiotics or blood thinners. Be sure to take your medicine as prescribed. Do not miss any doses.

DO NOT take cough or cold medicines unless your doctor says it is OK. Coughing helps your body get rid of mucus from your lungs.

Your provider will tell you if it is OK to use acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) for pain. If these medicines are OK to use, your provider will tell you how much to take and how often to take them.

OXYGEN THERAPY

Your doctor may prescribe oxygen for you to use at home. Oxygen helps you breathe better.

If you smoke, now is the time to quit. Do not allow smoking in your home.

BREATHING EXERCISES

Doing breathing exercises every day may be important to help strengthen the muscles you use to breathe and help open up your airways. Your provider may give you instructions on how to do breathing exercises. This may include:

Incentive spirometry - You may be sent home with a spirometer to use several times a day. This is a hand-held clear plastic device with a breathing tube and a movable gauge. You take long, sustained breaths to keep the gauge at the level your provider specified.

Rhythmic inhalation and coughing - Breathe deeply several times and then cough. This may help bring up mucus from your lungs.

Chest tapping - While lying down, tap your chest gently a few times a day. This may help bring up mucus from the lungs.

You may find that these exercises are not easy to do, but doing them every day may help you recover your lung function more quickly.

NUTRITION

Lingering COVID-19 symptoms including loss of taste and smell, nausea, or tiredness can make it hard to want to eat. Eating a healthy diet is important for your recovery. These suggestions may help:

Being short of breath can also make it harder to eat. To make it easier:

Drink plenty of liquids, as long as your provider says it is OK. Just don't fill up on liquids before or during your meals.

EXERCISE

Even though you don't have a lot of energy, it's important to move your body every day. This will help you regain your strength.

MENTAL HEALTH

It is common for people who have been hospitalized with COVID-19 to experience a range of emotions, including anxiety, depression, sadness, isolation, and anger. Some people experience post-traumatic stress disorder (PSTD) as a result.

Many of the things you do to help with your recovery, such as a healthy diet, regular activity, and enough sleep, will also help you keep a more positive outlook.

You can help reduce stress by practicing relaxation techniques such as:

Avoid mental isolation by reaching out to people you trust by phone calls, social media, or video calls. Talk about your experience and how you are feeling.

Call your health care provider right away if feelings of sadness, anxiety, or depression:

When to Call the Doctor

Call 911 or the local emergency number if symptoms re-appear, or you notice worsening of symptoms such as:

References

Centers for Disease Control and Prevention website. COVID-19: Treatments your healthcare provider might recommend if you are sick. www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html. Updated January 13, 2022. Accessed March 15, 2022.

COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. www.covid19treatmentguidelines.nih.gov. Updated March 2, 2022. Accessed March 15, 2022.

Prescott HC, Girard TD. Recovery From Severe COVID-19: Leveraging the Lessons of Survival From Sepsis. JAMA. 2020;324(8):739-740. PMID: 32777028 pubmed.ncbi.nlm.nih.gov/32777028/.

National Institutes of Health website. COVID-19 treatment guidelines. Therapeutic management of hospitalized adults with COVID-19. www.covid19treatmentguidelines.nih.gov/management/clinical-management/hospitalized-adults--therapeutic-management/. Updated February 24, 2022. Accessed March 15, 2022.

Spruit MA, Holland AE, Singh SJ, Tonia T, Wilson KC, Troosters T. COVID-19: Interim Guidance on Rehabilitation in the Hospital and Post-Hospital Phase from a European Respiratory Society and American Thoracic Society-coordinated International Task Force [published online ahead of print, 2020 Dec 3]. Eur Respir J. 2020 Dec; 56(6): 2002197. doi: 10.1183/13993003.02197-2020. PMID: 32817258 pubmed.ncbi.nlm.nih.gov/32817258/.

WHO website. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). February 16-24, 2020. www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf#:~:text=Using%20available%20preliminary%20data%2C,severe%20or%20critical%20disease. Accessed March 15, 2022.

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Review Date: 3/15/2022  

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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