PETALING JAYA: Covid-19 long haulers suffer an array of symptoms, with less than 70% of those referred to the rehabilitation unit at Hospital Sungai Buloh returning to work within three months of recovery.
Measures have been put in place by the Health Ministry to support long Covid sufferers, with at least 5,856 of them benefiting from rehabilitation at the ministry’s facilities, including Sabah and Sarawak.
Hospital Sungai Buloh rehabilitation medicine department head Dr Akmal Hafizah Zamli said its Covid-19 Rehabilitation Outpatient Specialised Services (CROSS) was established in November 2020 as the first rehabilitation medicine service dedicated to long Covid sufferers in the country.
According to the CROSS database from November 2020 to January 2022 of mainly Category 4 and 5 Covid-19 patients aged 13 to 89, 62.4% (or 2,987) continued to have symptoms after more than three months.
“Analysis of the CROSS database also revealed that from the total cohort of 2,987 patients, 1,470 out of 2,220 applicable patients, or 66.2%, successfully returned to work in less than three months.
“Meanwhile, the reasons for not returning to work are wide-ranging, including loss of job as the company had reduced operations or closed down due to the economic impact of the pandemic, trauma and fear of contracting the infection again, lack of new job opportunities and also still recovering from the after-effects of Covid-19 or long Covid.
“Common symptoms of long Covid are wide-ranging, with the most common being fatigue, exertional dyspnoea, cough, pain, insomnia, muscle weakness, abnormal sensations, anxiety, brain fog and hair loss,” Dr Akmal Hafizah told The Star.
Long Covid sufferers can seek treatment at any of the 2,838 government clinics nationwide and there are also close to 30 public hospitals with rehabilitation medicine clinical services, she said.
At the government clinic, assessment and management of long Covid patients is led by a family medicine specialist (FMS), while for complex cases, the patient may be referred to the various medical specialities or integrated multidisciplinary services as indicated during the assessment of the individual cases, she added.
Depending on the symptoms, patients may be referred to specialists in different fields such as respiratory, emergency, cardiology, neurology, psychiatry and rehabilitation.
“The Clinical Guideline Post Covid-19 Management Protocol, Ministry of Health Malaysia First Edition July 2021 is used to guide referrals by the government clinic to the various medical specialities for management,” she added.
Patients in need of rehabilitation services may be those who have physical impairments such as muscle weakness, pain, fatigue, limited joint range of motion and muscle or joint stiffness, as well as cognitive impairments such as poor concentration, impaired memory, brain fog or even psychological impairments such as stress, anxiety and insomnia.
A Post Covid-19 Functional Scale (PCFS), which is a tool to measure a patient’s functional status over time after a Covid-19 infection, might be used to guide referrals to facilities with a resident or visiting rehabilitation physician, said Dr Akmal Hafizah.
Besides public facilities, rehabilitation medicine services for long Covid are also available at several private hospitals such as ReGen Rehabilitation Hospital and Sunway Hospital, and also five Higher Education Ministry facilities such as Universiti Sains Malaysia, Universiti Malaya Medical Centre and Universiti Putra Malaysia Teaching Hospital.