normal within a specified time from the onset of their symptoms … The ‘ recovery ’ definition must include duration , severity and fluctuation of symptoms , as well as functionality , and quality of life . Everyone who is symptomatic would remain a ‘ case ’ until they fulfilled the recovery criteria or died . 7
The duration of convalescence tends to depend on whether the patient suffers a mild , moderate or severe case of COVID-19 , and whether intensive care or ventilation is required . Besides medical treatment , other important factors include pre-existing health conditions , individual constitution , emotional state and diet .
Recovery from COVID-19 is therefore more complex than merely testing negative for active infection or positive for antibodies , or being discharged from hospital . 7 Some young patients , for example , who do not have any underlying disease or constitutional weakness , and who suffer only from shortness of breath and fatigue during COVID-19 , still experience physical and mental dysfunction more than one year later . Such patients should be given convalescent support and guidance . 8
Traditional Chinese Medicine
Traditional Chinese medicine has been used as a primary method in the treatment of epidemic diseases since ancient times in China . In TCM it is held that improper treatment can lead to retention of pathogens , further disturbance or damage to the body , and long-term sequelae such as ‘ long COVID ’. Effective control of the acute phase of the disease is different from complete functional recovery . It is very important for physicians to pay attention to patients ’ comprehensive recovery , both physical and mental , whether they have been discharged from hospital or have been isolating at home . Comprehensive rehabilitation with TCM can promote recovery , improve quality of life , and prevent any recurrence of the disease .
When patients enter the convalescent stage of COVID- 19 , there is usually still some dysfunction of the zang-fu organs and disturbance of the circulation of qi and blood in the channels . During convalescence , the xie ( pathogenic ) qi has usually been by and large eliminated or is at least under control , but the zheng ( upright ) qi has been disturbed or damaged . The fight between zheng qi and xie qi is still occurring , indicating that methods should be used to eliminate the remaining pathogens and strengthen the zheng qi . During this period , common symptoms are pressure in the chest , shortness of breath , loss of smell and taste , spontaneous or night sweating , dry cough , fatigue , poor appetite , loose stools or diarrhoea , as well as various kinds of emotional disturbance . In severe cases , Lung function may have been seriously damaged and there may be symptoms due to withdrawal from steroid treatment . The convalescent phase is a crucial stage of recovery , which can determine the future condition of patients ’ health . Without proper treatment , or with incorrect treatment , long COVID can develop , which then greatly interferes with patients ’ quality of life and functionality at work .
Principles of treatment
Although a primary focus of treatment during the convalescent period is reinforcing zheng qi , this does not mean physicians should use tonifying treatment strategies indiscriminately without paying attention to eliminating remaining pathogenic factors . On the contrary , in the early stage of convalescence , sometimes the main treatment required is to clear dampness , heat , cold , toxin or blood stasis . Moreover , fatigue does not necessarily imply deficiency of qi or blood , since any remaining accumulation of dampness or phlegm can also lead to fatigue . If tonification is given before remaining pathogenic factors are removed , it may prolong the retention of the pathogens and make future improvement more difficult . On the other hand , if methods to strongly attack the pathogens are applied in those with qi deficiency without supportive tonification , such treatment will likely cause further weakness of the patient .
As well as focusing on physical complaints , the patient ’ s emotional state , lifestyle , diet and exercise habits should be taken into consideration . Each patient is an individual with different dietary habits , emotional states and underlying conditions and has a particular constitution and cultural background ; each will therefore experience the disease differently and will have received different treatments - therefore their clinical manifestations will vary significantly . If these individual factors are neglected , the resulting treatment will not be in line with the principles of TCM and is unlikely to be successful . Treatment should therefore be based upon careful syndrome differentiations , while also taking into account climate , season and geographic location .
The general aims of treatment at the convalescent stage are to tonify qi and benefit yin , resolve phlegm and regulate the Lung , activate the Spleen and eliminate damp , promote blood circulation and eliminate blood stasis , and calm the shen and harmonise the emotions . These principles will relieve cough , reduce inflammation , prevent pulmonary fibrosis , restore lung function , improve physical strength , and support emotional well-being .
Treatment
Treatment of the convalescent phase of COVID-19 is applied according to the following patterns :
1 . Incomplete elimination of damp and toxin Feverish feeling in the body but no raised temperature , sore throat , dry and weak cough , slight tightness of the chest , fatigue , lassitude , poor appetite , spontaneous sweating , body aches , ongoing positive PCR tests , a pale tongue with a white or greasy coating , and a slippery and / or rapid pulse .
Principles of treatment Clear toxin , disperse Lung qi , resolve dampness and harmonise the middle jiao .
Herbal treatment Cang Fu Dao Tan Tang ( Guide Out Phlegm with Atractylodes and Cyperus Decoction )