Older patients recover from Covid and then relapse

Social Affairs

Published: 21 Mar. 2022, 18:45 Updated: 21 Mar. 2022, 19:27

Older patients recover from Covid and then relapse

Medical staff transfer a patient at Seoul Medical Center in Jungnang District, eastern Seoul on Monday. To free up intensive care beds, from Monday, the government made Covid-19 patients whose symptoms have improved move out of I.C.U.s earlier. [NEWS1]

A growing number of elderly in Korea are being rushed to emergency rooms after thinking they recovered from Covid-19.

Sixty-four-year-old Ms. Kim, a pseudonym, suffered from hyperlipidemia and rheumatoid arthritis. She tested positive for the coronavirus on Feb. 26 and was put under home care, like most Covid-19 patients these days. She felt pretty good, and after seven days was released from quarantine.

Two days later, she started feeling bad. Her fever rose to 38 degrees and she experienced shortness of breath. She was rushed to the emergency room of a university hospital. An oxygen mask didn't help. She was eventually transferred the I.C.U. and put on a ventilator. With her condition deteriorated to secondary pneumonia, Kim still isn’t able to breathe without a mechanical respirator.

Ms. Lee, also a pseudonym, 61, experienced a similar situation. Lee, who didn’t have any underlying conditions, was let out of quarantine on Feb. 21. On March 5, she suddenly had difficulty breathing and went to the emergency room. She too ended up in the I.C.U. and is on a ventilator like Kim.

Frontline medical staff treating critical Covid-19 patients say that the number of elderly patients visiting emergency rooms is increasing, with their conditions suddenly deteriorating after being released from quarantine.

Korea’s daily Covid-19 cases dropped to 209,169 on Monday, falling below 300,000 for the first time in ten days. Yet the number of patients in critical care rose by 97 from the previous day to 1,130, with Monday registering the second-largest daily death toll for the whole pandemic, 329 deaths.

Eight out of 10 critically ill patients are aged 60 or older, while more than 90 percent of Monday’s reported fatalities were people in their 60s or older.

Medical professionals say that looser monitoring of high-risk groups following the surge of virus patients and expansion of home treatment is partly to blame.

"Since doctors have to rely on telemedicine, there is a limit to accurately checking a patient's condition," Eom Joong-sik, a professor from the infectious disease department at Gachon University Gil Medical Center, told the JoongAng Ilbo. “With the elderly, it's necessary to take X-rays to check for any signs of pneumonia before releasing from quarantine."

Some say there has been hiccups in prescribing oral Covid-19 pills, which may be fueling the rise in the number of critically ill patients.

Korea has been prescribing Pfizer’s Paxlovid for high-risk Covid-19 patients 60 or older since January, and gradually expanded the treatment to immunocompromised patients, people in their 50s with underlying conditions and people in their 40s with underlying symptoms. But delays in prescriptions have been reported at nursing homes, where an increasing number of cluster infections has been reported.

A pulmonologist treating critical Covid-19 patients at a university hospital in the Seoul metropolitan area said the antiviral pill which was once regarded as a game changer “hasn’t been playing that role at all.”

"Many of the patients coming to the hospital aren't even informed of Paxlovid," the pulmonologist said, "and there are patients who asked for the pill but couldn't get it as there are no supplies."

According to the Korea Disease Control and Prevention Agency (KDCA), Korea has received Paxlovid for 163,000 patients as of Sunday, and 87,000 doses have been administered.

There's only enough left for 76,000 more patients.

"Given the current stock, [the pills] can be administered for about two weeks, but prescriptions are increasing," Jeong Eun-kyeong, the KDCA commissioner said in a press briefing on Monday.

In response to the soaring demand for oral Covid-19 treatments, the government announced Monday that it would introduce Merck’s Molnupiravir (brand name Lagevrio) for 100,000 people in addition to Paxlovid.

Following the Ministry of Food and Drug Safety’s decision on its emergency use this week, Molnupiravir is expected to be prescribed to patients who can't tolerate Paxlovid for reasons such as impaired kidney or liver functions.

"I hear there are considerable restrictions on prescribing [Paxlovid] to the elderly as there are many people with impaired kidney function," Jeong said.

In addition, authorities said they are trying to get more Paxlovid, with discussions under way with the pharmaceutical company.

BY HWANG SU-YEON, SEO JI-EUN [seo.jieun1@joongang.co.kr]