At the St. Petersburg Veterans' Hospital, a rehabilitation center has been repurposed to treat patients suffering from symptoms of COVID-19 long after the initial infection. Current Time photographer Artyom Leshko visited the ward where long-haul patients are fighting to overcome the physical and mental toll of the virus.
Yelena was working as a nurse in a high-risk COVID-19 "red zone" when she contracted the disease. After the acute illness subsided, she quickly returned to work, but was plagued by physical and mental problems, including sudden mood swings.
“My temperament couldn’t have changed so suddenly on its own. It must have been a repercussion of COVID,” Yelena said. “My memory was failing and I had trouble understanding simple things. I stopped going out and responding to calls. My heart hurt. My eyesight deteriorated. It all happened at once."
Soon after returning to work, Yelena tripped and broke her leg. “It’s a strange thing to say, but the bone fracture did me some good, because I got some rest. That's when I started feeling better.”
To try to address the lingering symptoms, Yelena checked in to the rehab center at the veterans' hospital. Every day, she receives physical therapy, swims in the pool, and undergoes various procedures. Her symptoms have begun to improve, and she believes she'll be ready to return to work soon.
“After I recover fully, I’ll go to work in the red zone again. We've been assigned to deal with COVID. I feel guilty that I’m not with my colleagues, not helping them. I call them every day,” she said.
Two wards at the hospital now house patients coping with long COVID, a little-understood syndrome that can last for weeks or months. Patients might suffer from debilitating symptoms including fatigue, muscle pain, heart problems, gastrointestinal distress, anxiety, and depression.
Other units at the facility are not operating at all; the medical staff have been reassigned to other hospitals that are treating acute COVID cases.
Irina Klenina, the head of the cardiology department, works with patients who have had heart surgery after contracting COVID-19.
“The virus causes all kind of problems," Klenina said. "Lung problems are a classic result of pneumonia, but we also see a lot of damage to the heart, liver, and kidneys. One patient had muscular problems. The virus can affect the muscles, too. I think the Dutch were the first to report that COVID can affect the neurons in the brain.”
Anastasia Voloshina, an orthopedist, works with patients to help them recover their strength and mobility.
“Post-COVID syndrome changes your body," Voloshina said. "There’s no fever and the PCR test is clean, but you still don’t feel okay. Chronic diseases can worsen over time. Research has found that joint pain is one possible repercussion of the coronavirus.”
Voloshina herself suffered from long COVID-19 after a relatively mild initial infection. She spent three months in a rehabilitation program.
“My sense of taste hasn’t fully come back. But I still remember the smell of coffee when I was allowed to have it during rehabilitation. We are all coffee junkies here,” Voloshina said.
The percentage of COVID-19 patients who develop long-term symptoms is unclear. One U.K. study found that 14 percent of COVID-19 patients, or around one in seven, still had lingering symptoms three months after the acute infection had resolved.
Orthopedist Stanislav Shevchenko said the treatment offered at the hospital has reliable results. “Some patients still show symptoms of post-COVID syndrome after a course of rehabilitation, but they are milder," he said.
Most patients stay in the rehabilitation program for three weeks, but some face a much longer period of recovery. "In about 2 percent of patients, the symptoms can last longer than six months," Shevchenko said.
“Sometimes you feel tired of treatment," a patient named Viktor said. "You have no idea when it is going to end. Nothing is certain.”
Long-haul patients include younger people and those who had an initially mild case of the virus. “There's an increasing number of 25- to 30-year-olds with serious damage" after COVID-19, according to Taras Skoromets, the deputy head of the rehabilitation hospital.
“In severe cases, rehabilitation should begin while the patient is still in the ICU, once they've been taken off the ventilator. Then they will be sent to our center for a second stage,” Skoromets said.
Doctors and patients alike describe the heavy mental toll of long COVID-19. Symptoms like depression might result both from the virus itself and from the grueling struggle toward recovery.
One patient, Zinaida, spoke of her fears that she wouldn't recover fully. “I want to live, breathe, do nice things for my family. If I stay ill, I’ll be a burden," she said.
A patient named Tatyana described suffering from panic attacks and memory loss after her battle with COVID-19. “When you have a cold, you take medicine and expect to get better," she said. "With COVID, it’s different. You can have IV fluids and oxygen, but you keep getting worse. You feel helpless.”
"Some patients have suicidal thoughts," orthopedist Anastasia Voloshina said. "We explain that they are not to blame for feeling lazy or tired. It takes a lot of effort to convince them that treatment can be effective. An unmotivated patient won’t get good results.”
Russia has recorded more than 6 million cases of COVID-19, but the real number is thought to be much higher. An unknown number are still dealing with symptoms months after the infection. Authorities believe as many as 20,000 patients in St. Petersburg alone need rehabilitation after contracting COVID-19.
As the country fights to contain the spread of the virus, health workers are only beginning to see the full scale of an epidemic of long-term illness.