COVID-19 advice for patients in hospital and after discharge

What is COVID-19?

The most important symptoms of COVID-19 are recent onset of any of the following:

• a new continuous cough
• a high temperature
• loss or change to your sense of smell or taste

We also know that some people have very mild symptoms, flu-like symptoms and sometimes gastrointestinal symptoms such as nausea, vomiting, loss of appetite and diarrhoea.

The severity of symptoms and how long they last can vary for people who have COVID-19. Although symptoms are reported to reduce in most cases within 7 days.

With the wide roll out of vaccines most people who have been fully vaccinated and catch COVID-19 will not require admission to hospital and will recover at home naturally. Others will require monitoring in hospital and a small proportion will require treatment in intensive care.

COVID-19 testing while you are in hospital

There will be times due to new variants of this disease, or during the winter, when the number of COVID-19 infections in the community and in the hospital increases. Although we make every effort to prevent infections in hospital, unfortunately there will be times when the patients we are caring for come into contact with someone who is infectious and go on to test positive for COVID-19 themselves. Even people with very mild symptoms can unknowingly spread the virus to others.

Testing helps us to find out if people have COVID-19, this means we can take the right steps to protect you and others. We may need you to take regular tests (nose and throat swabs) to help reduce the spread of coronavirus. Whilst we would encourage you to have the test you are free to refuse it.

Being in contact with someone who tests positive for COVID-19 while you are in hospital

The Infection Prevention and Control Team look at all COVID-19 results in the hospital to identify any patients that have had close contact with an infected person (we call this being exposed) and pass this information onto the ward teams.

If you are in contact with another patient who tests positive for COVID-19 while you are an inpatient the ward team will let you and your family know. The doctors and nurses will check if you have any symptoms for 5 days after the contact. You may also have an additional COVID-19 test taken either during or after 5 days if you are still an inpatient. You may be moved to another bay or side room depending on the circumstances.

The time from being exposed to developing symptoms can vary between 2 and 10 days, but recent research has shown that most people will have developed symptoms by day 5 following close contact.

Bay and ward closures due to COVID-19 infections

Sometimes if an outbreak of COVID-19 infection is suspected it may be necessary to close individual Bays or Wards to new admissions, and limit general visiting. The ward team will inform you and your family if you are affected and will try very hard to keep everyone updated. The decision to close any area is made very carefully and is reviewed daily. During this time, we advise visiting is limited to compassionate grounds or special circumstances only to prevent further infections.

Testing positive for COVID-19 while you are in hospital

If you test positive for COVID-19 while you are an inpatient in hospital this may be because you were in contact with someone infectious before you were admitted or while you were a patient. In the hospital this could be another patient, a visitor or a staff member. It is usually difficult to pinpoint exactly where these infections come from. You may be moved to a side room or a bay/ward with other patients that have also tested positive. This is to keep people around you safe.

The doctors and nurses looking after you will continue to provide you with all the care and treatment you need as well as managing your COVID-19 infection.

Most people get better from COVID-19 within 3 weeks. You might have mild symptoms and feel unwell for a short time before slowly starting to feel better. To help you recover, you need to:

• rest as much as you can
• drink regular fluids

Leaving hospital after a COVID-19 infection

You will be discharged home when the team looking after you feel you are well enough to leave hospital.

Please make sure that you stay hydrated and take paracetamol if you have a temperature. To help with your recovery, try to avoid spending long periods of time lying flat in bed, try sitting in a chair or moving around at home.

You should usually stay at home and limit contact with other people for 5 days after testing positive for COVID-19, and avoid meeting people at higher risk from COVID-19 for 10 days. If it has been more than 10 days since your positive result you are no longer infectious.

You may still have a cough or feel tired or breathless, or have changes in mood for several weeks.

If these problems persist, please call your GP for advice. Your GP will talk to you about the care and support you might need or give you advice about how to manage and monitor your symptoms.

If the symptoms are having a big impact on your life, you may be referred to a specialist rehabilitation service or a service that specialises in the specific symptoms you have. These services can help you to manage your symptoms and help with your recovery.

Long-term effects of COVID-19 (long COVID)

For some people, COVID-19 can cause symptoms that last weeks or months after the infection has gone. This is sometimes called post-COVID-19 syndrome or "long COVID".

The chances of having long-term symptoms does not seem to be linked to how ill you are when you first get COVID-19. People who had mild symptoms at first can still have long-term problems.

Common long COVID symptoms include:

• extreme tiredness (fatigue)
• shortness of breath
• chest pain or tightness
• problems with memory and concentration (brain fog)
• difficulty sleeping (insomnia)
• heart palpitations
• dizziness
• pins and needles
• joint pain
• depression and anxiety
• tinnitus, earaches
• feeling sick, diarrhoea, stomach aches, loss of appetite
• a high temperature, cough, headaches, sore throat, changes to sense of smell or taste
• rashes

You can find more information to support your recovery on the NHS website www.yourcovidrecovery.nhs.uk

This website covers all aspects of COVID recovery including, how it might be affecting your mind and body, eating well, sleeping well, managing your daily activities and returning to work.

Patient

Further information

If you would like any further information regarding COVID-19 and how it has affected your stay in hospital you can speak to the doctors and nurses looking after you. Alternatively, you can ask for the Infection Prevention and Control Nurses to visit you on the ward from Monday to Friday, 9.00am to 4.00pm.

If you have any comments or concerns about your care then you can contact the Patient Advice and Liaison Service (PALS) on 0800 019 3282 (freephone) or write to:

PALS Office, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN