A happy recovery from Covid-19

Shortly after New Year’s Eve 2020, Francesca attended her regular dialysis treatment. When she showed symptoms of fever, coughing and severe breathing difficulties during treatment, we were immediately alarmed. After alerting 118, the Italian number for medical emergencies, she was admitted to the hospital with a Code red. Two weeks later, she was discharged with a diagnosis of "bacterial pneumonia in follow-up". Little did we know. Francesca passed the months of January and February in apparent good health.
When she came to our NephroCare centre on the 3^rd of March for consultation she was in good shape as usual. Still, during her dialysis treatment, she developed new symptoms with chills and exhaustion but no fever. We contacted the patient on the morrow to find out about her health status, and she reported that she was feeling well.

At the time, the national health system – especially in our region could not yet guarantee an adequate and rapid screening of suspect patients. We did not get clear indications from the reference hospitals that managed infected patients either. So, given the increase in Covid-19 cases in Naples city, we decided to treat her in so-called cohort isolation for her following treatments. That means we treated her together with patients showing similar diffuse symptoms, but separated from patients without symptoms.

Showing up for the treatment on 18th March, Francesca reported slight fatigue, but was free of fever. Sudden chills during treatment were accompanied by fever and respiratory distress. We immediately contacted the emergency to hospitalize our patient. A few hours later, the emergency service operators informed us that Francesca had refused hospitalization. Her justification being that she had already started to feel better during her transport to the hospital, could breathe more easily and her blood saturation had objectively improved.

Unfortunately, from that time, Francesca entered a state of panic. She did not want to go to the hospital due to the staggering increase of Covid-19 cases, afraid that she would not survive this new – and unchartered – pathology. Due to several unfortunate bureaucratic circumstances, she couldn’t perform a swab for a Covid-19 diagnosis either. Francesca resisted several attempts to hospitalise her, given the progress of symptoms. Obviously, her state of horror had taken over. We couldn’t think of any reason other than a psychological block triggered by fear. Meanwhile, Francesca needed her dialysis treatment at our clinic. All the same, the dire concomitants did not deter our staff from treating her with extreme affection, understanding and empathy.

On returning to the haemodialysis centre, Francesca had realized, that her recovery had not been a foregone conclusion, considering her previous respiratory condition. She expressed her gratitude to us for having assisted her and how much she appreciated that we had shown respect and empathy even in her most challenging moments of struggling - to accept the disease. Her respiratory situation was still compromised and needed a slow but gradual recovery, but her emotional state was clearly improved. She gradually got past the state of fear through the dawning awareness that the best option to fully recover would be to put all clinical recommendations into practice.

Thank you to the nursing team from NephroCare Italy, for sharing Francesca’s story. With the support of all involved health professionals Francesca has fully recovered from her Covid-19 illness. Although she consented to her story Francesca being told, she did not want it to happen under her real name and photograph. We respect her request and wish her all the best!