When the coronavirus pandemic hit us with full force in the spring, it heralded a journey into the unknown.

“In the early days, we treated the condition according to its symptoms, administering extra oxygen for oxygen deficiency and treating fever with paracetamol,” says pulmonary specialist Juuso Paajanen.

As research data has been accumulated, further means of treating the condition have been acquired. We realized at an early stage in the spring that COVID-19 is associated with an unusual tendency for thrombosis. We introduced anticoagulant therapy, first in inpatient care and later to some patients in home care.

“Another important discovery was that dexamethasone decreased mortality and prevented the onset of severe forms of the disease, particularly in coronavirus patients who were critically ill. We also found that other immunomodulators may boost the impact of steroids if administered at the right time,” says Paajanen.

Residual symptoms not well known yet

So far, little is known about the residual, or long-term symptoms of COVID-19. Patients with mild symptoms generally recover quickly, but many of those who develop a severe form of the disease face a slow recovery.

Numerous patients have reported of prolonged and recurring symptoms, alternating between different kinds of symptoms.

Remote connections are here to stay

“The major challenges in inpatient care are the rapid changes that have to be made to activities, facilities, personnel and on-call arrangements. We converted inpatient wards into coronavirus wards flexibly, according to patient numbers, and we set up an entire ward dedicated to coronavirus patients at the Surgical Hospital. Moreover, we transferred non-coronavirus patients to other wards, across specialty and department boundaries,” says Head Physician Pirkko Brander, Head of Pulmonary Diseases.

We relocated coronavirus patients from one hospital or ward to another as required in terms of their care and monitoring and admittance to an intensive care unit when necessary. We recruited new nursing personnel and gave them induction training with a rapid turnaround.

We curtailed our elective activities, and outpatient clinic patients were mainly seen by remote consultation. We made increased use of remote connections on the wards too, for rounds, reporting and various meetings. One of the effects of the year of the coronavirus is that remote connections are here to stay in our work in both inpatient and outpatient care, and in operational guidance in general.