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COVID-19 Booklet:
Management of Post
COVID-19 Conditions
Brought to you by KPJ Healthcare
What’s Inside
Introduction.................................................................................................................................... 3
A COVID-19 Survivor Story....................................................................................................4
What You Need to Know About Long COVID-19 and the Effects.............. 7
Importance of doing COVID-19 Screening.............................................................. 13
Post COVID-19 Screening Package............................................................................... 17
Treatment Package................................................................................................................. 18
KPJ Must Have Kit & Using the Oximeter.................................................................... 19
Post COVID-19 Nutrition Care............................................................................................ 21
Contact Us..................................................................................................................................... 26
COVID-19 Booklet:
Management of Post COVID-19 Conditions | Brought to you by KPJ Healthcare
Introduction
This document is a generic, interim guidance for the public and should be used to support any local or other more
contemporaneous advice, acknowledging that in this rapidly changing pandemic environment, uncertainties remain in our
understanding of the spread of COVID-19 and its management.
At KPJ Healthcare, we take pride in our role as the caretaker of your health and
well-being, improving your health and quality of life for you and your family. The
COVID-19 pandemic continues to have a tremendous impact on many patients'
physical and emotional health.
While many people recover from COVID-19 completely, there is a population of

survivors who suffer long-term effects of the virus such as shortness of breath,
continued loss of taste or smell, dizziness or headaches, to cognitive symptoms
including fatigue, brain fog, or increased anxiety or depression.
Our Post COVID-19 Booklet is a comprehensive guide, that we have put together
to help you manage the long-term effects of COVID-19.
COVID-19 Booklet: Management of Post COVID-19 Conditions | Brought to you by KPJ Healthcare 3
A COVID-19 Survivor
Story
Lavarn Senthirajah & Debbie Cindy Munting - Klang, Selangor
In many cases, survival does not necessarily mean complete recovery. Some
patients still bear the scars of their past illnesses.
We spoke to Debbie Cindy Munting and her husband, Lavarn Senthirajah, who
were both COVID-19 survivors. She recalls the harrowing experience of hearing the
news and shared with us what it was like to have been diagnosed with COVID-19.
Getting tested & confirmation

“On 16th July 2021, my maid was tested positive for COVID -19. It took us by surprise,
and not long after, my mum-in-law and niece were tested positive as well. I began
to feel feverish two days later and immediately went for a PCR test. I was later
confirmed positive alongside my husband and children.
We did not know what stage of COVID-19 we were in, except that our RT values
were about 18, which was rather infectious. My husband and I were scheduled to
receive our second dose of the Sinovac vaccine on 24 July 2021. Unfortunately, we
had to reschedule since we were tested positive”.
A COVID-19 Survivor
Storycont.
Going through the recovery process
“I was in the hospital for ten days, with three days in the High Dependency Unit (HDU),
four days in the Intensive Care Unit (ICU), and three days in the normal ward.
My fever never subsided, with temperature of 38.5c to 39c for several days and no
appetite to eat. Finally, on my 6th day, despite the continuous monitoring of my
oxygen level to not go below 95%, things began to deteriorate when it went below 90%
(~88%).”
“As both of our health worsened, we decided to admit ourselves to the hospital on the
24 July 2021. Both of us were admitted to the ICU and needed oxygen support, with
my husband categorised as Stage 5 while I was diagnosed as Stage 4. My husband
was on the ventilator for about ten days. It was a harrowing experience when you
could not predict what lies ahead. The thought of going to the ICU was pretty
daunting, especially when you have never been admitted to one.”
A COVID-19 Survivor
Storycont.
Going through the recovery process cont.

“The doctors and the nurses encouraged me to do proning frequently to improve my
oxygen level. In the ICU, I had to use the high-flow nasal cannula in the mornings for
about three days. In addition, I had to also be on the Continuous Positive Airway
Pressure mask while in the proning position. Prone position is a body position in which
the person lies flat with the chest down and the back, up. Imagine trying to sleep at
night with the oxygen mask while you lie on your stomach for a few hours”.
“As I gradually built my strength and the oxygen assistance was at the minimum
level, I was transferred into the normal ward for COVID-19 patients. I was beyond
happy when the doctor told me that I could be discharged.”
Recovering from COVID-19

“We went for a follow-up medical check-up three weeks after we were discharged. I
had shortness of breath when I was infected with COVID-19, but the doctor said that
my lung conditions improved significantly. I have taken the initiative to exercise
regularly to increase my energy and stamina.”
What you need
to know about long COVID-19
and the effects
Post-COVID conditions are a wide range of new, returning, or ongoing health
problems people can experience four or more weeks after first being infected with
the virus that causes COVID-19.
Even people who did not have COVID-19 symptoms in the days or weeks after they
were infected can have post-COVID-19 conditions.
To effectively diagnose, treat and manage a condition, it needs
to be defined and distinguished from other conditions.
Acute COVID-19
Signs and symptoms of COVID-19 for up to 4 weeks.
Ongoing symptomatic COVID-19
Signs and symptoms of COVID-19 from 4 to 12 weeks.
Post COVID-19 syndrome

Signs and symptoms that develop during or after an
infection consistent with COVID-19, continue for more than
12 weeks and are not explained by an alternative diagnosis.
What you need
to know about long COVID-19
and the effects cont.
Conditions Sequelae
Ear, Nose, Throat Tinnitus, Earache, Sore throat, Loss of Taste and/or Smell
Dermatological Skin rashes
Respiratory Breathlessness, Cough
Generalised Fatique, Fever, Pain
Cardiovascular Chest Tightness, Chest Pain, Palpitations
Gastrointestinal Abdominal pain, Nausea, Diarrhoea, Anorexia and Reduced Appetite
Musculoskeletal Joint Pain, Muscle Pain
Psychological/
Depression Symptoms, Anxiety Symptoms
Psychiatric
Cognitive impairment ("brain fog, "loss of concentration or memory

Neurological issues), Headache, Sleep Disturbance, Peripheral Neuropathy
Symptoms, Dizziness, Delirium
Multiorgan
Effects of COVID-19
Some people who had severe illness with COVID-19 experience multiorgan effects
or autoimmune conditions over a longer time with symptoms lasting weeks or
months after COVID-19 illness.
Multiorgan effects can affect most, if not all, body systems,

including heart, lung, kidney, skin, and brain functions.
Autoimmune conditions happen when your immune system

attacks healthy cells in your body by mistake, causing
inflammation (painful swelling) or tissue damage in the
affected parts of the body.
Multiorgan
Effects of COVID-19 cont.
Organs affected Sequelae
Liver dysfunction, Malnutrition due to vomiting and
Gastrointestinal
diarrhoea/ breathlessness/ loss of appetite
Nephrology Renal impairment, Acute kidney injury
Dermatology Skin rashes, Hair loss
Pulmonary Persisting interstitial lung disease, Impaired lung function,

Pneumonia/Lung cavitation, Complications of
intubation/ventilation
Myocardial infarction, Myocarditis, Pericarditis,

Cardiovascular
Arrhythmia, Heart failure
Hypercoagulable state, Anaemia,

Haematological
Venous thromboembolism (VTE)
Multiorgan
Effects of COVID-19 cont.
Organs affected Sequelae
Stroke, Cognitive impairment, Encephalopathy, Epilepsy
Myelitis, Critical care neuropathy/myopathy, Cognitive
Neurological
impairment/school performance, Deterioration, Sleep
disturbances
Rheumatological Post viral syndrome similar to chronic fatigue syndrome
Deterioration of diabetic control, New onset diabetes,

Thyroiditis and thyroid dysfunction, Primary and secondary
Endocrine
adrenal insufficiency, Osteoporosis due to prolonged
immobilization
Worsening of cognitive decline, Depression, Anxiety, Post-

Mental Health traumatic stress disorder (PTSD) following severe illness
Selected functional and other testing tools for
evaluating people with
post-COVID-19 conditions
Exercise capacity
1-minute sit-to-stand test
2-minute step test
10 Meter Walk Test (10MWT)
6-minute walk
The Importance of Doing
Post COVID-19 Screening
It has been observed that COVID- 19 patients experience long-term negative health
impacts that may, in turn, develop into more serious conditions along with
destroying our body's immune system. On that basis, a post-recovery screening is
recommended for patients.
Why should you get a post-COVID-19 check-up done?

IgG antibody tests
After fighting off the infection, the body produces helpful antibodies which prevent
future infections. Therefore, determining the level of antibodies can help you get a
better idea of how immune-protected are you and accommodating if you are
eligible for plasma donation.
Typically, it takes the body somewhere around a week or two to develop antibodies,
so wait until you have recovered from the virus. If you donate plasma, get a test
done within a month of recovery, which is also the ideal time for donation.
Complete Blood Count (CBC) Tests
CBC tests measure the different types of blood cells (RBCs, WBCs, Platelets, etc.) and
give you an idea of how well you have responded to a COVID-19 infection. It could
also, in a way, guide you to take additional measures you may need post-recovery.
Post COVID-19 Screening cont.
Why should you get a post-COVID-19 check-up done? cont.
Glucose, Cholesterol Tests
Since the virus is susceptible to causing inflammation and clotting, some people
report fluctuations and flare-up in their vital parameters, including blood glucose
and blood pressure levels. This is also the reason why COVID-19 patients are
encouraged to keep track of their vitals in recovery.
Post-recovery, getting routine function tests such as these could be crucial if you
have pre-existing conditions such as Type-1, Type-2 diabetes, cholesterol, or are
prone to cardiac complications. For example, for many COVID-19 patients, blood
glucose levels could remain altered (either higher or lower than usual) post-
recovery and a revision of medications, doctor’s advice may be needed.
So go for frequent check-ups, and continue to track your vitals now more than ever.
Further tests such as Biochemistry, creatinine, liver, and kidney function tests are
recommended for those at risk.
Neuro-Function Tests
Many patients reported neurological and psychological symptoms weeks and
months after recovery, which can impact day-to-day function. As a result, the
emergence of these symptoms has become a matter of concern, with more and
more medical experts stressing the importance of brain and neurological function
tests weeks after recovery.
Lingering symptoms of COVID-19, such as brain fog, anxiety, tremors, dizziness,
fatigue should also be looked into. Women over the age of 40 are more prone to
the risks and may need priority testing.
Heart Imaging and Cardiac Screenings

A COVID-19 infection triggers widespread inflammation in the body, which causes
weakening and damage of important heart muscles and arrhythmias and leads
to complications such as myocarditis, one of the most common post-COVID-19
recovery problems reported. It can also aggravate the condition should the
survivor is already prone to heart complication risk.
Chest Scans
HRCT (high-resolution computerised tomography) scans are being hailed right
now for their accuracy in detecting disease severity. It also showcases the level of
lung involvement caused by COVID-19.
While doctors say that most people's lungs recover well after COVID-19, high levels
of involvement and viral infection could leave many dependent on external
oxygenation and respiratory support. To determine the recovery, undergoing repeat
CT (computerised tomography) scans and lung function tests could be helpful.
Post COVID-19 Screening
RM 348
Enjoy a
10% discount
when you book for 50 pax or more
If you are a survivor and are worried about the symptoms after recovering from
COVID-19, contact us and we will help you get back on your feet.
Physical Examination by Health Screening Doctor
(Height, Weight, Blood Pressure, Body Mass Index, Visual Acuity)
Chest X-ray
Resting Electrocardiogram (ECG)
Lung Function Test (LFT)
Blood & Urine Test

(Full Blood Count, Liver Function Test, Renal Profile with Urine FEME, C-
Reaction Protein Test (CRP), Erythrocyte Sedimentation Rate (ESR))
Book an Appointment
Do book your appointment three (3) days in advance. You are required to bring your
COVID-19 test result during your appointment.
Get a complimentary one (1) box of Neutrovis face mask*

Find us on social media
when you book an appointment with us.
*while stocks last
Comprehensive
Post COVID-19 Care
Continuity from the Basic Post COVID-19 screening, our medical team at KPJ, with a
guideline from the Ministry of Health, has proposed several packages and
treatments recommended for COVID-19 survivors to improve their health quality.
Respiratory Recovery Package

Respiratory Recovery Package is a programme that helps patients
to improve their respiratory function by attending several physicals,
blood tests and rehabilitation sessions with our medical expert for a
duration of 2 to 6 times a year.
Neurocognitive and Psychological Package
Some COVID-19 patients with severe cases might suffer
from neurological and psychological problems and require
follow-up treatment either with a neurologist or a
psychiatrist. The recommended follow-up period is six times
a year with an additional magnetic resonance imaging
(MRI) of the brain when needed.
Why you should have one
KPJ Must Have Kit at home?
Our KPJ Must Have Kit contains all the essentials you and your family need to have
at home during COVID-19.
Pulse Oximeter
Digital Thermometer
COVID-19 Self-Test Kit
Hand Sanitizer
Face Mask
Vitamin C Tablet (1000mg)
Paracetamol Tablet (500mg)
Disinfectant Wipes
Available on KPJ Healthshoppe,

www.kpjshoppe.com
Why you should have one
Pulse Oximeter at home?
Using the Pulse Oximeter
A pulse oximeter is an electronic device that is placed on a fingertip to measure
the oxygen levels in your blood.
Oxygen Saturation Pulse Rate Temps

Observation (SpO2)% (bpm) (C)
Normal readings 96% and higher 60- 1 00 36.5 - 37.5
Acceptable to continue
95% 101 - 109 38
home monitoring
Seek advice from your GP 93 - 94% 110 - 130 38.1 - 39
Need urgent medical

92% or less 131 or more 39 or more
advice – call 999
Post COVID-19 Nutrition Care
COVID-19 infection symptoms such as fever, cough, lethargic, difficulty in breathing,
dry mouth, and changes of tastes and smell may affect your nutrition status.
Therefore, good nutrition is important for recovery, restoration of function, and prevent
further worsening of the conditions.
Health Status Recovery Journey

Weight Monitoring: Body Mass Index (BMI)
Classification Range
Underweight <18.5kg/m2
Ideal 18.5 - 22.9kg/m2
Overweight 23 - 24.9kg/m2
Pre - Obese 25 - 29.9kg/m2
Obese >30kg/m2
Gender Range
Male 10% - 20%
Female 18% - 28%
Post COVID-19 Nutrition Care cont.
Balanced and Variety Diet
1/4 Protein
Meat, Chicken, Fish, Egg, Tofu, Beans, and Legumes
1/2 Fruits and Vegetables

Choose a variety of fruits and vegetables
1/2 Carbohydrates
Rice, Noodles, Bread, and Potatoes
Getting Enough Proteins

Include a protein source at each meal. In addition, adding a high protein supplement
to your diet with advice from your Dietitian.
Protein Food Sources (1 Exchange = 7g Proten)
2 slices of cheese 1 serving of tempeh (45g)
Vege
Non-vege
1 nos of egg 1 piece of fucuk (15g)

1 medium fish 1 piece of tofu (90g)
1 medium chicken (50g) ½ cup of cup beans/legumes (cooked)
1 medium squid
1 glass of milk
Optimise Vitamins and Minerals
Research has shown that Vit C, D zinc, selenium, and iron are critical in maintaining
your immune cells' function and growth. However, maintaining a healthy lifestyle and
a balanced diet also play a bigger role in strengthening your immunity system.
Eating a share of fruits and greens is good for your health. The optimal amount
you should aim for every day is (five) 5 servings of fruits and vegetables.
2 servings of fruits/per day. Example:
1 serving
1 serving
3 servings of vegetables/per day. Example:
1/2 cup cooked squash = 1 serving
1 cup raw fruits or vegetables = 1 serving
1 cup leafy greens = 1 serving
Stay Hydrated
Getting enough fluid every day is important for your health and can prevent
dehydration. Most of your fluid needs are through the water and beverages you
drink. Take at least 8 - 12 glasses of water a day.
You can also get some fluids through the foods you eat – especially foods with high
water content, such as many fruits and vegetables.
Tips to manage your dehydration symptoms
Symptoms Prevention
Small and frequent meals
Shortness of breath
Soft and moist texture foods
Rinse and gargle with water after using an inhaler

Take a sugar-free sweet or chew sugar-free gum to
Dry mouth
help saliva production
Get enough fluids
Experiment with different herbs and spices in cooking

Changes of
Exploring cold foods dishes (if you are struggling with
taste and smell
a strong taste of hot meals)
Rehabilitation
Slowly increase your physical activity level by adding time, strength and frequency.
Muscle Strength Training
Recommend frequency: 2 - 3 times/per week
Aerobic Exercise
Recommend frequency: 3 - 5 times/per week. To spend at least 20 - 30 minutes
with intensity level gradually increase from moderate level. Example of activities, brisk
walking, yoga, walking up and down the stairs
Dietitian Services
Our team of dietitians is available to provide you with one-on-one
nutrition counseling and help you build personalised nutrition plans.
To make an appointment with

the dietitian, please contact the
nearest KPJ’s Hospitals near you.
Contact Us
KPJ Healthcare hospital network and rehabilitation speciality centre:
Central Region
Hospitals Emergency Line General Line
KPJ Ampang Puteri +603 4270 7060 -

KPJ Damansara +603 7722 3500 +603 7718 1000
KPJ Tawakkal Kl +603 7718 1000 +603 4026 7777
KPJ Selangor +603 5543 1722 +603 5543 1111
KPJ Klang +603 3377 7999 +603 3377 7888
KPJ Kajang +603 8769 2911 +603 8769 2999
KPJ Sentosa Kl +603 4043 7166 +603 4043 7166
KPJ Rawang +603 6099 8888 +603 6099 8999
KPJ Seremban +606 763 6900 +606 768 6000
Contact Us
Southern Region
KPJ Johor +607 225 3199 +607 225 3000

KPJ Puteri +6019 774 2692 +607 225 3222
KPJ Kluang +607 771 6999 +607 771 8999
KPJ Pasir Gudang +607 257 3900 +607 257 3999
KPJ Bandar Dato' Onn +607 301 1000 +607 301 1000
KPJ Bandar Maharani +606 956 4500 +606 956 4500
KPJ Batu Pahat +607 459 1000 +607 459 1000
Contact Us
Northern Region
KPJ Ipoh +605 241 8989 +605 240 8777

KPJ Penang +604 548 6799 +604 548 6688
KPJ Taiping +605 807 1049 +605 807 1049
Kedah Medical Centre +604 730 8878 +604 730 8878
KPJ Perlis +604 970 7777 +604 970 7777
KPJ Sri Manjung - +605 691 8153
Contact Us
East Coast Region
KPJ Pahang +609 511 2681 +609 511 2692

KPJ Perdana +609 747 3140 +609 745 8000
East Malaysia
KPJ Sabah +6088 322 199 +6088 322 000

KPJ Kuching +6082 365 030 +6082 365 777
KPJ Sibu +6084 329 900 +6084 329 900
KPJ Miri +6085 649 999 +6085 649 999
COVID-19 Booklet:
Management of Post
COVID-19 Conditions
Brought to you by KPJ Healthcare
KPJ Healthcare Berhad

199201015575 (247079-M)
Level 12, Menara KPJ, 238 Jalan Tun Razak

50400 Kuala Lumpur, Malaysia
T: +603 2681 6222
F: +603 2681 6888
www.kpjhealthcare.com.my
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COVID-19 Booklet:

A COVID-19 Survivor Story....................................................................................................4

Importance of doing COVID-19 Screening.............................................................. 13

Post COVID-19 Screening Package............................................................................... 17

KPJ Must Have Kit & Using the Oximeter.................................................................... 19

Post COVID-19 Nutrition Care............................................................................................ 21

While many people recover from COVID-19 completely, there is a population of

Getting tested & confirmation

Going through the recovery process

Going through the recovery process cont.

Recovering from COVID-19

Post COVID-19 syndrome

Cognitive impairment ("brain fog, "loss of concentration or memory

Multiorgan effects can affect most, if not all, body systems,

Autoimmune conditions happen when your immune system

Nephrology Renal impairment, Acute kidney injury

Dermatology Skin rashes, Hair loss

Pulmonary Persisting interstitial lung disease, Impaired lung function,

Myocardial infarction, Myocarditis, Pericarditis,

Hypercoagulable state, Anaemia,

Rheumatological Post viral syndrome similar to chronic fatigue syndrome

Deterioration of diabetic control, New onset diabetes,

Worsening of cognitive decline, Depression, Anxiety, Post-

Why should you get a post-COVID-19 check-up done?

Heart Imaging and Cardiac Screenings

Lung Function Test (LFT)

Blood & Urine Test

Get a complimentary one (1) box of Neutrovis face mask*

Respiratory Recovery Package

Available on KPJ Healthshoppe,

Oxygen Saturation Pulse Rate Temps

Normal readings 96% and higher 60- 1 00 36.5 - 37.5

Seek advice from your GP 93 - 94% 110 - 130 38.1 - 39

Need urgent medical

Health Status Recovery Journey

Ideal 18.5 - 22.9kg/m2

Pre - Obese 25 - 29.9kg/m2

Female 18% - 28%

1/2 Fruits and Vegetables

Getting Enough Proteins

1 nos of egg 1 piece of fucuk (15g)

2 servings of fruits/per day. Example:

3 servings of vegetables/per day. Example:

1/2 cup cooked squash = 1 serving

1 cup raw fruits or vegetables = 1 serving

1 cup leafy greens = 1 serving

Rinse and gargle with water after using an inhaler

Experiment with different herbs and spices in cooking

To make an appointment with

Hospitals Emergency Line General Line

KPJ Ampang Puteri +603 4270 7060 -

Hospitals Emergency Line General Line

KPJ Johor +607 225 3199 +607 225 3000

Hospitals Emergency Line General Line

KPJ Ipoh +605 241 8989 +605 240 8777

East Coast Region

Hospitals Emergency Line General Line

KPJ Pahang +609 511 2681 +609 511 2692

Hospitals Emergency Line General Line

KPJ Sabah +6088 322 199 +6088 322 000

KPJ Healthcare Berhad

Level 12, Menara KPJ, 238 Jalan Tun Razak

Find us on social media