JAMESTOWN, N.D. — Lynne Tucker’s ordeal began with a bout of persistent nausea and fatigue. After she described her symptoms to a nurse, her doctor had her come in immediately for a checkup.
"He suspected COVID when the nurse told him my symptoms," she said. "He had me come in and immediately had me go to the emergency room, with oxygen on."
In the emergency room, a rapid test indicated she was infected by the coronavirus. Her condition was serious enough that she was admitted on Nov. 13, 2020, during North Dakota’s record pandemic peak.
Tucker, who is 65 and retired, spent eight days at Jamestown Regional Medical Center. Although she didn’t experience shortness of breath, she required oxygen — lots of oxygen, 15 liters.
She still needs oxygen at night to sleep, but the amount of oxygen has decreased from four liters to two liters.
Although Tucker didn’t notice any shortness of breath at the onset of her COVID-19 infection, she now battles chronic shortness of breath and fatigue, 10 months after her diagnosis.
“I don’t have the energy I used to have,” she said. “I have to take really long naps every day.”
Tucker’s “long COVID” illness has another manifestation: severe depression. Her reliance on oxygen and lower energy levels exacerbated a case of depression that was easily managed before COVID-19, she said.
“It’s a full-force depression,” Tucker said. “I’m dealing with having to take an air compressor when I go overnight someplace to stay. I can’t sleep without the oxygen or I cough a lot.”
She’s been working with a doctor to adjust her anti-depression medication, but so far hasn’t found the right balance. Before contracting COVID-19, “I was stable and it set off a severe depression,” requiring psychiatric medication.
Depression among those coping with the varied and debilitating symptoms of chronic COVID-19 aftereffects is not uncommon, according to the American Psychological Association.
Studies published in the Journal of the American Medical Association and the British Medical Journal have estimated that 10% of COVID-19 patients develop lingering “long COVID” symptoms.
A study in Wuhan, China, where the pandemic was first reported, found that six months after hospitalization, 63% of COVID-19 patients reported fatigue or muscle weakness, 26% reported sleep difficulties and 23% reported anxiety or depression.
Madeline Ranum, cardiopulmonary rehabilitation coordinator at Jamestown Regional Medical Center, said many of the COVID-19 patients who start rehab therapy are anxious following their hospitalization.
“It was pretty terrifying,” she said. “Some were close to death.”
Ranum said she reassures patients and gets them exercising to improve their cardiopulmonary function. The heart and lungs work together.
“We’ve seen it improve in a lot of cases,” she said, referring to the need for supplemental oxygen. “Not everybody’s getting off of it. If I were to guess, I’d say it’s 50-50.”
Long COVID patients with lingering breathing difficulty often ask if they’ll get off of oxygen. “I don’t know how to answer that question,” Ranum said. “It really depends on what kind of condition their lungs were in before. It’s hard to say.”
Generally, patients who did not have pre-existing health conditions, including asthma, chronic obstructive pulmonary disease, heart conditions or interstitial lung disease have better outcomes, she said.
For those who improve, “It takes time to get there,” Ranum added.
While hospitalized, Tucker received convalescent plasma containing antibodies from a donor who had recovered from COVID-19. This was before monoclonal antibodies were available.
“I really believe that turned me around,” she said. “Kept me off a ventilator.”
Tucker, who has had cardiopulmonary rehabilitation, continues to exercise at a Jamestown fitness center in the hope of improving her lung function and weaning herself from oxygen at night.
She goes in for oximeter testing every six months at the Sanford Sleep Center in Fargo.
“I’m hopeful that my lungs will improve,” she said, adding that she's noticed improvement recently. “There’s no exercises I can do. It’s just got to heal.”
COVID-19 vaccines weren’t available when Tucker got infected. She’s since been vaccinated. Sometimes, even patients who aren’t hospitalized develop long COVID, a risk people can minimize by getting vaccinated, she said.
Before getting infected, Tucker wore a mask in public indoors and took other precautions. “I’ve been cautious for years and bammo, this came along,” she said.
“A lot of people have hardly any symptoms or it’s like a cold and you get better,” Tucker added. “But you can’t guarantee it.”