"Recovered from COVID-19" and then died while playing badminton? Several people have developed severe symptoms after infection—doctors emphasize: These situations require careful attention.

After testing negative, physical exercise can be gradually resumed over five weeks, with each week representing a distinct phase. In the first week, start at 25% to 50% of your pre-infection exercise intensity, incorporating gentle stretching exercises. By the second week, increase to 70%, then progress to 80% in the third week, reach 90% in the fourth week, and finally return to your normal activity level by the fifth week.

Among these, the first two phases are the most critical. Rehabilitation therapist Huang Xu recommends maintaining a 1:4 ratio of exercise to rest during the first week, gradually increasing it to 1:3 in the second week. Non-consecutive workouts are ideal, ideally 2 to 3 times per week. "This balance ensures that you don’t feel overly fatigued while still providing optimal recovery for your heart and muscles," he explains. After the first two weeks, you can gradually increase the intensity of your workouts based on how you personally feel.

Huang Xu and Liu Jing, associate chief physician of the Department of Internal Medicine at Beijing Delkangni Orthopedic Hospital, both emphasized that during the recovery phase after testing negative, it’s crucial to prioritize nutrition. Trace elements and vitamins found in fruits and vegetables can significantly aid rapid recovery, while consuming protein-rich foods like milk and eggs is equally beneficial for helping the body regain strength. Additionally, Liu Jing strongly advised getting ample sleep, as sleep itself plays a key role in promoting the self-repair of tissues and organs, boosting the body’s ability to produce antibodies, and activating the immune system. "Proper sleep management is an essential strategy for supporting post-illness recovery," she added.

Omicron surges, putting immense pressure on emergency departments across hospitals—many infected individuals are now becoming severely ill! One common detail has prompted doctors to issue an urgent appeal: This matters deeply.

We are currently in the peak season for respiratory infectious diseases—both colds and COVID-19 are respiratory illnesses caused by viral infections. It’s important to remain vigilant about the risk of "co-infection" with COVID-19 and influenza, and we must also pay close attention to "silent hypoxia," which can occur in older adults after they contract COVID-19. Additionally, doctors have noticed that critically ill elderly patients admitted to the emergency room often suffer from underlying malnutrition issues.

Someone has already been infected simultaneously! Pay attention to elderly family members at home.

Wan Shaobing, head of the fever clinic and director of the Emergency Department at the Shouyi Branch of Wuhan Third Hospital, explained that colds are caused by influenza viruses, while COVID-19 is triggered by the novel coronavirus. If a person becomes infected with both pathogens simultaneously, they could end up contracting both illnesses at once. In fact, patients with a common cold might also develop a secondary COVID-19 infection—but not the other way around. Conversely, if someone accidentally contracts COVID-19, their risk of catching a cold would likely increase as well.

During a cold, the body's immune defenses weaken, and the upper respiratory tract's ability to fight off infections also becomes less effective. This creates an ideal opportunity for the novel coronavirus to invade and infect the body, potentially leading to COVID-19. If you’ve had any history of contact with someone infected with the virus, it’s important to promptly perform a self-test using antigen kits—or visit a hospital for a PCR test—to determine whether you’ve been infected.

Cold symptoms overlap with early signs of COVID-19, as both may include nasal congestion, runny nose, cough, and sore throat. However, the key difference is that after contracting COVID-19, patients typically experience more pronounced fever and body aches, along with the production of thick, sticky mucus in larger quantities. Additionally, some patients may develop reduced or lost sense of smell and taste, as well as diarrhea.

Currently, cases have been identified involving both influenza and COVID-19 simultaneously. Given that older adults naturally have weaker immune systems and often suffer from multiple underlying health conditions—such as cardiovascular and cerebrovascular diseases, diabetes, and others—they represent a particularly vulnerable population that requires close monitoring.

Beware of "silent hypoxia" in elderly individuals

Li Yanming, director of the Department of Respiratory and Critical Care Medicine at Beijing Hospital, emphasized that once elderly individuals experience fever or test positive for COVID-19 at home, they must step up monitoring—especially with close attention from family members. Compared to younger people, older adults may not exhibit such obvious physical responses to abnormalities; for instance, some seniors might already have an elevated body temperature yet remain unaware that they’re actually running a fever.

Li Yanming noted that elderly individuals infected with COVID-19 may experience "silent hypoxia." Family members might perceive the elderly person's breathing as still stable and relatively normal, but their blood oxygen saturation could already be quite low. This is especially critical when caring for elderly individuals who are unable to care for themselves—caregivers must closely monitor the patient’s temperature, heart rate, pulse, and changes in peripheral blood oxygen saturation. If these vital signs remain relatively stable, it likely indicates a less urgent situation. However, if any of these indicators become abnormal—particularly if blood oxygen saturation drops—it’s essential to seek medical attention promptly. The earlier treatment begins, the higher the chances of a successful recovery.

Zhang Wenhong, director of the National Center for Infectious Disease Medicine, recently warned during a speech to remain vigilant about "silent hypoxia" among elderly individuals. He explained that some older patients arrive at the hospital already in critical condition because their bodies are slow to respond to low oxygen levels—or sometimes they don’t even notice symptoms like chest tightness or difficulty breathing at all. This phenomenon is aptly referred to as "silent hypoxia." He cited an example: a 90-plus-year-old patient lay motionless in bed, and by the time family members noticed something was wrong, the person had already been suffering from severe oxygen deprivation for hours. Zhang emphasized that this risk of "silent hypoxia" may be particularly heightened for seniors whose daily care is managed by caregivers—such as nannies—while their children are busy with work or other responsibilities.

Cao Bin, Vice President of China-Japan Friendship Hospital, Director of the Department of Respiratory and Critical Care Medicine, and Deputy Director of the National Center for Respiratory Medicine, recommends that vulnerable populations begin antiviral treatment as early as possible in the initial stages of illness, and advises them to keep a pulse oximeter on hand for monitoring severe symptoms. He noted that some elderly patients may experience dangerously low oxygen levels—such as blood oxygen saturation dropping below 70%—without even noticing obvious chest tightness or breathing difficulties. "This is extremely dangerous and calls for immediate oxygen supplementation," he emphasized.

"If oxygen deficiency isn’t corrected promptly, patients can easily progress to severe pneumonia," Zhang Wenhong emphasized, stressing the need to move the detection of high-risk cases even earlier in the process.

Severely ill elderly individuals commonly suffer from malnutrition.

On the morning of December 23, Huashan Hospital’s emergency room had more than 30 COVID patients under observation. Hearing that their conditions were all quite critical, Dr. Ai Jingwen and her colleague, Dr. Wang Jinyu, immediately rushed over to review the chest CT scans of all 30-plus patients one by one. They identified approximately 10 cases showing classic signs of viral pneumonia, including one patient with a severe, typical form of viral pneumonia characterized by diffuse interstitial lung damage. "From our frontline clinical experience," Dr. Ai noted, "the likelihood of developing severe pneumonia or requiring intubation due to Omicron has significantly decreased compared to the early days of the pandemic in 2020, as well as compared to earlier variants like Alpha and Delta that dominated globally in 2021."

Ai Jingwen noticed a "remarkable" phenomenon: besides the typical patient with severe viral pneumonia, she found herself surrounded by elderly patients in their 80s and 90s who had contracted COVID-19. Although their lung CT scans showed only mild signs of viral pneumonia, most of them also suffered from underlying health conditions and were in extremely poor overall condition—clearly classified as critical cases.

She patiently asked the family members one by one for details about the patient’s illness—“Couldn’t eat anything after developing a fever,” and “Has been drinking only rice porridge for the past two days straight.” The family members responded in unison.

This has raised her concerns. After speaking with doctors like Yang Shibo and Wang Yiduo, who are working in the emergency department, they noticed a common pattern: "We’ve found that elderly patients admitted to the emergency room with severe conditions almost always suffer from malnutrition," said Ai Jingwen. "When people have a fever, it’s true that they often lose their appetite. While young individuals might manage fine with just a few days of inadequate nutrition, older adults are like living in a fragile thatched-roof hut—already precarious and unstable. If their nutritional intake doesn’t keep up, their health can quickly deteriorate. Frustrated family members then rush them straight to the emergency room."

However, the emergency room is now overwhelmed. Chen Mingquan, director of the Emergency Department at Huashan Hospital, notes that while the hospital previously received around 30 ambulances daily, that number has now surged three to four times higher—now averaging 90 to more than 120 vehicles per day. Meanwhile, a significant number of emergency doctors have fallen ill due to infection, forcing many others to continue working despite being unwell. As a result, both waiting times for treatment and the duration required for intravenous hydration have lengthened compared to the past. Many elderly patients are left feeling both hungry and weak; though their lungs may not yet be infected with the virus at this stage, the situation becomes increasingly risky as the illness progresses and secondary bacterial infections or underlying health conditions emerge.

After speaking with ICU doctors from Shanghai's other top-tier hospitals, Ai Jingwen learned that many of the elderly patients they treat also have underlying conditions and concurrent bacterial infections, often accompanied by inadequate nutritional support.

Therefore, Dr. Ai Jingwen advises: Be alert to the phenomenon of weakened immunity in elderly individuals during the early stages of infection, often caused by nutritional deficiencies.

In home care, it’s crucial to pay special attention to replenishing nutrients and fluids from the early stages of infection in elderly individuals. In fact, energy intake should actually be increased during the infection—this is one of the key strategies that helps our body fight off the virus. Soft, easily digestible foods like porridge and soups are ideal during illness, but make sure to balance them with other essential nutrients as well. A great option is to include two eggs a day, or perhaps a gentle, protein-rich steamed egg custard. If eating becomes too difficult, consider supplementing with milk, protein powders, or other nutritional preparations to ensure adequate energy intake. And if you have underlying health conditions, it’s always best to consult your doctor for personalized advice on how to optimize your nutrient intake. As Ai Jingwen often hears her mentor, Professor Zhang Wenhong, say: "During illness, treat every meal like medicine." This approach is vital to prevent malnutrition from triggering secondary infections—and ultimately avoiding life-threatening complications.

As long as families prioritize the nutritional needs of their elderly loved ones—treating seniors like precious "babies"—ensuring they receive both adequate staple foods and nutritious side dishes is crucial. At the same time, it’s essential to closely monitor elderly patients; ideally, having a household pulse oximeter on hand to track blood oxygen levels would be even better. If an oxygen-monitoring device isn’t available, caregivers should watch for signs such as increased sluggishness or difficulty performing everyday activities like walking or chatting. These subtle indicators can help detect early signs of worsening health conditions. And once any abnormalities are spotted, seeking medical attention promptly will lead to much more effective care. On the other hand, rushing to the emergency room during periods of stable health won’t benefit the elderly person’s well-being at all.

I’ve tested negative, so why am I still coughing nonstop? Could this persistent cough lead to pneumonia? And if there’s ever an issue with my lungs, can I check myself at home?

After contracting COVID-19, even if nucleic acid and antigen tests come back negative, the cough symptom may still persist—mainly because the Omicron variant damages the respiratory tract's mucous membrane during infection. Coughing is a natural protective mechanism of the body, and post-infection coughing is a common symptom seen in many respiratory viral infections. In most cases, there’s no need to worry excessively.

Does persistent coughing after testing negative for the virus lead to pneumonia?

Lu Lijun, deputy chief physician of the Pulmonary Department at Wuhan Municipal Hospital of Traditional Chinese Medicine, explained that cough and pneumonia are distinct concepts—cough is merely a symptom of an underlying illness and does not, by itself, cause pneumonia. Typically, cough occurs when pathogens like viruses or bacteria affect only the upper respiratory tract, leaving the lower airways unaffected. However, if the inflammation spreads to the lower respiratory tract, it can progress into pneumonia.

If you experience coughing up blood (blood in your sputum), worsening cough at night (or when changing positions), producing large amounts of yellow, purulent mucus, or developing a fever again, along with noticeable increases in existing symptoms such as shortness of breath, difficulty breathing, or chest pain—and especially if your cough persists for more than 2 weeks—we recommend seeking medical attention promptly.

Fu Guiling, chief physician at the Integrated Traditional Chinese and Western Medicine Hospital in Changping District, Beijing, advises against forcefully coughing solely by using your voice. Not only is this ineffective for clearing respiratory secretions, but it can also lead to sore throat and hoarseness. Particularly, individuals with a history of cerebral vascular rupture, embolism, or vascular malformations should avoid forceful coughing altogether.

Fu Guiling strongly advises paying close attention to cough treatment—don’t simply "tough it out" if a persistent cough persists, as this could lead to minor conditions worsening into more serious health issues. Instead, seek timely medical attention at the relevant outpatient department of a nearby hospital.

How to determine for yourself whether you have pneumonia

Lu Lijun stated: "Pay close attention to whether the following symptoms appear."

Systemic symptoms: Presence or absence of general malaise, fatigue, headache, loss of appetite, or pain in the muscles and joints throughout the body;

Local symptoms: Whether or not common pneumonia symptoms such as cough, sputum production, chest tightness, shortness of breath, and difficulty breathing have appeared;

Other symptoms: Patients should personally check for signs such as shortness of breath or an increased respiratory rate. Additionally, family members can observe whether elderly individuals, children, or other household members exhibit any unusual behaviors compared to their usual patterns—such as feeling unusually fatigued, breathing rapidly, or noticing bluish discoloration around the lips.

Additionally, does the elderly person exhibit signs such as diminished awareness, altered mental status, or excessive fatigue and declining physical stamina, along with slower responses and delayed communication? If any of these symptoms are present, it’s crucial to seek medical attention promptly for a clear diagnosis and proactive treatment—before the condition worsens.