Page 142 - COVID-19 COUNTRY REPORT: Moving Beyond Pandemic EDITION 2022

Moving Beyond Pandemic (Edition 2022)

6.4.1.3 Management of Long COVID in Malaysia
Following the announcement of Sungai Buloh Hospital as one of the main COVID-19
facilities, various fields of multi-discipline expertise, such as the Department of Medicine,
the Department of Psychiatry & Mental Health, the Respiratory Unit of MARA Technology
University Hospital, and the Department of Rehabilitation Medicine have started service
initiatives for COVID-19 (level 4 and 5) survivors who have multiple residual medical
impairments and physical disabilities. The service has been named the COVID-19
Rehabilitation Outpatient Specialized Services (CROSS). As of March 2021, more than 1,000
patients with COVID-19 have been referred for this service (35).
The MOH released a guideline for post-COVID-19 Management Protocol as a reference for
treating long Covid symptoms. This management involves a variety of disciplines, including
primary health, infectious diseases, internal medicine, nephrology, cardiology, respiratory,
obstetrics, paediatrics, psychiatry, and medical rehabilitation. The confirmed COVID-19
patients in Malaysia are categorised and specifically managed based on five categories:
stage 1 (asymptomatic), stage 2 (symptomatic without pneumonia), stage 3 (symptomatic
with pneumonia), stage 4 (symptomatic with pneumonia and needing supplemental
oxygen), and stage 5 (critically ill with multi-organ involvement) (36). Figure 6.5 illustrates
the general post-Covid management protocol.

Figure 6.5: General workflow of Post-Covid Management for Hospitalised Patients (Category 4 & 5)
and Walk-In Patients (37).

2,712 long COVID patients were referred to CROSS at Hospital Sungai Buloh between
November 2020 and September 2021. Of this, 36.3% fully recovered from symptoms, with
the remaining 63.2% of cases reporting persistent symptoms. According to the Director
General of Health, as of October 2021, 31 public hospitals, four university hospitals, and six
private hospitals were treating and monitoring 5,193 Long COVID patients nationally (37). The
MOH is using the “Recognition, Rehabilitation, and Research” approach (38), and a special
rehabilitation programme is in place to assist patients experiencing Long COVID symptoms.
As of March 2022, there are 41 Rehabilitation Medicine facilities that offer rehabilitation
services for long COVID patients in Malaysia, including 32 government hospitals, three
university hospitals, four private hospitals, and one rehabilitation centre under the Ministry
of Human Resources. Comprehensive respiratory services for long Covid patients are also
provided at 21 government hospitals nationwide. As of March 2022, 15,564 COVID-19 patients
discharged from hospitals (categories 4 & 5) have been referred for this special service (39).

132 Chapter 6 -Evolution of COVID-19 Patient Management