The most critical Covid-19 patient in Vietnam, who had been lethargic for months, has regained consciousness and is now able to smile to doctors, local media reported.

The Covid-19 treatment sub-committee under the Ministry of Health said the patient’s smile carried a lot of meaning, showing he has waken up from the coma.

His digestive system has improved. The distension in his stomach has reduced, his kidney has recovered functions and the patient has been able to move his hands and legs, said doctors at Cho Ray Hospital in Ho Chi Minh City.

The patient has also developed a stronger cough reflex. His pulmonary ventilation has increased and is more stable than previous days.

However, he is still dependent on life support and remains on the extracorporeal membrane oxygenation (ECMO) machine.

The patient is undergoing intensive care at Cho Ray Hospital

Tran Thanh Linh, deputy head of the emergency department at the hospital, said an X-ray image of his lungs a week ago had revealed tissue or fluid blocking blood vessels in both lungs, but the one taken on Tuesday showed that more than half of the left lung has completely recovered.

"His muscle weakness has also reduced. This is the right time to reduce his dependence on the ECMO," the doctor said.

Earlier, the patient had suffered from cytokine storm syndrome, which happened when his immune system overreacted to the novel coronavirus attack in the body, releasing too many cytokines and damaging his organs.

He suffers from infection with Burkholderia cenocepacia, a type of opportunistic bacteria, which doctors said is difficult to treat.

He is still on blood thinners. Doctors are also feeding him either directly or intravenously. They will focus now on curing his lung infections and making him less reliant on the ECMO machine.

They are also looking for suitable donors for a lung transplant, as decided earlier by the Health Ministry.

However, the patient's lungs are still infected with two types of bacteria, although the white blood cell count decreased, there was still sputum, so the expert committee assessed that the patient's serious condition continues.

He is currently undergoing physical therapy to repair motor muscles, monitor electrolyte regulation, uses furosemide to maintain fluid balance, and receives care for the ulcer and amputation due to excessive lying.

He was admitted to hospital on March 18 and has gone through 76 days of treatment. Until now, the patient has eight negative tests with SARS-CoV-2 and has relied on ECMO for 57 days.

He was declared free of the novel coronavirus on May 20 after seven negative tests in a row, and transferred from the HCMC Tropical for Hospital Disease to Cho Ray Hospital for further treatment.

Vietnam has mounted an all-out effort to save the life of the patient, a British pilot who works for national carrier of Vietnam Airlines, more than VND5 billion (US$200,000) has been spent on his treatment, local media reported.

Vietnam has recorded 328 Covid-19 cases so far, of which 298 have recovered and no deaths.