Hospitals see a rise in cases of post-Covid complications
- Nearly 15-20% of hospitalised Covid-19 patients return with some complications
After Delhi witnessed a massive surge in Covid-19 infections in the second wave, patients are now returning to hospitals with not just the fungal infection, mucormycosis, but a myriad of symptoms, city doctors said. Extreme fatigue, lethargy, body and joint pain, brain fog, and fever are the most common, but there have also been cases of pneumonia, collapsed lungs, heart attacks, and strokes.
Cases of mucormycosis, referred to as black fungus, have shot up across the country with the disease being declared an epidemic in Delhi and several other states. So far, at least 848 cases of the infection have been reported by Delhi hospitals.
But doctors say that nearly 15-20% of hospitalised Covid-19 patients return with some complications; and that some who were not hospitalised when they got Covid may need hospital care for a second bout of health problems. “I would say around 15-20% of the hospitalised Covid-19 patients are returning with some or the other health problem. The number of people experiencing long Covid symptoms could be higher because many with lethargy, fever, body and joint ache might not be coming back to hospitals,” said Dr Vivek Nangia, head of the department of respiratory medicine at Max hospital, Saket. Long Covid has been described as a range of symptoms such as fatigue, headache, loss of smell, dizziness, chest pain, fever, depression that Covid-19 patients may experience up to 12 weeks after recovery.
Fever, rare infections
Dr Suranjit Chatterjee, senior consultant of internal medicine at Indraprastha Apollo hospital, said almost 80% of the current hospitalisations are because of complications arising out of Covid-19. He added that many patients were coming in with high grade fever ranging between 102-104 degrees Fahrenheit, seven to 14 days after recovering from Covid-19. “Now, the fever can be because of the increased inflammation due to Covid-19 or it could be because of secondary infections. People must visit a doctor if they have persistent fever. We are seeing bacterial and fungal infections causing pneumonia. Aside from mucormycosis, I have also seen rare infection like nocardia (which can affect the lungs, brain, and skin) that usually affects those who are immuno-compromised,” Chatterjee said.
Use of steroids to treat Covid-19 patients has also led to many people developing high blood sugar, and for many, it is unlikely to be resolved, said Dr Anoop Misra, chairman, Fortis-CDOC Centre for Diabetes, Metabolic Diseases and Endocrinology. He said seven of every 10 new diabetes patients who consulted him last month were linked to Covid-19.
“Over 90% of the new-onset diabetes cases linked to Covid-19 was because of the use of steroids which drives up the blood glucose level. Among these people, there are some who have family history of diabetes, are obese, were pre-diabetics. Diabetes induced by steroids in these people is unlikely to resolve. It may resolve in those who are not overweight and do not have other risk factors for diabetes,” said Dr Misra.
He added that it was a fast-changing scenario and the numbers were likely to reduce this month as steroid use has gone down. He said the use of steroids was also leading to fluctuations in blood pressure that could lead to heart conditions.
Dr Nangia has also been treating patients with secondary pneumonia caused by bacteria and fungus developed after recovering from Covid-19 penumonia. At the post-Covid clinic, he said that he gets patients who are unable to get off oxygen even after weeks of being discharged from the hospital.
“Today, I saw a 25-year-old patient who was unable to get off oxygen six weeks after she was discharged. This is because of fibrosis or scarring of the lung tissues. Now, theories state that the fibrosis resolves on its own after several weeks without any specific treatment. But, there are likely to be some people who will have permanent fibrosis as well,” said Dr Nangia.
The damage to the lungs, especially during the inflammatory phase of Covid-19, also makes the tissue prone to injuries. “Another serious post-Covid complication is pulmonary embolism where a clot blocks the blood supply to the lungs. It can be life-threatening with patients dying within minutes, if the clot is big,” he said.
He said that people with sudden chest pain, breathlessness, and drop in oxygen saturation should go to hospital.
Dr RR Kasliwal, chairman of cardiology department at Medanta hospital, said those who have recovered from Covid-19 should carefully monitor their heart for six months to a year.
“We’ve been seeing people develop heart dysfunction, high and irregular heart rhythm,” he said. This is in addition to some people who get heart attacks due to clotting in the inflammatory phase of Covid.
“After recovering from Covid-19, people should not sit at home and gain weight, but they should also not jump back in. They should go slow, start with light workout and then scale it up,” he said.
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