Post-Covid illnesses on the rise, the recovered need oxygen

Private hospitals are reporting an increased footfall of patients who developed lung fibrosis and severe pneumonia after recovering from Covid-19 and need immediate hospitalisation with oxygen support

Private hospitals are reporting an increased footfall of patients who developed lung fibrosis and severe pneumonia after recovering from Covid-19 and need immediate hospitalisation with oxygen support.

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According to Dr Dhruv Chaudhary, the state nodal officer for tertiary care of Covid-19 patients, and who is also a lung and respiratory disease specialist at the Post Graduate Institute Medical Sciences- Rohtak, since the magnitude of the second Covid-19 wave has been massive, such cases have increased everywhere.

“It is mostly seen in patients who were admitted to intensive care units (ICUs) for treatment after testing positive. Such patients require a sufficient number of days to recover. But, to manage beds and to accommodate other patients, many people are asked to leave hospitals and home-isolate without complete recovery. Therefore, 10 to 15% of the recovered patients develop lung infections and need to be put on oxygen support,” said Dr Chaudhary.

The district administration also hiked the oxygen quota for hospitals treating such cases.

“Post-Covid care and treatment are most important and the number of people complaining of lung (illnesses) and pneumonia has increased. The administration is aware that such cases are on the rise. Therefore, we have increased the oxygen quota by nearly 30% so that hospitals can cater to such patients and store additional oxygen for emergency purpose,” said Yash Garg, Gurugram deputy commissioner.

The administration has been supplying oxygen to at least 82 hospitals in the district.

Dr Vikram Singh, the director of Aarvy Hospital, said that due to the current burden on hospitals to admit seriously ill patients, many people are asked to remain on oxygen support system at homes. “If required, they are admitted to hospitals. At least 30-40% recovered patients develop lung fibrosis and are suggested to remain on oxygen support at their homes,” said Singh.

Dr Neeraj Gupta, a pulmonologist and the head of ICU care at W Pratiksha Hospital, is currently treating at least three recovered Covid-19 patients who developed pneumonia and are admitted to the ICU. “Such patients have high oxygen demand as their lungs could not heal properly even after recovery. Many patients have to be given immediate treatment in hospital, while some are suggested to remain at home and continue with treatment.”

Gupta said she comes across at least nine such cases every day, of whom two to three people develop serious symptoms.

Causes for post-Covid illness

Dr Mohit Mathur, associate director of critical care at Max Hospital, Gurugram, said, “The scar tissue which replaces the diseased lung tissue after the infection is not capable of the original function to transfer oxygen into the blood. Such patients are left with a persistent oxygen requirement,” said Mathur.

In many cases, people discharged from hospitals said that they found it difficult to walk even 10 steps.

Swati Saxena, 34, a resident of MG Road, said that she was discharged from the ICU on April 28 within seven days of getting admitted. She was later admitted again on May 2 and discharged earlier this week. “I had heart rate issue, breathlessness and chest pain. It took three days to recover from the pain. Four oxygen cylinders were used daily and the volume of oxygen given to me was high, as compared to when I was first admitted for Covid-19,” said Saxena.

“Basically, in many cases compromised lung capacity or poor lung function due to this infection has been causing further multiple complications even after recovery,” said Dr Satish Kaul, head of the department and director, internal medicine, Narayana Hospital.

Detecting the illness

At present, there is no certain way to definitely say which patients will eventually develop lung fibrosis, doctors said. A few existing studies show that age, severe illnesses, prolonged ICU treatment, need for mechanical ventilation, a history of smoking and chronic alcoholism may increase the risk of developing lung fibrosis after recovery from Covid-19.

“CT chest and restrictive pattern on pulmonary function test are some of the ways to detect this problem. The bigger challenge is that apart from few anti-fibrotic agents which are of doubtful efficacy, there are not many drugs to address this problem. Therefore, recovery becomes a slow process, extending over months,” said Mathur, who is treating 10 such cases on average every day.