Delhi: Man slips into coma due to blood clots in brain after Covid-19, recovers

With immune therapy and steroids, the doctors were able to gradually revive the patient to complete consciousness within seven days

After weaning a man recovering from coronavirus disease (Covid-19) off a ventilator, doctors from a city hospital were left perplexed when he did not wake up and instead slipped into coma. The doctors discovered he had multiple swellings in his brain and nearly 400 micro-clots.

Representational photo. (AP)

The condition has come to be known as Covid encephalitis worldwide. The condition, which before Covid-19 was known as acute haemorrhagic leukoencephalitis, is a rare disorder that follows a viral or bacterial infection and causes sudden swelling in the brain and the spinal cord, damaging the myelin layer of the nerves or the white matter in the brain.

This, doctors from Indraprastha Apollo Hospital in Delhi say, might be the first reported case of Covid encephalitis from India.

The man, 55-year-old Mithilesh Labru from Jammu, was advised home isolation after he was diagnosed with Covid-19 as he was thought to have a mild course of the disease. However, after four or five days of home isolation in early November, his condition started deteriorating rapidly.

He was admitted to a local hospital in Jammu with shortness of breath. The doctors there found that he had developed pneumonia – inflammation in the lungs because of an infection – and put him on a ventilator to help him breathe.

They then consulted a team of doctors from Apollo, Delhi, as the patient’s condition was critical and he also had comorbidities such as diabetes and hypertension.

A team of doctors from Apollo, including senior cardiac surgeon Dr Mukesh Goel, senior interventionist Dr Devjeevan and head of emergency department Dr Priyadarshini Pal were flown to Jammu to stabilise the patient.

Even with the support of a heart-lung machine the patient was unstable and could not be flown to Delhi. The team of doctors stabilised his condition for two or three days there before flying him to Delhi in an air ambulance.

At Indraprastha Apollo hospital, he was admitted to the Covid ICU under respiratory disease specialist Dr Rajesh Chawla.

“He was admitted to the Covid ICU on a ventilator at the hospital and his condition was monitored closely. When he started showing signs of recovery, he was removed from the ventilator. But he had slipped into a deep coma,” said Dr Chawla.

Usually, when patients are weaned off a ventilator, they wake up after a few hours.

“When patients recovering from Covid pneumonia are removed from sedation and muscle relaxants after being on a ventilator, they come back to consciousness within hours. But that did not happen with the patient. His MRI revealed that there were multiple swellings in the brain along with over 400 micro blood clots,” said Dr Vinit Suri, senior consultant of Neurosciences, Indraprastha Apollo Hospitals.

With immune therapy and steroids, the doctors were able to gradually revive the patient to complete consciousness within seven days. He still had slight weakness of the limbs.

“However, his post treatment MRI shows more than 50% recovery and the patient has been discharged on December 26,” said Dr Suri.