They beat the virus, but Covid anxiety still haunts survivors
Rohit Dutta, 45, the first person in Delhi to be diagnosed with coronavirus disease (Covid-19) on March 2, bounced back and returned home on March 14. He quickly went back to his daily routine of aerobics and yoga . He has no breathing difficulty of fatigue.
“In the hospital, I had a mild fever of 99.5(Fahrenheit) and really bad cough for several days, but there were no symptoms at all after that. I feel very healthy and very lucky to have survived an infection that is killing so many others around the world,” said Dutta.
But the illness, and the fact that he got infected without knowing about it, has made him anxious. He prefers to stay in his room, and is visibly nervous when he gets follow-up calls from authorities who want to make sure he hasn’t been reinfected.
Safdarjung hospital’s Dr Huda -- who wants to be identified just by her last name -- did not have severe symptoms when she tested positive. “One day I could not get up from my bed, I was drained and had body ache. That is when I got tested and the result turned out to be positive. Other than that, I just had some cough for a day and half” she said.
She has been upset by the reaction of others, though. “Everyone is scared and anxious and even after I have recovered and completed my quarantine, people still want to stay away, they don’t want to talk. The other day, when my neighbour saw me on the balcony he went inside,” she said.
Dr Mohinder Sadana, 62, and his wife Dr Poonam Sadana, 61, both had almost no symptoms when they tested positive and say they feel “100% fit”. They exercise for an hour each morning. “I have no fatigue, no weakness. Nothing at all. And, even when we tested positive my symptoms were milder than a flu,”he said.
Other than anxiety and some stigma , many people in Delhi who have recovered from coronavirus disease (Covid-19) show none of the long-term lung and health damage the disease is known to have.
The Sars-Cov-2 virus, which causes Covid-19, belongs to the family of at least 39 known species of coronavirus, seven of which can infect humans. There has been a lot of research on the long-term impact , especially after hospitalisation, for coronavirus diseases such as the Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), and Covid-19. According to this research, people who recover may have impaired lung function, reduced exercise capability, and psychological disorders including post-traumatic stress disorder (PTSD), depression, and anxiety even six months after recovery.
A yet to be published study by researchers in the United Kingdom looked at 18 studies and found that the diffusing capacity of the lung – or its ability to perform gaseous exchange of oxygen and carbon dioxide -- was considerably low six months of infection. All but one of the 18 studies involved SARS patients, which was not as infectious as Covid-19, but deadlier, according to researchers. The other study was on MERS.
The authors said healthcare systems should prepare for long-term health effects, according to the study published in the pre-print server medRxiv.
Although the patients who have recovered from Covid-19 in Delhi might not be showing long term symptoms, doctors believe there might still be damage to the lungs.
“Certainly, there could be some long-term damage. What we have seen so far is that the clinical symptoms do not match the radiological diagnosis. A patient might be very comfortable, but their x-rays show damage to the lungs, which will take time to recover,” said Dr Amit Kohli, intensive care specialist from Lok Nayak hospital, which is handling the highest number and the most serious Covid-19 cases in the city.
Dr SK Sarin, director of the Institute of Liver and Biliary Sciences and the chair of the committee advising the chief minister of Delhi on Covid-19 said, “Around 20% of the patients, despite having very mild or no symptoms, will have lung lesions and low-degree pneumonia. That is a very large number.”
Doctors who analysed the clinical symptoms of the first 21 patients at Safdarjung hospital suggested following up the patients to check for lung fibrosis, which is caused due to damage and scarring of the lungs.
“The long-term impact on diffusion capability of the lungs is possible as we know that the viral infection attacks the interstitial tissues (a lace-like structure that supports the alveoli or air sacs in the lungs). These tissues help in the gas exchange, meaning patients with damaged tissues will be breathless,” said Dr Nitesh Gupta, department of pulmonary medicine at Safdarjung hospital.
As for the psychological impact, it will have more to do with “social exclusion and economic hardship,” according to Dr Nimesh Desai, director, Institute of Human Behaviour and Allied Sciences.
“I think PTSD is an overrated American concept.”