Following is the text of an important report published in "Times Now Digital" on 23rd Sept, 2020
“Some patients who have recovered from COVID-19 infection had to be rushed back with low oxygen saturation levels to the emergency department just a day after discharge, says a doctor.
Key Highlight
The novel coronavirus is known to attack the endothelial cells that line the blood vessels, resulting in excessive blood clotting
Research suggests that many patients who have recovered from COVID-19 reported persistence of at least one symptom
After recovering from COVID-19, some patients came back to the hospital's ER with reduced heart function, heart attack or stroke.
New Delhi: The coronavirus pandemic has hit the world hard. Worldwide, at least 965,760 people have now succumbed to coronavirus infection. According to health experts, many patients develop complications like organ damage and have a prolonged stay in the ICU before making a complete recovery. A study conducted in Italy showed an overwhelming 87.4% of patients, who have recovered from COVID-19, reported persistence of at least one symptom - particularly fatigue and dyspnoea (labored breathing), this was reported even after two months of being discharged from the hospital !
Some patients who have recovered from COVID-19 infection had to be rushed back with low oxygen saturation levels to the emergency department just a day after discharge, said Dr Md Shakeel, Head-Emergency & trauma, Hiranandani Hospital, Vashi-A Fortis Network Hospital.
"These patients were admitted to the hospital for at least 10 days and had been discharged after they were doing well, and all the symptoms had been resolved. These patients came back to the hospital emergency with a whole spectrum of lung diseases - from fibrosis (formation of hard fibrous tissues as the lung heals from an injury) to secondary infections and pneumonia. It was also noted that, after recovering from COVID19, some patients came back to the hospital’s Emergency Room with reduced heart function, heart attack, or even stroke," Dr Md Shakeel added.
Post-COVID syndrome
COVID-19 is known to attack the endothelial cells that line the blood vessels, leading to excessive blood clotting across the body. "Now that the disease has been in the country for over five months and we understand it slightly better, we need to start looking at post-COVID rehabilitation, which has become a must, especially after having dozens of patients coming back into the Emergency Room with post-COVID symptoms. These long and short term impact of COVID-19 is called ‘Post-COVID Syndrome’. This means, after the acute phase of COVID-19 is over, patients come back to hospitals with symptoms such as lethargy, body aches, and itchy throats even four to six weeks later. Patients are also seen to have had psychological impact of the infection, leading to anxiety and depression. It is of utmost importance to monitor such cases, and a proper post-discharge rehabilitation plan should be put in place to monitor the patient’s health, so timely intervention could be done," he added.
According to Dr Shakeel, the extent of post-COVID distress would likely depend on the extent and impact of the infection the patient suffered. Other factors such as smoking history, advanced age and co-morbid conditions like diabetes, hypertension, renal disorders also come into the picture, which further reduces the immune response of patients. Additionally, it has been observed that men and women report the same post-COVID issues. But the incidence of post-COVID syndrome/distress is seen more amongst males, than females.
What COVID-19 survivors need to assess
The doctor said there are some important things that COVID-19 survivors need to assess to ensure that everything is in the range. These include:
Daily check of oxygen saturation, it should be maintained at >94% on room air
Watch for respiratory symptoms i.e. persistence or worsening of symptoms like cough and breathlessness
Persistent rise of body temperature above 100F
Watch for signs of lethargy, drowsiness, and altered sensorium
Regular monitoring of blood sugar in known diabetic patients is needed. COVID-19 infection (as any other infection) alters blood sugar levels of the body. Strict monitoring once in three days and regular consultation with your doctor is required
Regular blood pressure monitoring in known hypertensive patients is required to avoid accelerated hypertension-related complications. Weekly blood pressure monitoring in case of controlled hypertension, or more frequently in case of abnormal readings is required
Follow up consultation with your doctor within 7 days of discharge
Blood investigations like CBC, CRP at first follow up, and subsequent follow-ups, if advised by your physician
Repeat CT scan of the chest after 3 months to look the extent of lung recovery post the COVID infection
What happens if a patient skips these assessments?
Patients may go into ‘cytokine storm’ - immune cells flood and attack the lungs they should actually be protecting !
Blood vessels could leak, or the blood starts clotting
Blood pressure could plummet and organs could start to fail
Secondary complications are highly common in post-COVID infections like pulmonary fibrosis, pulmonary embolism, renal failure, liver dysfunction, coagulopathy (excessive bleeding or clotting), acute stroke, and myocardial Infarction.
Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a professional healthcare provider if you have any specific questions about any medical matter.
