Covid beaten but not lung problems, cough

Noida/Ghaziabad: They completed their recovery and were discharged after testing negative but doctors are seeing instances of Covid-19 patients report back to them with pneumonia-like complications, cough or breathing difficulties.
The complications are being reported a few days or more than a week after ‘recovery’, leading to doctors advising that all patients should keep monitoring their blood oxygen saturation (SPO2) levels for a few weeks after discharge. A drop in the SPO2 level will indicate a lung infection even if symptoms of it don’t manifest.
Dr Rahul K Sharma, director and head of pulmonary and critical care at Le Crest Hospital in Ghaziabad’s Vasundhara, said, “This is a common phenomenon with the virus. After viral infection, the body’s immunity remains compromised for some time and there are high chances of contracting a superimposed bacterial infection. That is what is happening. Even after patients are testing negative, immunity is compromised for some time, and during this, superimposed infection is being contracted. Those who developed pneumonia due to Covid are taking a long time to recover even after they test negative.”
Le Crest has seen three such patients so far. One of them is a a 61-year-old man, who was given Tocilizumab and Remedesivir and discharged under the Covid protocol after he tested negative. Five days later, he developed a fever and an X-ray showed he had pneumonia. A 52-year-old man who was admitted in a serious condition and spent 19 days at the hospital was discharged after he tested negative. But his pneumonia-like symptoms are back. Dr Vijay Hadda, associate professor (pulmonary medicine and sleep disorders) at AIIMS, said post-recovery complications were being seen in a large number of patients. “Even after RT-PCR test is negative, some symptoms remain in patients. However, it is not exactly pneumonia, but some breathing-related complications. Many patients complain about a cough.”
“In many people, Covid was negative, and even an X-ray confirmed there was no pneumonia, but breathing difficulties and cough persisted. These problems are being seen in a substantial number of patients. There are patients who contracted the disease a month back and recovered but still suffering from dry cough. In other patients, when CT scan or X-ray was done, it was found that although active features of pneumonia have gone, still there are some changes in the lungs. Those could be the reason for breathing trouble and cough. These could be post-pneumonia changes.”
In Noida, a sizeable number of Covid-19 patients -- 30% to 40% is a ballpark estimate -- who have been discharged from L2 and L3 facilities that treat symptomatic and critical cases have been reporting pneumonitis-related problems later on, doctors and health officials say. Doctors said since the Covid-19 infection results in severe inflammation in the lungs several patients, monitoring has to continue for some weeks after discharge.
Doctors at Sharda hospital, which is treating serious patients, said almost a third of the patients who have been discharged have reported acute respiratory distress syndrome a week later.
NK Sharma, a general physician and president of the Indian Medical Association (Noida chapter), said, “All Covid patients who have been discharged need to note that they have managed to beat only the virus successfully. The complications induced by the virus continue to stay on. Those with breathing problem or pneumonitis need to keep using spirometer, follow lung physiotherapy exercises, do yoga to improve breathing among others. Cold things have to be avoided and only lukewarm water is advised. Steam therapy should be continued for a few weeks.”
Dr Brijesh Prajapat of Yashoda Hospital, Nehru Nagar, said, “The scars arising out of pneumonia take a long time to heal. We are seeing many such patients. We call them every week and conduct X-rays to see the extent of healing.”