Recovered Covid patients can suffer lasting lung ailments

JAIPUR: Like any respiratory diseases, Covid can cause lasting lung ailments even after patients recover, just like swine flu. Doctors are now using the swine flu experience in dealing with these patients.
At the Institute of Respiratory Diseases, a wing of Sawai Man Singh Hospital, doctors are regularly receiving patients with lung-related problems.

“Around 15 patients who recovered from Covid approached the OPD of our institute with a wide spectrum of respiratory symptoms – from residual cough, shortness of breath, secondary infections to fibrosis (formation of hard fibrous tissues as the lung heals from an injury). This is more prominent among patients who have had severe symptoms of Covid and needed either ventilator support or non-invasive ventilation like Bipap or Cpap or had baseline lung ailment,” said Dr Narendra Khippal, senior professor, Institute of Respiratory Diseases, SMS Hospital.
Residual lung fibrosis is the most common post-recovery complication in which the lung capacity decreases as it loses its elasticity to some extent hardening the tissues. Residual lung fibrosis is not restricted to Covid and has been seen in other viral infections such as swine flu and influenza.
“This is something we have seen in patients resulting in inadequate oxygenation. Usually fibrosis caused by other diseases improves over time, but Covid is a new disease and we require a long-term follow up to reach to some conclusion as far as prognosis is concerned,” said Dr Khippal.
However, doctors claimed that Covid patients, who are coming back to hospitals with breathing difficulties, are not many.
“Almost 95% of Covid patients are asymptomatic or have mild symptoms. Only 5% face severe problems and may require oxygen or non-invasive ventilation or mechanical ventilation. Covid pneumonia takes some time to resolve, in a few cases around a month. Some Covid pneumonia patients may have cough and mild difficulties in breathing,” said Dr Sheetu Singh, associate professor (respiratory diseases), SMS Medical College.
Doctors claimed that such patients are responding well to oral medicines. “Usually they respond well to oral steroids. Rarely patients develop extensive fibrosis in which they need empirically anti-fibrotic drugs such as Pirfenidone. However, there are no studies or evidence to advocate the use of these medicines. Even in the swine flu epidemic, there were patients with post swine flu fibrosis after resolution of pneumonia. They also responded well to oral corticosteroids and we had published these findings in Lung India,” said Dr Singh.
Some doctors claimed that various drugs were being tried – like a longer course of steroids or anti-fibrosis drugs like Pirfenidone — but results were not satisfactory and they felt the need for pulmonary rehabilitation in such patients.