Post-Covid complications rise in absence of specialised care clinics

Ranchi: Purushottam Kumar (34) was discharged from Ranchi sadar hospital’s ICU unit earlier this month after he tested negative for Covid-19. Little over a week later, Kumar complained of difficulties in breathing. As his oxygen saturation levels began plummeting, Kumar was wheeled back into sadar hospital’s Covid-19 ICU ward on Monday afternoon.
Rajesh Pragya (name changed on request), returned home a week ago from a city-based private hospital after emerging victorious from a 15-day long fight with Covid-19 infection. On Sunday night, the septuagenarian complained of breathlessness. Soon after, he succumbed to a massive cardiac arrest.
A city-based doctor, who was discharged from the hospital after recovering from Covid-19, was airlifted to a private hospital in Hyderabad on Sunday after complaints of breathlessness led to tests, which showed 80% irreversible damage to his lungs. Currently under extracorporeal membrane oxygen (ECMO) support, the doctor is due to undergo a lung transplant in coming weeks.
Although Covid-19 cases have begun declining in Ranchi, post Covid complications are emerging as silent killers. While the Jharkhand government is not documenting these deaths, there is also a lack of awareness among patients and their kin, which is adding to fatalities.
A sizeable chunk of Covid patients, including those who recovered in home isolation, are developing critical complications. Fibrosis of the lungs, cardiac arrests, renal failures, neurological problems, swelling on faces and diabetes are the most common among the complications.
Overuse of steroids during treatment can lead to diabetes while usage of blood thinners to prevent clotting in lungs and the heart can lead to internal bleedings and multiorgan failures.
“A Covid-19 negative report does not indicate that an individual is alright,” said Dr Sanjay Kumar, vice-president of Ranchi’s Bhagwan Mahavir Medica Superspecialty Hospital. “Once recovered, patients try to return to their normal lives and resume work and in process, they ignore the symptoms of the post Covid-19 complications,” he added.
Besides ignorance on part of the patients, there is a shortage of post Covid-19 care clinics. Prominent hospitals, who are treating active patients, do not have enough manpower to attend to the recovered patients.
Singh, a veteran physician in Ranchi, said, “In many cases, doctors go by the common protocol such as prescribing doxycycline, ivermectin and other drugs when infection kicks in. The important markers, which can be ascertained through tests like CRP, D-dimer and TCDC tests, are ignored. Post Covid complications can surface anywhere between seven days to nine months and can kill patients silently.”
Kumar added that patients who recovered from Covid-19 infection must also regularly take up breathing exercises to re-modulate the functioning of their lungs. “Owing to low immunity, Covid-19 patients are succumbing to bacterial and fungal infections of the lungs. Hence, there is a need for regular check-ups, especially those who turned critical during infection.”
Kumar advocated that every hospital in the state should set up post Covid-19 care clinics on priority which can provide staged diagnosis and clinical management. Though the state health department wrote to all government hospitals to set up such clinics, none have come up with one.
“Since the cases are decreasing and bed occupancy is falling, we plan to carve out a post Covid-19 care facility from out of the 1,108 Covid-19 beds. Currently, we have asked all departments to submit a plan of action regarding the post Covid-19 management. We are monitoring the situation for a week before setting up the facility,” Rims director Dr Kameshwar Prasad told TOI.