Long-haul Covid-19 haunts patients in Karnataka

BENGALURU: Hospitals are reporting a much higher number of post-Covid-19 infections compared to what was witnessed during the first wave of the pandemic last year. 

There is an estimated 40 per cent increase in such cases. The first wave presented only one-third of moderate to severe cases with post-Covid infections. But now it has shot up to 50-60 per cent of such patients.

The infections last up to four weeks after discharge -- which only adds to the burden of bed availability for fresh Covid-19 patients. 

​This worrisome spike comes in the midst of already existing concerns of lack of beds, oxygen and rising number of cases of mucormycosis (black fungus) being reported from across the state. And it is not just elderly citizens suffering from post-Covid symptoms, but even younger patients.

Doctors from various hospitals, while confirming the significant increase in post-Covid infections, said more cases of lung fibrosis are being reported, besides pulmonary embolism (blood clotting in lungs) and pneumomediastinum (air leakage inside the chest). Lung fibrosis (or pulmonary fibrosis) is a condition in which lungs become scarred internally over time. Symptoms include shortness of breath, dry cough, fatigued feeling, weight loss and nail clubbing.

Complications may include pulmonary hypertension, respiratory failure, pneumothorax (which occurs when air leaks into the space between the lung and the chest wall) and also lung cancer.

Dr Sachin Kumar, Senior Consultant, Pulmonology and Critical Care Medicine, Sakra World Hospital, said, “This time, rare presentations include increased incidence of both subsegmetal pulmonary embolism and pneumomediastinum and post-Covid lung fibrosis. At least 30-40 per cent more cases are reported this time. The main symptoms are persistent high oxygen requirements even after home discharge, besides dry cough and chest discomfort with occasional pain." 

With such cases at Sakra World Hospital, they recently started remote assessment and monitoring system to be used on high-risk post-Covid patients for monitoring from home to a cloud-based central monitoring system.

“A multidisciplinary approach, including a pulmonologist, pulmonary rehabilitation specialist and psychological support is required to tackle these cases,” said Dr Kumar. Dr Sachin D, Consultant - Interventional Pulmonology, Critical Care And Sleep Medicine Specialist, Manipal Hospital, Old Airport Road, said delayed resolution of symptoms and persistent post- Covid sympt oms f o r more than 2-3 months is unique for the second wave.

“People developing post-Covid lung fibrosis is also significantly high during the second wave,” he explained. “Adequate rest and gradual mobilisation with relaxation techniques and sleep hygiene is advised for all patients in Covid recovery. Healthy diet with lots of fluid intake and avoiding heavy exercises immediately after recovery is necessary. Early initiation of antifibrotics in people developing lung fibrosis can prevent a permanent progressive lung scarring, and restore lung capacity in such individuals.” Dr Sachin said. Dr Pradeep Rangappa, Senior Consultant - Critical Care, Columbia Asia Referral Hospital, Yeshwanthpur, said psychological symptoms of increased anxiety are also seen.

“ICU admissions typically are due to breathlessness and residual lung damage necessitating need for oxygen, VTEs (blood clots in the vein) and sometimes vascular events like heart attacks and strokes are also being reported. Difference in the second wave is that we are increasingly seeing mucormycosis as post-Covid presentation,” said Dr Rangappa.