Mumbai: Now, OPDs to tackle post-COVID complications
With recovered patients developing new conditions, like diabetes, Fortis opens special OPD, KEM to get one soon, as Hinduja doc preps for detailed study
Apart from fatigue, breathlessness and lung diseases, members of the COVID task force and doctors have identified diabetes as yet another complication of the disease. Against this backdrop and a growing need, hospitals are planning out-patient departments (OPD) just for post-COVID care of patients.
Hospitals have been following up with recovered patients on call. However, there has been a growing need for a specialised platform which has prompted hospitals to consider the specific OPD.
Dr Shashank Joshi, an endocrinologist and member of the COVID task force said that in his private practice, he has seen patients with mild as well as moderate to severe symptoms develop diabetes.
"Since last month, patients who didn't have diabetes before are being diagnosed with it after recovering from COVID-19. Patients are also suffering from thyroiditis (inflammation of thyroid gland). They are being treated symptomatically and only time will tell how long these symptoms will last," he said.
Need to study effect of steroids
According to doctors at Lilavati Hospital, 30 per cent of their recovered patients develop diabetes. Dr Jalil Parkar, a pulmonologist at Lilavati Hospital, said that while steroids given during COVID treatment can increase blood sugar levels, diabetes could also be caused by the virus itself. "Even for patients who are not diabetic and are on the fence, we have seen fluctuating blood sugar levels. While it can be attributed to steroids, a comparative study with patients who develop sepsis in hospitals (and are given steroids) indicates that their blood sugar levels don't fluctuate the way we are seeing in COVID patients," he said. He added that while steroids are not given to mild symptomatic patients, some of them have developed mild diabetes as well. Dr Parkar added that in such patients, they have to put them on insulin even after they have been discharged until their blood sugar levels normalise after which they can be given oral medications.
A Kandivli resident gets tested for COVID-19 at a civic camp. Pic/Satej Shinde
Another member of the COVID task force and infectious diseases specialist, Om Srivastava, said among the patients he treated, he noticed metabolic complications like diabetes, insulitis or inflammation of the pancreas (that produces insulin) and damage to adrenal glands. "There have been cases of newly diagnosed high blood sugar after recovering from COVID and these symptoms need to be corrected immediately. I have seen enough to make one wonder about them and whether the symptoms will be transient or long term will have to be aggressively studied," he said.
Since little is known about post-COVID complications, doctors unanimously agree that a study is needed to understand the causes. Dr Lancelot Pinto, a pulmonologist at Hinduja Hospital said that while he too has seen many patients develop diabetes, one cannot say for certain that it is COVID-associated. To assess the consequences of COVID over the next six months after discharge, he is planning to take up a study on the same and is in the process of submitting his proposal to the hospital's ethics committee.
"Hinduja hospital has treated around 600 patients till now. We will be assessing recovered patients and will follow up with every single patient. We will observe all kinds of post COVID symptoms patients have developed," he said.
Among private hospitals, Fortis Hospital was the first to open an OPD for patients with post COVID complications on Friday. Dr Rahul Pandit, another member of the COVID task force said he has seen 20-25 patients at Fortis with fluctuating blood sugar.
"We have had patients who come with uncontrolled sugar. One kind of patients have pre-existing diabetes and tweaking of their medication is required. The other kind involves non-diabetic patients who require insulin or glucose control for a few months before things settle down. Whether this is diabetes or uncontrolled sugar post-illness is a big question and we are observing them closely," he said.
An option will be available in government hospitals too as Dr Hemant Deshmukh, dean of KEM Hospital, said that while they are keeping in touch with their patients on call, they are also planning to open a post-COVID OPD next month.
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