Coronavirus Outbreak: Fight does not stop with recovering from COVID-19, say health experts

Updated: May 30, 2020, 16:52 IST | Vinod Kumar Menon | Mumbai

Doctors warn that battling the virus could lead to other health issues for recovered patients, especially for those with comorbidities, and so they need to have regular check-ups

Doctors say recovered patients should be monitored for few weeks after discharge. Pic/Pradeep Dhivar
Doctors say recovered patients should be monitored for few weeks after discharge. Pic/Pradeep Dhivar

Health experts have a word of caution for those who have bravely fought COVID-19. They say they might have to get regular medical check-ups. Doctors say fighting COVID-19 can lead to multiple other health issues and these need to be monitored, especially for those who fought the virus with existing comorbidities.

On Friday, the total number of cases in the country went up to 1,65,799, after an all time jump of 7,466 new cases was registered. Out of 89,987 active cases, nearly 71,105 patients have recovered and were discharged. India has recorded total deaths of 4,706. The concern being raised by health experts is for the 71,105 recovered patients, who may need regular monitoring.

Words of warning

Medical experts say COVID-19 does not merely impact the lungs or the respiratory tract, but it can even have a multi-organ spread. Confirming the same Dr Wiqar Shaikh, senior allergy and asthma specialist said, "It is a myth that COVID-19 only attacks the upper respiratory tract or causes lung infections. It can attack multiple organs."

Dr Shaikh, added that discharged patients could have damage to the liver, leading to chronic liver failure. The virus can even cause irregular beating of the heart (arrhythmia), thereby causing cardiac complications. It could also harm the kidneys.

He warned that the disease could also cause multi-system inflammatory syndrome in children (MIS-C). In this condition, children may develop fever, stomach pain, skin rash, headache and confusion which may continue on a long-term basis and could even lead to mortality. This is similar in nature to another ailment called Kawasaki disease.

The fifth condition the virus can cause, is Rhabdomyolysis, in which there is break down of muscles which lead to acute kidney injury and chronic kidney failure.

Senior Neurosurgeon Dr Shashank Joshi, said, "The novel Coronavirus can cause a systemic inflammatory response, which is usually confined to the lungs and affects other organs like the intestine and in some rare instances, it has even affected brains, causing stroke-like symptoms and thrombosis (clotting of blood) in the body, which could be risky."

"Covid 19 can lead to a condition called cytokine storm (IL-6) in this condition, the patient has an elevated level of a cytokine (a group of proteins) called IL-6, which will lead to fever followed by damage to body tissues, heart, lungs and kidneys. In this condition alone, the drug of choice is an expensive monoclonal antibody called 'Tocilizumab'. It is usually used in rheumatoid arthritis, and this drug is now being used by the Brihanmumbai Municipal Corporation (BMC) in treating select patients at KEM, Nair, Sion, Seven Hills etc. It seems to be working well on patients with IL-6 problem," said Dr Shaikh.

He further added that COVID-19 can also cause a condition called DIC (Disseminated Intravascular Coagulation) in which there could be bleeding internally in the organs and externally from the body (orifices) and may also lead to abnormal clot formation in the arteries and veins.

'Continue routine check-ups'

Dr Shaikh has advised, "In order to ensure that the above complications or underlying issues are not ignored, the patients who have recovered need to be extra cautious and should continue with routine medical check-ups." He said patients should be medically be monitored for at least a few weeks after discharge.

In case of people with comorbidity issues like heart diseases, renal problem, hypertension and diabetes, the risk of future complications is much more, compared to patients who do not have them, he said. Dr Virendra Singh, senior pulmonologist and president of Rajasthan Hospital, speaking to mid-day from Jaipur, said, "Those who are discharged, but still have significant radiological lung shadowing, should remain under the regular care of a chest physician. These patients should also have control on their comorbid conditions."

'Be careful in the monsoon'

Dr Virendra Singh, senior pulmonologist, Rajasthan Hospital, had a warning for citizens. "With monsoon, the challenge is so far we (India) do not know the nature of the COVID virus, especially when it comes to routine influenza. We must refrain from getting wet in the rain, as chances of getting influenza are higher. This monsoon it will be more challenging, especially to deal with upper and lower respiratory tract infections," he said.

'Patients must be informed at discharge'

Dr Ketan Vagholkar, professor of surgery at DY Patil Medical College, Nerul said, the discharge criteria are well-defined and patients are discharged only after satisfying them. But he warned patients must be informed about keeping watch on their health after discharge. "Since the virus behaves differently in different patients, the course of events after discharge continue to be unpredictable. Therefore, elaborate patient education at the time of discharge is absolutely essential," he said. Dr Vagholkar further added, "Unlike, other viral diseases wherein a single infection imparts good immunity against the virus, no such phenomenon has been observed in COVID-19. Therefore, the antibody status evaluation, as an indicator of protection, is a debatable issue."

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