'Correct post-COVID care can heal complications,' say doctors

The death of a doctor after recovering from COVID has raised fresh concerns over postCOVID19 complications Dr Ratneesh Saah from Jalore Rajasthan died on Wednesday of cardiac arrest He had resumed work a few weeks agoDr Wiqar Shaikh senior allergy and asthma specialist said Given the incidence of postCOVID19 complications it is essential for all public hospitals to start stringent screening of recovered patients by multidisciplinary specialists The virus affects several other organs and psyche It can also lead to blood clots It is now a multiorgan diseaseDr Ratneesh Saah left from Rajasthan died after recoveryHe added The WHO has estimated that between 20 to 40 per cent of recovered COVID19 patients could develop complications However there is no data on such patients in India yetThe symptoms nowDr Subhash Hira Professor of Global Health at University of WashingtonSeattle USA and health advisor to several UN Indian and African health agencies During Phase I Of the COVID patients from abroad from JanuaryMarch 2 per cent progressed to vascular clots and autoinflammatory syndrome During the pandemic in India from AprilJune the pandemic was in Phase II local human transmission COVID19 patients were being discharged by day 10 of the onset of symptoms Soon over 20 per cent of such discharged patients started returning to hospitals with ground glass opacities in lungs cardiomyopathies kidney shutdowns and vessel and brain clots causing multiple paralysesDr Hira added The intensely debated Phase III community transmission started in JuneJuly The clinical features attributed to COVID19 now include dermatological swellings on tips of fingerstoes neural deafness transient blindness with retinal clots etc mostly attributed to hypercoagulation of blood in circulation due to autoinflammatory syndrome attributed to cytokine storm released from COVIDinfected human cells onorafter 12 to 15 days of onset of early symptomsDr Hira added Soon ICMR suggested postponing discharge in suspect cases to the 16th day since the onset of early symptoms All complications are preventable provided the patient is counselled appropriately and gets a weekly followup for four to six weeksCold to add to caseloadWith winter around the corner common cold and influenza are likely to add on to the caseload The following are the differences seen between these and COVID19 COVID19 starts with lowgrade fever and gradually adds on more illnesses common cold begins with a sore throat and gradually adds on watery eyes sneezing and running nose influenzas start with a cough and abruptly add highfever headache sore throat and running nose body pains etc said Dr HiraTreating postCOVID casesDr Ketan Vagholkar Professor of surgery at DY Patil Medical college has started getting cases of postCOVID complications in the past few weeksA middleaged female patient Navi Mumbai had to be rushed to the emergency room a week after her discharge as she developed severe abdominal symptoms of distension and vomiting a classic gastrointestinal complication Luckily her CT did not show any thrombosis of the intestineDr Vagholkar said Though the recovery rate of COVID has improved late complications after recovery are increasing too There is an urgent need for meticulous followups Increased incidents of blood clot formation is serious It can cause sudden heart failure stroke and various gastrointestinal complicationsComorbid patients are at a high risk of late complications Follow up visits should be spread over eight weeks There has to be assessment of heart lung liver and kidney function Patients suffering from neurological problems should be assessed by a neurologist said Dr Vagholkar He concluded saying Recovered patients should first be tested for thrombotic complications across all organs All COVID hospitals and centres should immediately start followup OPDsOther deaths after recoveryHead Constable Deepak Hate died a few hours after being dischargedOn May 28 53yearold Mumbai police Head Constable Deepak Hate died four hours after returning home from the COVID19 at Jumbo Centre at Worli In another case K Raja Subramanian from Madurai Tamil Nadu was discharged from a local government hospital after he was treated for fever for three days He was comorbid and after returning home he again developed complications and was shifted to a medical college where he died on September 10 due to severe acute respiratory infectionNew postCOVID OPD at BKC jumbo centreThe BMCs Jumbo COVID centre at BKC has started a postCOVID19 OPD It is for the sole purpose of serving patients discharged from this Jumbo facility It started on October 3 said Dr Rajesh Dhere dean of the facilityMP Supriya Sule and Dr Rajesh Dhere dean of BKCrsquos Jumbo COVID centre at the OPD for recovered patientsDr Dhere added The OPD has three pillars mdash clinical assessment to tackle the residual impact psychological intervention and rehabilitative care to assess the impact on mobility exercise tolerance and muscle weakness Patients will also be assessed for lung fibrosis and pulmonary fibrosis especially among those with complicated recoveriesThe OPD has two chest physicians two diabetologists a cardiologist a psychiatrist two psychological counsellors three physiotherapists four junior doctors and two nurses There will be telephonic followups and those needing a physical examination will be called to the OPD on day 14 28 in the second fourth and sixth month after recoveryKeep scrolling to read more newsCatch up on all the latest Mumbai news crime news current affairs and a complete guide from food to things to do and events across Mumbai Also download the new midday Android and iOS apps to get latest updates MidDay is now on Telegram Click here to join our channel middayinfomedialtd and stay updated with the latest news