Covid cured, but patients report serious ailments

FIGHTING COVID-19

Covid cured, but patients report serious ailments

Increase In No. Of People Returning To Hospitals With Strokes, Heart Attacks, Clots In Vessels, Say Docs

Pushpa.Narayan@timesgroup.com

25.07.2020

The growing challenge for people discharged from Covid-19 wards is complete recovery.

While many struggle to overcome residual symptoms such as pain and fatigue, doctors in emergency rooms say there is an increase in the number of people being wheeled in with strokes, heart attacks and life-threatening clots in blood vessels. In some cases, chronic conditions such as diabetes and hypertension — both risk factors — have worsened.

A fortnight ago, an 84-year-old discharged Covid-19 patient returned to Gleneagles Global Hospital with severe stroke. “We treated her for a stroke and sent her back home. In just a few days, she developed breathlessness and died at home,” said infectious diseases expert Dr Subramanian Swaminathan. The cause of death, he suspects, could be a heart attack or pulmonary embolism blockage in a pulmonary artery of the lungs — triggered by Covid-19 complications.

Many younger patients with no co-morbidities are also being brought back to hospitals with clots. Kauvery Hospitals senior vascular surgeon Dr N Sekar said at least 10 recovered Covid-19 patients returned with clots on limbs, intestine, brain, and heart in the last 10 days. These included those with mild or no symptoms when infected with Covid-19.

Data from across the globe is also showing the virus can worsen or cause diabetes. “Some viruses such as mumps, measles and coxsackievirus attack pancreatic cells (beta cells) that produce insulin. Senior diabetologists across India are forming a registry to study effects of the virus,” he said.

Cities like Chennai, Coimbatore, Madurai and Trichy have super specialists such as vascular surgeons who attempt surgical intervention to save limbs. Patients in districts aren’t that lucky. “As numbers increase in the districts morbidity and mortality will go up. Although TN has a better doctor-patient ratio compared to many states, doctors are not uniformly spread. So is access to care,” said public health expert T S Sunderraman.

While ICMR has asked all states to record and notify post-covid complications carefully, doctors are already tweaking treatment protocols. These protocols, however, are not uniform across hospitals.

Dr Sekar says the infectious diseases team at his hospital has now made it mandatory to give blood thinners to all those testing positive for Covid-19, unless they have complications that prevent them from taking the drug. “All young and healthy patients with no symptoms are advised blood thinner pills for at least a month. Elderly or patients with mild or moderate symptoms are given both blood thinners and anticoagulants for six weeks,” he said. The prescriptions attached to discharge summaries for patients at Apollo Hospitals have only anticoagulants for people who had moderate and severe symptoms. “We added these two weeks ago after medical journals strongly recommended medications to prevent complications,” said infectious diseases expert Dr V Ramasubramanian, who is also on the expert medical panel for the state government.

Even among government hospitals protocol for post-covid management differs. While Rajiv Gandhi Government General Hospital does not offer blood thinner or anti-clotting medicine, Omandurar hospital gives patients with moderate and severe symptoms blood thinners (asprin), or anticoagulant (clopidogrel).