‘Lung damage shows virus hasn’t lost sting’

‘Lung damage shows virus hasn’t lost sting’

Sumitra.DebRoy@timesgroup.com

Mumbai:23.03.2021 

Mumbai’s doctors have witnessed a rapid deterioration of the lung in select young Covid patients, prompting them to reiterate that the virus has not lost its sting completely. A subset of these patients has been asymptomatic for the initial few days before going on to have severe disease.

Doctors at SevenHills Hospital in Andheri have treated a 40-year-old who went from mildly symptomatic to high oxygen dependence in four days. Intensivist Dr Rahul Sawalia said she subsequently needed a non-invasive ventilator despite having been detected on the second day of symptoms. It was an unusual case as involvement of 80% of the lung takes a minimum of 10 days. “We have observed this swift progression in a few young patients in the second wave,” he said. In another case, a patient’s lungs developed a fully cloudy appearance in a span of 18 hours that he took to travel from his native place to SevenHills. This patient was a senior citizen and couldn’t be saved.

A similar prognosis has now been flagged by experts at the civic-run BKC jumbo facility too. Here, doctors have not just seen young patients deteriorating fast, they found that many were completely asymptomatic in the initial few days. Civic authorities have been harping that even though cases were rising, a vast majority were asymptomatic. Doctors are worried though that it was sending out a mixed signal as many are delaying tests or seeking care.

A senior doctor from BKC jumbo hospital said 15-20% of the asymptomatic cases are coming with X-ray reports showing an involvement of lungs. “Patients whose X-rays are bad also have high D-dimer levels, indicative of active formation of blood clots,” said the expert, adding that in spite of blood thinners, D-dimer remains high. “The improvement is very slow in these patients, and when they deteriorate, it’s very fast,” he added.

The Covid death audit committee has noted at least five deaths in young patients. “It has been reported to us. We are trying to understand if this quick progression is more common than we know,” said Dr Avinash Supe, the panel chairman, adding that young lives shouldn’t be lost because of late hospitalisation.

Vashi’s MPCT Hospital has treated a 27-year-old who came in critical condition and had to be started on remdesivir and non-invasive ventilator immediately on admission. Doctors found 80% of his lungs were involved by the eighth day. Intriguingly, despite persistent symptoms, he wasn’t advised a Covid test. “We saved him since he came at the right window, but people cannot take it lightly thinking everyone will be asymptomatic,” said MPCT CEO Dr Prince Surana.