A private hospital in Mumbai has recorded five cases of multi-inflammatory syndrome in adults, weeks after they recovered from Covid-19. The inflammation proved fatal in two cases — both elderly patients. Two others recovered, and one remains in the hospital.
Post Covid complications are expanding, which include loss of smell and taste, fatigue, respiratory problems, blood clots, loss of vision and hearing, encephalitis, stammering, menstrual problems, neurotic problems, epileptic attacks and inflammation.
Mumbai has over 18,000 active coronavirus cases. It has a much larger pool of 2.22 lakh patients who have started showing health problems weeks or even months after recovering from Covid-19.
In the case of multi-inflammatory syndrome, which is a Kawasaki-like illness, people are returning with high-grade fever three to four weeks after recovering from coronavirus. Kawasaki disease mainly affects children below the age of five. It causes high-grade ever and inflammation in blood vessels, and can permanently damage coronary arteries. Earlier on in the pandemic, several children infected with Covid-19 showed multi-inflammatory symptoms like Kawasaki, and now adults are developing the same complications. Two of the five patients who died did not consent to continuing treatment due to old age.
Dr Tanu Singhal, infectious disease expert, said that in two cases, patients had tested positive for Covid-19, while in the rest, an antibody test showed they had been exposed to the virus in the past. “This shows that even with mild symptoms, where the patient isn’t even aware they have Covid, this disease can manifest,” Dr Singhal said. The three patients were put on steroids to reduce inflammation.
One patient came in with heart failure, one came in with jaundice, and another came in with drowsiness. All of them had fever and eventually developed inflammation. One remains admitted in Kokilaben Dhirubhai Ambani Hospital.
Similar cases have been reported in Chennai, Pune and Bengaluru.
Hospitals have now started discussions on the need to strategise exclusive out-patient services to tackle the post-Covid load. Dr Sanjay Oak, head of the Mumbai Covid task force, said vision problems will be discussed in the next meeting.
“Active cases, for now, have started drying up,” said Dr Om Srivastava, infectious disease expert. “We need to revise our strategy for Covid-19. A multi-system involvement is required for the post recovery phase. There are some patients who have started stammering while speaking. Anxiety and stress is common. Some have vision problems, wherein they have headaches when exposed to too much light. These are people who have never had eye problems before.”
Doctors said patients who are developing post-Covid complications were those who were critically ill, as well as those with mild symptoms. A woman in her forties came to Kokilaben Hospital with sudden loss of vision, a month after she recovered from the virus. “Tests showed the part of her brain that deals with vision was swollen. We put her on steroids and it took two to three days for her vision to be restored,” Dr Singhal said. The woman was in home isolation and had no severe symptoms.
Covid-19 is also affected the menstrual cycles of recovered patients. A doctor from Bhatia Hospital who was infected with the virus said her cycle was delayed by two and a half months after she recovered. Gynaecologists said severe illnesses are known to temporarily affect menstruation.
“We now know how to treat acute Covid patients, but post-Covid treatment is a new area,” said Dr Gunjan Chanchalani, head intensivist at Bhatia Hospital. “There are different manifestations that we have not seen before.” The hospital plans to call each discharged patient for follow ups regarding any health problems they may have. For now, it has been providing only basic physiotherapy and breathing exercises for recovered patients.
Dr Rahul Pandit, who works at Fortis Hospital, said they started a dedicated post-Covid recovery OPD to deal with all clinical manifestations in patients three months ago. Nair Hospital, too, has started a dedicated OPD for recovered patients. In KEM Hospital, dean Dr Hemant Deshmukh said they had put two recovered patients on oxygen support at home, since lung fibrosis has made this a long-term requirement that may stretch on for months.
However, most hospitals are yet to begin a full-fledged facility for the rising post-Covid load. St George’s Hospital, which as treated 2,613 Covid-19 patients till now, is mulling over a post-Covid OPD.
Doctors are also testing patients with sudden and inexplicable illnesses for Covid antibodies to rule out other causes of infection.
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