Post-COVID complications aplenty, say doctors - The Hindu

As in the first wave of COVID-19, hospitals are seeing a steady flow of patients with post-COVID-19 complications. While the number of patients with complications is much higher, considering the exponential rise in cases in the second wave, many of them are returning to hospitals with psychological symptoms, lung-related complications, and stroke and cardiac arrest due to blood clots.

The complications are aplenty, according to a number of doctors at government and private hospitals. While mucormycosis is one of the main complications seen by doctors, there are many other worrying trends.

At the post-COVID clinic of the Rajiv Gandhi Government General Hospital, doctors are receiving 30-40 patients a day, Dean E. Theranirajan said. "There are many with psychological issues. We see patients with insomnia, new onset diabetes, myocardial infarction, stroke, lung fibrosis, chronic fatigue syndrome, brain fog and depression. Some show symptoms of memory loss and poor concentration. There are patients mainly with neuro and cardiac complications."

There are a lot of patients with breathing issues, complications such as clot formations and generalised myalgia for an extended period, said Koushik Muthu Raja, associate professor and consultant, Department of Respiratory Medicine, Sri Ramachandra Medical College and Hospital.

"We are finding pulmonary embolism in patients. Lung damage is persisting in patients who had moderate to severe COVID-19. Some continue to require oxygen support. We start active pulmonary rehabilitation at the hospital itself. This is basically a holistic approach in which a complete evaluation is done and patients are put on a battery of exercises, including those to train muscles and increase the expanding capacity of lungs, nutritional assessment, and relaxation techniques. We are slowly seeing an increase in the number of such patients," he said.

N. Sridhar, consultant intensivist and head of Critical Care, Kauvery Hospital, Chennai, said the hospital had patients returning with sudden pain and breathlessness, and CT scans found pneumothorax, collection of air between the chest wall and lungs. "We are seeing an increased tendency of developing blood clots and stroke in some young patients in the post-COVID period. Some have nerve weakness, and we are seeing an increased number of heart attacks. Patients also experience diarrhoea," he said. Usually, the complications set in after two to four weeks of the onset of illness.

Patients are being asked to come for periodic reviews for at least a month, said Aishwarya Vinoth, consultant, interventional pulmonologist, Dr. Rela Institute and Medical Centre. "We take CT scans of patients experiencing breathlessness. In such cases, we have found patients having gross pneumonic changes involving many areas of the lungs. This is taking a longer period to heal," she noted.

In this wave, many have been oxygen-dependent for long. Such patients are given lung exercises and advised weekly follow-ups.

"Along with physical and mental rehabilitation, post-COVID-19 clinics are running pulmonary rehabilitation," she said.