Covid-19: Complications even after recovery

4 months ago 24
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Patients get discharged from a hospital after they recovered from COVID-19, in Karad (PTI)

NEW DELHI: Symptoms and complications persist in majority of people, infected with acute or severe COVID-19, even after two months of their recovery from the disease. While many reported body ache and breathlessness, there are also cases of significant organ dysfunction, mainly the lungs and brain.
A latest study - conducted in Italy and published in the Journal of the American Medical Association (JAMA) - shows an overwhelming 87.4% of patients recovered from COVID-19 reported persistence of at least one symptom, particularly fatigue and dyspnea, even after two months of being discharged from the hospital.
Similar trend has also been noticed in India where doctors are witnessing recovered patients coming back with complications, prompting long term follow-up studies on people recovering from the disease.
“There are two types of things happening. One is there are persistent non-specific symptoms like body ache and dry cough - which are troublesome but will not last for long and people will eventually recover. The other category may be worrisome where we have seen a number of patients who had severe pneumonia and there is total scarring of lungs after they recover. Such complications can cause permanent damage ad though these patients can recover, the damage may not go away completely,” says Dr Randeep Guleria, director of All India Institute of Medical Sciences (AIIMS).
Similarly, COVID recovered people are also suffering strokes leading to clots which may not recover and have a long lasting impact.
“We are witnessing impaired lung function in many patients who had recovered and were without pre-existing lung disease before they got infected with COVID-19, similar to our experience in H1N1. However, this is too early and we have to keep a look out for lung functions,” says Dr Neeraj Jain, Chairman, chest medicine at Ganga Ram Hospital.
Dr Guleria says since the number of critical patients in India is only 5-10% of the total infected, those facing severe complications after recovering are even lower at around 15-20% of the critical patients. However, the trend is worrisome as it may eventually impact the death rate.
Findings of the JAMA study show very few patients were symptom-free, whereas quality of life of more than 44% of patients worsened due to the disease.
Over 53% individuals in the study showed fatigue, 43.4% dyspnea, whereas 27.3% had joint pain and around 22% continued with chest pain. Around 32% participants had 1 or 2 symptoms and 55% had 3 or more. None of the patients had fever or any signs or symptoms of acute illness.
However, only 12.6% were completely free of any COVID-19–related symptom at the time of the evaluation, researchers said.
The study, ‘Persistent Symptoms in Patients After Acute Covid-19’, concludes that clinicians and researchers have focused on the acute phase of the disease, but continued monitoring after discharge for long-lasting effects is needed.
Limitations of the study include the lack of information on symptom history before acute COVID-19 illness and the lack of details on symptom severity. Furthermore, this is a single-center study with a relatively small number of patients and without a control group of patients discharged for other reasons.
All patients who met the World Health Organisation criteria for discontinuation of quarantine (no fever for three consecutive days, improvement in other symptoms and two negative test results) were followed up. From April 21 to May 29, 179 patients aged between 19 and 84 years were potentially eligible for the follow-up post-acute care assessment, of which 53 (37%) were women.

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