Covid-19 leaves long-term complications in its wake

Many being treated at home for breathlessness are using oxygen cylinders and concentrators

What doesn’t kill you doesn’t make you stronger in the case of Covid-19. Doctors say that post-Covid complications can be dangerous and common in those who have recovered from severe versions of the infection.

Some of these complications include lung fibrosis, blood clots and PTSD.

Fibrosis

Dr Ajay Handa, interventional pulmonologist, says that post-Covid lung sequelae is a common complication that can be significantly reversed if treated appropriately. “We treat it with a combination of antifibrotic medication and low dose steroids for six to eight weeks. Many a time we identify those with severe lung damage when they are in the hospital itself and start them on a course of the medication as it requires a gradual increase of dosage,” he explains. He adds that these patients also undergo pulmonary rehabilitation through a variety of breathing exercises.

“We also advise that these patients continue home oxygen therapy with oxygen concentrators. Some of them with a 30 to 40 per cent damage in their lungs may require it for up to six months,” says Dr Balakrishna G K, internal medicine.

Dr Pruthu Narendra Dhekane, infectious diseases, adds that many at times patients may not exhibit signs of lung fibrosis during discharge. “We ask them to monitor their oxygen levels and breathing and if they see a drop in either, they are asked to come to the hospital,” he says.

Blood clots

Another common complication faced by recovered people is the high incidence of blood clots. “This complication is the only one that has a possible preventative measure. Patients who have recovered from moderate and severe Covid are prescribed a short course of blood thinners,” says Dr Pruthu.

He explains that blood clots can form in your legs and travel to the brain, lungs or other pulmonary vessels and cause problems like pulmonary embolisms, heart attacks, stroke and even paralysis.

“Post-Covid you are generally fatigued as well, and this lack of movement can also contribute to the formation of blood clots in one’s legs,” adds Dr Ajay.

Inflammation

Multisystem Inflammatory Syndrome is observed on both adults and children who have recovered. “It can show up in people even six to eight weeks after recovery,” warns Dr Pruthu.

Neurological complications

“Neurological complications are common in everyone who has recovered from the disease. This includes weakness, easy fatigue, inability to do daily activities, memory impairment, anxiety, depression and sometimes even PTSD,” says Dr Ajay

What to watch out for?

“While we cannot predict who exactly will be affected by the complications, we have an idea of who is at high risk and we monitor them closely for four to six weeks after discharge,” says Dr Pruthu.

Patients must adhere to their follow-up schedule and finish mandatory isolation. Dr Balakrishna also emphasises the importance of home isolation for a week after discharge. “All safety precautions must be adhered to strictly for at least a week. This is an added layer of security to prevent the spread of the virus,” he explains.

Dr Pruthu says that patients are asked to keep an eye on new breathing difficulties, oxygen levels, chest pain, joint pain and swelling and persistent cough. “If you have a fever after discharge and isolation it could be a sign of MIS-A,” he says.

He adds that prevention is difficult but self-monitoring and early diagnosis and intervention can help stop the escalation of the disease and more permanent damage.