Since the first half of June this year, India is experiencing an optimistic situation as the doctors are being optimistic to keep the Covid-19 surge in control. The number of Covid cases is decreasing drastically as the vaccination drive for people above 18 years is pacing up. However, the rising mortality rate of the nation seems to be a threat currently to the healthcare sector. It has already claimed too many lives worldwide till date. People who have survived the infection are experiencing its adverse effects in different body parts especially on lungs, heart, throat, ears, and nervous system.
The Covid survivors are suffering from the after effects till the next 3-4 months. The Covid-19 virus leaves the maximum impact on the lungs. People with adverse Covid symptoms can deal with the complications for years after recovery. The infection is primarily a form of respiratory illness where the air sacs in the lungs become filled with fluid which leads to limited oxygen absorption. As a result, people experience coughs, shortness of breath etc.
According to Raja Dhar, pulmonologist, Head of the Pulmonology Department, CMRI/BMB, “By far the most common post-Covid lung complication is lung fibrosis. The initial lung damage heals in the first phase by formation of scar tissue and further healing happens by fibrosis. The leading cause for formation of scars and fibrosis is inflammation. Whenever there is excessive inflammatory reaction in the lungs, fibrosis is the factor which we have to combat with. The other very important issue is Pulmonary Thromboembolism (PTE). It is a clot in the pulmonary artery which restricts the oxygen to reach to the lungs. It happens because of a prolonged restriction of physical movement. The formation of clots is difficult to diagnose and you need to have high degree of clinical suspicion to diagnose this condition. Blood thinning medications in the long term is the treatment for formation of blood clots.
The other problem that we face in the post-COVID period is the lower respiratory tract infection. This is because at this time the immune system of the body is handicapped and the use of drugs like steroids and monoclonal antibodies impair the immune system even further.
These infections lead to fever and symptoms like hypoxia. The saturation drops significantly because of these lower respiratory tract infections. Obesity is a risk factor for all the aforementioned complications. Interestingly in the covid and post-covid period there can be a significant weight loss in a large number of our patients which might amount to 10-20% of recovered patients. The use of steroids need to be judicious. Steroids should not be used early on in covid infections unless there is hypoxia and the doses of steroids need to be toned down as far as possible.
All these treatment manoeuvres need to be implemented under the help of a clinician. Use of drugs at home with over the counter medication actually causes more damage and might increase the risk of mortality”.
Moving forward, Dr. Dhar advises, “Months after recovery, we are suggesting specific pulmonary exercises and breathing exercises to keep the lungs healthy. Along with this right diet is also crucial to fight back the post-Covid complications. People who are facing weight loss should definitely include fat in their diet whereas people who are obese should consume protein to 35%, carbs to 35-40% and less than 10% of fat. Cereals, fruits, and preferably animal protein should be a part of your diet during post-Covid period.”
Another major Covid after effects are observed on the heart. A large number of people are reporting to their doctors with problems such as very fast or slow heart rates, dizziness, severe fatigue, chest pain, palpitations, and shortness of breath. In a study it is observed that SARS Cov-2 corona virus damages the heart muscle, disrupting heart function.
In the opinion of Dr. Anjan Siotia, Interventional Cardiologist, BM Birla Heart Research Centre, “Before entering the cells, corona virus attaches to the ACE-2 receptors. The damage also happens because of the excessive inflammation circulating the body. While the immune system of the body remains busy fighting off the virus, it damages some healthy tissues of the heart. Covid-19 virus also affects the inner walls of the arteries and veins, resulting in inflammation in blood vessels and damaging the small vessels. This compromises the blood flow to all the body parts including heart which leads to blood clots and ultimately heart attack. We have received few recovered patients whose arteries are full of blood clots.”
When asked about the instructions, he further adds, “Active lifestyle, healthy food and regular check-ups are the key to keep a healthy heart. People with previous cardiac issues are strictly advised to do constant doctor consultation when it comes to medication. If someone experiences rapid increase in heartbeat, chest discomfort, dizziness upon standing abruptly, then maybe they are the signs of post Covid after effects. Blood thinning medication for a limited period of 4 weeks can be advised to young people under medical supervision. Make sure you are keeping your body hydrating by taking enough fluids.”
The weak immune system of the Covid patients is the prime reason to make them vulnerable physically. The families of the Covid patients should ensure that they are providing proper medications and care even post recovery.
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