“How early is early intervention” is a common question raised by doctors handling COVID-19 patients.
“But in an epidemic, when there is an unknown agent, even the first response to treatment is important,” said Dr. A. Fathahudeen, professor and head of the department of pulmonology and critical care at Government Medical College, Ernakulam.
Two seriously sick patients were cured of the disease at the hospital. One, a 57-year-old British national who went to the hospital with very severe symptoms and the other, a 37-year-old online cab driver who was a primary contact of a COVID-19 patient who died. Though serious, the cab driver was not as critical as the British national, said Dr. Fathahudeen, who is also the nodal officer for corona care.
“The UK citizen had come in with hyper infection symptoms like high fever and muscle pain but not much breathlessness. When we saw a suspicious shadow of pneumonia in the X-ray, we decided to get a CT scan done,” he added.
Though the good prognosis of the British national could be replicated in the case of the cab driver, it is important that the drugs probably have better efficacy if treatment is started early, he observed. “However, we need to do more such trials as the two were not in comparable age groups, with the second patient having the advantage of age with no co-morbid conditions,” he said.
According to Dr. Fathahudeen, the medical fraternity should take the treatment protocol with optimism. He used a combination of drugs including hydroxychloroquine, azithromicin, and lopinavir and ritonavir.
“My observation is that there is no point in starting medication late when the patient has advanced pneumonia that will land him in the intensive care unit and then the ventilator,” he said.
In the case of the second patient, fever continued for three more days, before it showed signs of coming down.
It was on the sixth day of medication that the patient’s temperature returned to normal. And, the viral load in him turned negative on the 10th day.
Compared to the British national, who was put on non-invasive mask ventilation, the second patient recovered sooner, mainly because his treatment began early,” said Dr. Fathahudeen.
