At the launch of post-COVID recovery clinics, doctors flagged concerns on long-term persistent effects of the disease and the need for continuum of care for patients.
From persistent fatigue to breathlessness, loss of appetite, sleeplessness, scarring of lungs, risk of blood clots and cardiac manifestations, doctors are seeing patients, who have recovered from COVID-19, with many such symptoms.
“We are 10 months into the pandemic. When it began, there was a lot of panic. The panic is still present. We thought all people are susceptible, with the elderly and those with comorbidities at a high risk for complications. So, the initial response was on how to stay protected. People were told to go to hospitals early if they developed the infection. We are realising that it does not end there. Persons who have recovered are running into a lot of problems,” V. Ramasubramanian, senior consultant, Infectious Diseases, Apollo Hospitals, said on Tuesday as the Apollo Hospitals Group launched post-COVID recovery clinics across its network.
COVID-19, he said, was not only a respiratory illness but also a systemic disease affecting all organs, predominantly the lungs. “Some of the commonest symptoms are tiredness, mild breathlessness, joint pain, dryness in mouth, problems with appetite and sleeplessness. Persons who did not require hospitalisation for COVID-19 are experiencing such symptoms,” he added.
Scarring in lungs and blood clots are other possibilities, while psychological effects due to isolation and stigmatisation are being felt.
“Some have neurological problems such as mind fog or brain fog. Some of my colleagues cannot use cell phones to send messages. They find the letters blurred on electronic devices. We realised that COVID-19 affects all organs. There are long haulers with persistent fatigue, breathlessness even with an oxygen saturation of 98 to 99. This is called autonomic abnormality. We need to tackle this, for which a comprehensive multidisciplinary unit is required,” Dr. Ramasubramanian explained.
On the effects of COVID-19 on the heart, Dr. Ramasubramanian said there was an increased risk of blood clots forming in blood vessels due to inflammation. “Studies have shown that the heart function is temporarily damaged during COVID-19. There could be problems in heart function, contraction, blood flow and rhythm disturbances. There is an increased risk of sudden death after weeks,” he said.
L. Sundararajan, senior consultant pulmonologist, said 80% of patients recover well. “Even among them, some have long lasting effects of COVID-19 on almost all organs,” he said.
In the outpatient department, doctors were seeing patients three to four months later with scarring of lungs and symptoms of breathlessness with minimal exertion, he pointed out.
Referring to long COVID-19 syndrome, he added that it might take weeks or months for a patient to make a full recovery, raising the need for a platform such as a recovery clinic to make a complete assessment of patients. At least 50% of persons have symptoms, D. Suresh Kumar, senior consultant, Infectious Diseases, added. He recalled how a young person complained of hair loss after suffering from COVID-19.
While the elderly had symptoms of fatigue, problems in appetite and giddiness, the young had symptoms such as anxiety and lack of sleep.
Preetha Reddy, vice-chairperson of the Apollo Hospitals Group, stressed on the importance of continuum of care post-recovery.
