Tamil Nadu

Diagnosed with COVID-19 in April, patient finally returns home

In good hands: The patient with the team of doctors who treated him at the RGGGH.  

It took nearly 90 days for 37-year-old Naresh, a resident of Gudiyatham, to recover from multiple complications caused due to severe COVID-19.

In a span of over three months, he was treated in four different hospitals, the longest stretch of hospitalisation being at the Rajiv Gandhi Government General Hospital (RGGGH), from where he was discharged on Friday.

It was during the last week of April that he tested positive for COVID-19. He had developed loose stools, fever and cough on April 24, and was admitted to a private hospital. He was discharged the next day. However, his symptoms worsened, and he was admitted to the Government Hospital, Chromepet, on May 6 with breathlessness, fever and cough. He was referred to the Tambaram Sanitorium on the same day, where he continued treatment for a month.

He was oxygen dependent — 15 litres per min. But his condition continued to deteriorate, according to doctors.

On June 6, he was referred to the RGGGH in a critical condition. He had developed right hydropneumothorax — accumulation of fluid and air in the pleural cavity, and a CT scan of the chest revealed Grade-4 changes, suggestive of severe COVID-19 pneumonia. An intercostal drain tube was inserted, but he continued to have multi-loculated pneumothorax, warranting multiple interventions by a team of chest physicians, cardiothoracic surgeons, anaesthetists and intensivists.

“The lungs turn weak due to COVID-19. When scarring happens, air bubbles may develop in the lungs. We identified his condition immediately and did an intercostal drain tube insertion or else the lungs could collapse. We had to wait for 48 days to remove the tube as the tear was large. In the meantime, he developed a lot of infections,” said A. Mahilmaran, director, Institute of Thoracic Medicine, RGGGH.

To prevent recurrence of pneumothorax, a procedure called ‘pleurodesis’ was done in which chemicals are instilled into the pleural space.

As he recovered gradually, the tube was removed on July 16. He started to maintain good oxygen saturation in room air. Doctors waited for another week to run a few tests to rule out any other complications.

“His recovery was slow as there were multiple complications. Once he tested negative for COVID-19, we shifted him to the pulmonology ward for continuum of care,” said E. Theranirajan, Dean of RGGGH.

There are multiple factors at play. “The patient was young. Care always involved a multi-disciplinary approach by engaging doctors from various specialities, including cardiology, cardiothoracic surgery, pulmonology and internal medicine. The challenges included prolonged stay, psychological impact on patient and family and social factors. We had to ensure that he did not lose hope,” he said.

Doctors recounted how both the patient and his family needed persistent psychological counselling as the treatment continued. “We had to instill confidence in him. This was one of the toughest things,” Dr. Mahilmaran added.

Mr. Naresh walked out of RGGGH on Friday.

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Printable version | Sep 18, 2021 8:33:08 AM | https://www.thehindu.com/news/national/tamil-nadu/diagnosed-with-covid-19-in-april-patient-finally-returns-home/article35501633.ece

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