The impact of Covid-19 is being seen on patients’ lungs, heart and brain, even after recovery. This is raising questions about the risk of long-term health problems due to the infection. The elderly and those with serious medical conditions are most likely to experience lingering Covid-19 symptoms, but it can also happen to people of all ages.
A recent study by King’s College, London, using data from the Covid Symptom Study App and health science company ZOE, showed that 1 in 20 people with Covid-19 is likely to have symptoms for eight weeks or more. This study suggests that prolonged Covid-19 affects around 10% of people in the age group of 18-49 years who were unwell with the virus. “The Covid Symptom Study App has released key findings on long Covid-19 that show that older people, women and those with a greater number of different symptoms in the first week of their illness were more likely to develop long Covid-19. Around 1 in 7 had Covid-19 symptoms lasting for at least four weeks, with around 1 in 20 staying ill for eight weeks and 1 in 50 suffering for more than 12 weeks,” said Dr Claire Steves, a clinical academic at KCL and lead scientist at Covid Symptom Study App.
Dr Ravi Gupta, Cardiologist at Wockhardt Hospital, Mumbai Central, says, “Covid-19 survivors may face a range of problems. Patients with comorbidities like heart conditions or even diabetes should be extra cautious as it can give a tough time to your heart by increasing the risk of problems like angina, chest pain, heart attack, or even heart failure.”
Various studies also show the potential impact of Covid-19 on the neurons, putting those with neurological ailments at an elevated risk. Dr Jaideep Bansal, HOD- Consultant, Neurology at Saroj Super Specialty Hospital, Delhi says, “People with pre-existing conditions or undergoing treatment for epilepsy, Parkinson’s Disease, or those who have had a history of a stroke attack, may be highly vulnerable to elevated symptoms like seizures, loss of steadiness, dizziness, impaired consciousness, cognitive impairment or even loss of smell and taste.” Dr Anil Ramakrishna, Head of Neurology at Columbia Asia Hospital Hebbal, Bengaluru, says, “The neurological complications post Covid-19 are strokes, where patients present with weakness of a hand or legs, and paralysis. This is because the coronavirus can cause damage to the blood vessel cells which can then activate the coagulation pathway and inflammation-causing blockage of the vessels and sometimes rupture the vessels causing a stroke.” He explains, “Some patients post Covid-19 can experience tingling, burning, pain in the hands and legs because of the damage to the nerve, which is called neuropathy. Few patients may also have post-viral encephalitis because of the infection or the inflammation of the brain cells, where patients present with irritability, behavioural issues, restlessness and sleep issues. Few patients may also develop seizures. After Covid, myelin, the covering of the brain and spinal cord, can also get damaged.”
“India is likely to witness a second wave of Covid-19 in the upcoming months. Lower winter temperatures and the rise in pollution levels caused by the burning of crop stubble in North India could lead to a rise in Covid-19 cases. Typically, asthma and COPD (chronic obstructive pulmonary disease) infections are known to go up at this time of the year. People who have recovered from Covid-19 remain particularly susceptible as their lungs are still weak. Therefore, wearing masks and following social distancing norms are a must during this period and will not only help to avoid coronavirus but respiratory infections as well,” advises Dr Gurpreet Sandhu, president of Council for Healthcare and Pharma, a global think tank.
According to research, led by Xiao Wu and Rachel Nethery at the Harvard University T.H. Chan School of Public Health, an increase of just 1 microgram of particulate matter per cubic metre corresponded to a 15% increase in Covid-19 deaths. “Chronic exposure to air pollutants has been associated with lung ACE-2 over-expression which is known to be the main receptor for SARS-CoV-2. Air pollution may affect a person infected with Covid-19 as their lung functions could remain compromised for a while. A possible link between air pollution exposure and Covid-19 related deaths, no matter how small, should be an indication that air pollution needs to be urgently tackled,” opines Dr Yash Javeri, Head, Critical Care, Anesthesia & Emergency Medicine at Regency Super Specialty Hospital, Lucknow.
“With stubble burning in the northern plains, plus the winter setting in, the air quality has worsened considerably from low two digits to high three digits. It was around 30-40 in the days of the lockdown, but now, it is nearing 400. And with worsening air quality and increasing air pollution, the compromised lungs of post-Covid patients are even more susceptible to infectious diseases such as pneumonia, superadded bacterial and viral infections. So, we need to be very careful,” says Dr Shuchin Bajaj, a volunteer doctor at StepOne, the telemedicine platform that is helping Covid-19 patients with the state governments.
In winter, in addition to outdoor pollution caused by industries, cars and stubble burning, we also have increased indoor pollution, be it through incense sticks, mosquito coils or other items. Closed doors and windows in winter also lead to indoor pollution rising significantly. Dr Shuchin Bajaj asserts that we need to be very careful and take care of our lungs, throat and respiratory system in the days to come. Moreover, weakened lungs after Covid recovery coupled with high pollution can leave a person susceptible to re-infection by the coronavirus too.
“Anxiety is frequently being seen in patients recovering from Covid-19. The unpredictable nature of the illness and the diverse nature of complications can also be a source of constant rumination and worry for Covid survivors. Major psychiatric disorders such as depression and Post Traumatic Stress Disorder (PTSD) may also get precipitated due to the stress associated with the diagnosis, the unfamiliar experience during admission and the treatment process,” says Dr Kedar Tilwe, Psychiatrist at Fortis Mulund & Hiranandani Hospital, Vashi. Showing support, helping them overcome negative thoughts by letting them vent, relaxation exercises and mindfulness practices are some of the ways in which loved ones can help Covid patients. If needed, the help of mental health professionals should be sought.
SYMPTOMS CORONAVIRUS SURVIVORS SHOULDN’T IGNORE
• Fever, cold, throat pain, body ache, vomiting, diarrhoea, loss of smell, loss of taste, allergic rash, breathing difficulty, leg pain, backache, feeling unwell, headache, giddiness, loss of appetite, tingling in hands and feet, a stroke-like presentation which can mimic a heart attack, difficulty to walk or limb weakness, intermittent fever, chest tightness, blood in sputum, bluish toes and fingers. If one notices these symptoms, they must not ignore them and immediately consult a doctor.
• Neglecting any of these symptoms can be risky. Also, make sure that one takes all the medications prescribed by the doctor and goes for regular follow-ups post Covid. Self-medication is a strict no-no.
• Covid-19 creates havoc on one’s health and constant monitoring is needed to minimise its impacts, because they can range from being moderate to severe and land a person in the hospital.
• It is a known fact that though coronavirus is a respiratory illness, it can also have a negative impact on other body parts.
• Eating a well-balanced diet and exercising daily is important. It is advisable to stick to a healthy lifestyle and follow the Covid-19 protocol: washing hands properly, maintaining six feet distance, and using a handkerchief while coughing and sneezing.
—By Dr Manjusha Agarwal, Internal Medicine Specialist at Global Hospital Mumbai.
