Since March 2020, a large number of patients were hospitalized with Covid-19 and as more people survive the disease, there is an increasing need for rehabilitation. Many people with severe Covid-19 infection exhibit physical, cognitive and even psychological symptoms even after leaving the hospital. Keeping in mind, the recovery of these patients, Global Hospital, Parel, has come up with a Post-Covid Rehabilitation Clinic.
Coronavirus was initially thought to take a toll only on one’s respiratory system. But currently it has been seen that the virus affects multiple organs, increasing the risk of blood clots and inflammation.
A 58 years old male with Hypertension was admitted with Symptoms suggestive of Covid 19 infection. His HRCT was very bad having severity score of 20/25. He was immediately started on necessary treatment for Covid but his condition went on deteriorating and he required to be put on ventilator. Required to be proned for more than 5 days 16-18 hours per day. He received immunosuppression medication in form of Tocilizumab, Convalescent plasma and Antiviral therapy was also given. His tests indicating blood clotting ability was very high hence he was also given high dose blood thinner injections.
Antibiotics were upgraded as per patient’s condition and culture report, with all these aggressive forms of management he started showing signs of improvement. Slowly he improved, but required a long term stay of around 60 days in the ICU. In all this while he became very weak and was unable to walk, but with good nutrition and Physiotherapy he regained his ability to walk and then he was eventually discharged with oxygen support. This severe form of Covid damaged his lungs badly and it showed evidence of fibrosis on CT scan done before discharge. So, he was started on antifibrotic medicine, necessary nebulization and other supportive care medication.
After discharge also he was in constant touch via video consultation and he continued Medicine, oxygen and Physiotherapy at home. With all this he improved gradually and he could get rid of oxygen and regained his lost strength. The subsequent CT scan of Chest showed reduction in fibrosis which was very much evident on discharge. So, with adequate treatment, good physiotherapy and regular follow up he is almost normal now doing his normal routine daily activities.
Dr Harish Chafle, Consultant Intensivist and Chest Physician, Global Hospital, Mumbai, said “SARS-COV-2 virus attacks the lungs and causes scarring of the linings across the respiratory organs leading to lung fibrosis and other complications. One may experience bouts of breathlessness, excessive dry cough, fatigue, low oxygen saturation weeks or months after testing negative. These symptoms of lung fibrosis will require prompt treatment and follow up. Someone who is over the age of 50, or who is prone for respiratory disorders, may face serious consequences.”
He adds, “The above patient will require to follow up every 2 months to assess whether the fibrosis in lung is progressing or regressing. With repeat HRCT whenever required to see disease progression. The no of new patients visiting the clinic has reduced now with decease in no of cases. But as the follow up no is tremendous the total patients visiting the clinic will take some time to come down.”
This clinic is a boon for patients who have got infected with Covid-19 and still continue to exhibit symptoms, those patients who have recovered from the mild infection of Covid but have been showing symptoms like fatigue, fever, headaches, dry cough, chest pain, upset stomach, muscle pain and weakness, rashes, and even other cognitive difficulties and those who are severely infected with Covid-19 and had breathlessness have been detected with lung fibrosis, Acute Respiratory Distress Syndrome (ARDS), pneumonia, anxiety, depression, brain fog, and post-traumatic stress disorder, and are returning to the hospitals for follow up and treatment. Thus, to assist these patients and focus on their recovery, Post-Covid Rehabilitation Clinic has been initiated by Global Hospital, Parel, Mumbai.
Not each and every patient recovering from Covid will have long-term complications. But many may encounter persistent respiratory and other serious symptoms like scarring of the lungs and even heart issues. The multidisciplinary team in the clinic will assess the patients and suggest relevant medication, an appropriate diet and exercise to get back on track. This dedicated clinic will be beneficial for the patients to aid faster recovery,” concluded Dr Vivek Talaulikar, Chief Executive Officer, Global Hospital, Mumbai.