Experts for strategy to deal with post-Covid complications

PARAG BISWAS, SNS, SILIGURI, 9 SEPTEMBER 21 : The sudden demise of the Deputy Chief Medical Officer of Health, Alipurduar, Dr Rudra Kumar Biswarari, who reportedly died in a private hospital in Siliguri following "post-Covid complications" yesterday, the Rajasthan Chief Minister Ashok Gehlot's claim on August 28 that his lingering cardiac issues were due to post-Covid complications and the passing away of eminent Bengali writer Buddhadeb Guha reportedly due to post-Covid complications after a massive cardiac arrest in a private hospital in Kolkata two days later has once again brought to light the issue of post-Covid complications.

A day after undergoing angioplasty, the 70-year-old Gehlot on August 28 said he was unable to go amongst people for the past several days as he was suffering from post-Covid health issues, while according to reports, the 85 year-old Guha, who had contracted Covid-19 earlier this year in April and spent 33 days in hospital, had returned from hospital but never really recovered as he had to be hospitalized again earlier this month after complaining of breathlessness and urinary infection. Like Guha, Krishna Roy, wife of Senior Trinamul Congress leader Mukul Roy, had also reportedly died at a private hospital in Chennai on July 6 after having a cardiac arrest reportedly due to post-Covid complications.

0n August 28, a few hours after Gehlot urged people to consult a doctor if they had any symptoms after recovering from Covid- 19, a report published by Dr PV Sudhakar, Principal of Andhra Medical College and Covid-19 Nodal Officer said that about 30 percent of people, who had recovered from coronavirus, were facing post-Covid complications and most of them were those who were severely affected and were on oxygen support, while a study published two days later in the Journal of Clinical Investigation claimed that the experts who had conducted the study had found clues to just how lung damage developed in the aftermath of a Covid-19 respiratory infection.

Experts in north Bengal, who expressed concern at the findings of various surveys and expert committees on post-Covid complications, felt that there was an urgent need to develop a multipronged strategy to deaI with post-Covid symptoms and syndromes.

The Head of the Department of Physical Medicine and Rehabilitation at the North Bengal Medical College and Hospital, Dr Partha Pratim Paul, who has been constantly monitoring the physical and psychological aspects of Covid patients in north Bengal since the start of the pandemic in March last year, stressed the exigent need for covid patients and their near and dear ones to realize the value and importance of post-Covid management and care. "Patients, who have just recovered from Covid-19 or returned home from the hospital, have no doubt won the battle but the war is still on. They must pat themselves and get ready for more battles as they get back to their routine lives," he emphasized.

Dr Pan said that many persons, who had recovered from coronavirus, might face a series of post-Covid complications, which might require immediate or even emergency medical care. "The most common post-Covid complications are fatigue, respiratory stress and secondary infections. The other complications include neurological and psychological as well as cognitive problems such as confusion, impaired judgment, short-term memory loss and to plan properly or solve problems. The more serious problems include speech problems, hoarseness of voice, symantec disharmony in language and dysphagia, that is, difficulty in swallowing. 'The common covid symptoms of anosmia and hypogeusia, which mean the partial or complete loss of the sense of smell or taste respectively. continue in many patients even a month after recovering from Covid. It leads to a loss of appetite, which in turn, leads to malnutrition," he said. The senior physical medicine expert cautioned that many patients encounter a number of pulmonary problems after recovering from Covid and if these were left unattended and untreated, they could turn out to be very serious and complicated. "Covid-19 mainly affects the lungs. It causes viral pneumonia characterized by thrombotic episodes in patients suffering the disease. It also results in pulmonary fibrosis due to which the expansiveness of the lungs suffers and a patient may become progressively short of breath. In addition to this, patients suffer from myositis, which means inflammation of the muscles, muscle atrophy, that is, the thinning or loss of muscle tissues, as well as the serious condition of neuro myopathy, which include muscle cramps, stiffness, and spasm. These conditions may continue even after 12 weeks of recovery and may cause serious post-Covid complications in patients suffering from these conditions, which is now referred to as long Covid," he said.

Dwelling upon the measures that should be taken to prevent, identify and solve post-Covid problems Dr Pan stressed the need to follow the "Four- Vs" strategy of Pacing, Planning, Prioritizing and Positioning. "After recovery, every patient should pace their activities properly, that is, should take short and regular breaks during their works or take a brief rest after every three stairs, while climbing up staircases. They should plan their activities well in advance and also do more important activities only, while avoiding the less important ones. They should most importantly keep the articles required for their day-to-day activities well within their reach," he suggested.

The renowned rehab care specialist also emphasized the need to follow certain physical and psychological exercises under the proper advice, guidance and supervision of experts. "Patients who have recovered from covid should return to work gradually' and keep their expectation slow. They may not he able to perform as well as they did before contracting the disease but they should not allow it to depress them. They should involve themselves in healthy pastimes and creative activities like painting, gardening, solving simple riddles, playing with children and playing games such as chess. They should also do light exercises such as walking, static cycling and simple aerobics after adequate consultation with experts as every patient is different and need a specific set of exercises with varying nature and intensity, which are tailor-made to help them recover front their specific conditions. They should also consult accomplished speech-therapists to solve their speech problems and go for smell and taste training under the guidance of qualified experts to cure themselves of both anosmia and hypogeusia. If they strictly and properly follow the regime suggested by the experts, they will definitely recover quickly from both their physical and cognitive problems," he said.