SHALINI SAKSENA speaks with doctors who say that post-COVID complications have been on the rise like insomnia, renal injury, cardiac problems and poor exercise tolerance to name a few
It has been over a year now since the pandemic hit worldwide. And during this time, people who have tested positive and recovered have complained of many complications that they are now suffering. Dr Chetan Rao Vaddepally, consultant pulmonologist at the Yashoda Hospitals, Hyderabad tells you that besides the organs complications like acute liver failure, gastrointestinal complications like acute bowel ischaemia and gangrenes and skin complications like hemorrhagic bullae with intra-bullae blood clots and dissecting hematomas, Isolated herpetiform lesions, petechial rash, there are several complications that have come up. Some of these complications that have risen post recovery include:
Poor exercise tolerance: This is mainly a complication caused due to the corona virus infection and reduced physical movement. This can be due to the affect or the damage done by the virus on lungs, heart, blood vessels or muscle changes.
Cardiac complications: Recent studies reported an increased risk of heart failure in COVID-19 patients. Post-COVID cardiac complications like acute coronary syndrome (ACS), Acute MI (stroke), dysrhythmias, persistent hypotension, infective myocarditis have been reported.
Heart damage or cardiac muscle injury complication is seen after several days or weeks of recovery. The infection from COVID-19 can lead to inflammation in various parts of the body resulting in the weakening of the heart muscle, abnormal heart rhythm and could even cause blood clots in blood vessels. Complications like Myocarditis or an inflammation of the heart leads to it not pumping blood properly, causing the narrowing of the arteries, triggering high BP, and thus leaving one susceptible to a heart attack.
Renal injury or failure complications: Elevated levels of protein in the urine and abnormal blood work confirm kidney problems in patients, even in those who did not have renal issues before Covid. Hypertensive and diabetic COVID-19 patients are at a higher risk of kidney complication post COVID-19. Some complications may even require dialysis. This organ acts like a filter for the body by flushing out the extra water, toxins and waste products from the body. Thus, its proper functioning plays a vital role. Blood clots can stifle the tiny blood vessels in the kidneys leading to its damage.
Central nervous system complications: Reported complications include; acute strokes, encephalopathy, Guillain-Barre syndrome, taste impairment, smell impairment, vision impairment and neuropathy.
Acute necrotizing encephalopathy: Acute necrotizing encephalopathy(ANE) is an immune mediated disease which is usually seen after infection with mycoplasma,influenza A and herpes simplex virus. However it was recently reported in post-COVID patients and seen in children rarely.
Multiple cases of MIS-C are being reported in the pediatric population. As COVID is a pro-inflammatory condition we tend to see these complications with direct injury to the central nervous system. Direct invasion of virus is also another possibility. ANE is a life threatening condition. It needs immediate ICU admission, MRI to look for abnormalities in the brain, EEG to look for subclinical seizures and CSF analysis to rule out CNS infection.
Vascular complications: COVID-19 is an infectious disease that leads to a proinflammatory and prothrombotic state, resulting in both micro- and macrovascular thrombosis, and both arterial and venous thrombotic events.One-third of patients hospitalized due to severe COVID-19 develops macrovascular thrombotic complications, including venous thromboembolism, myocardial injury/infarction and stroke. Complications like acute pulmonary thromboembolism, deep vein thrombosis, acute limb ischemia/ gangrene, mesenteric ischaemia are seen.
Insomnia: This is a sleep disorder which affects the central nervous system where the sleep cycle of the person gets affected, leading to slower recovery. Various factors can trigger this state which includes anxiety, stress and loneliness. This is more so for patients who stay alone for weeks in hospitalisation or isolation, thus making insomnia a post COVID complication.
The list of complications keeps increasing. In order to avoid such complications, it is wise to avoid exposure to the infection by ensuring precautions.