Why One Needs To Be Careful While Recovering From COVID-19

Long COVID syndrome, is the period when the virus has left your body but has left behind a little bit of damage. Many of the patients do recover without any damage but some of the patients suffer from some residual effects.  Most of the time, Coronavirus affects 4 organs predominantly the lungs, heart, nerves, and general system which can present with weakness, fatigue, etc.

So Long COVID is a syndrome where the symptoms persist even after the fever has subsided for more than 3 months. This is when we need to look for the organs which have suffered from some damage. We generally do not wait for 3 months to investigate but in case these patients have not done an ECHO earlier, then they should undergo the same under the advice of the doctor.

ETV Bharat Sukhibhava was in conversation with Dr. Mahendra Kare, MBBS MD, Fellowship in cardiology from Singapore, Member of American College of Cardiology, Member of the American society of echocardiography, Fellow of the Indian society of echocardiography, Member of the Endocrine Society, Ex lecturer of Goa Medical College for insights into the same.

Lung: Here the long-term damage is that pneumonia heals but leaves an area of fibrosis or scarred tissue. These scars decrease the oxygen exchange capacity of the lung so the person is unable to breathe insufficient oxygen and therefore the person has to breathe in with more effort than before. In such cases, the patient has to approach the doctor and we do something called the 6 minutes walking test and if the oxygen saturation drops below 95 % or sometimes below 90% we feel that the patient may be having some amount of pulmonary fibrosis.

Brain: COVID 19 can also affect the brain and the nerves, where the patient may present with some memory lapses or memory loss.

Generalized weakness and fatigue: this is commonly seen in post-viral phases.

Red flags to look for Post recovery -You should be looking for breathlessness, chest pain or feeling giddy after walking or after doing any activity. Then they should seek medical help immediately.

Diabetes is very important comorbidity when it comes to COVID.

1. Many of the patients who did not know they had diabetes, were detected when they got COVID. It could be because most of them may have been in the prediabetic phase or may have never had symptoms so they never went to the doctor to get themselves tested and due to COVID they got themselves tested and were found to be diabetic.
2. You may completely normal and non-diabetic and because of the viral infection, there is an increase in the stress hormone you may go into diabetes.
3. If you are already diabetic, then your blood sugar level will worsen especially with the viral infection and the ongoing fever.
4. When the patients are in the second phase and if they are diabetic, we need to start you on steroids and these steroids tend to increase the blood sugar levels.
5. If you are diabetic and if you are on high-dose steroids, you are prone to Mucormycosis, a fungal infection.

So, it is important to address all these 5 components when it comes to diabetes. there is a little apprehension amongst patients as to why I am being given Insulin. The reason is the nature of COVID-19 infection where steroids may have to be given to abate the infection and the blood sugar has to be strictly controlled and therefore there is no other choice but to give insulin to further complications. Insulin is the only option and the patient should accept insulin at that point in time and the blood sugar has to be well controlled.