A 26-year-old man who had recovered from Covid-19 three months back suffered a cerebral stroke this week and died at a hospital in Calcutta.
The youth’s family members, who did not want to disclose his identity, said he did not have any medical condition before being infected with the novel coronavirus.
There have been a number of cases in the city of people suffering a cerebral stroke or a cardiac arrest a few weeks or months after recovering from Covid. Doctors are classifying these, as well as other serious problems like infections in the brain, as some of the severe post-Covid complications.
Doctors differ on whether to prescribe anticoagulant drugs to Covid patients when they are being discharged from hospital to ensure they don’t suffer stroke or pulmonary embolism, a condition where blood clots in a pulmonary artery.
“Recently, a 57-year-old man who had contracted Covid was discharged from hospital and the family hired a nurse from our organisation to take care of him at home,” said Souvik Bhattacharya, the unit head of Apollo Home Healthcare in Calcutta.
“One day the nurse reported the patient had suffered a severe cardiac arrest. He was resuscitated and taken to a hospital, where he died. The man had suffered severe fibrosis of lungs because of Covid,” he said. Pulmonary fibrosis is a condition in which tissues of the lungs are damaged.
Bhattacharya said at least 10 per cent of their patients had to be readmitted to hospital because of post-Covid complications.
Doctors said that apart from the usual post-Covid complications such as weakness, shortness of breath, body ache and cramps, they are observing embolism or blood clots in different parts of the body and severe infections.
“Many people who had suffered from Covid are coming back two to three months after being discharged with complications like stroke and infections. I recently saw two women, one of whom had herpes in the brain and another brain tuberculosis,” said Hrishikesh Kumar, the head of neurology at the Institute of Neurosciences Kolkata.
“The natural deduction is that reduced immunity because of Covid was responsible for the herpes and the tuberculosis.”
Kumar said he prescribed anticoagulant drugs to some people who had severe Covid to prevent blood clot. “They need to continue with the medicine for some time. During that time, they have to undergo tests which will show whether they have any chance of bleeding,” said Kumar.
Some doctors, however, said they were not prescribing anticoagulant drugs.
“During Covid, our body’s immune response system reacts and has a tendency to cause thrombosis. So most patients admitted to hospital are given anticoagulant drugs,” said Chandramouli Bhattacharya, an infectious diseases expert and a member of the Covid treatment team at Peerless Hospital.
“Anticoagulant drugs reduce chances of blood clot but increases risk of bleeding. So it’s a double-aged sword.”
Bhattacharya said apart from blood clot, people were also complaining of breathlessness weeks after discharge, although their X-ray showed improvement and oxygen saturation was well above 93 per cent.
Doctors said both the heart and the lungs were getting seriously damaged in the aftermath of the infection.
“We have carried out a few autopsies to understand how the coronavirus is causing thrombotic complications,” said Himadri Chakrabarty, a senior physician who is leading a team of doctors across state-run Covid hospitals in Bidhannagar, Baranagar, Dum Dum, Barasat and Barrackpore.
“Before discharging the patients, we are doing ECG and then following it up after a gap of four and six weeks. In most cases, we are prescribing breathing exercises along with steroids and even anti-coagulants.”
“We are asking relatives of some patients to arrange for oxygen support at home before discharging them. They are being advised to come back for evaluation after six weeks,” said Sandip Ghosh, an assistant professor at the RG Kar Medical College and Hospital. “A few of these patients are being prescribed anti-fribrotic drugs but there is still debate over use of this medicine.”