Ankan Jaiswal, 47, feels dizzy and short of breath even when she climbs stairs or walks more than a kilometer. Sometimes his mind is in a fog. Three years after the Covid infection put him in the ICU, its after-effects still seem to be taking a toll on him. He and other survivors were tracked for three years at the Long Covid Clinic in AIIMS, Delhi, where 70.7 percent were found to be breathing properly or not getting enough oxygen in their blood from the air.
The study is important because it shows that the after-effects can be quite severe and last up to two years after the initial Covid diagnosis. It was especially common in women, the elderly, those with severe infections and smokers. “This is one of the first studies to report long-term pulmonary sequelae (after effects) of COVID-19 from a low- and middle-income country (LMIC). Some of them still require occasional oxygen support,” says Dr Anant Mohan, head of the Department of Pulmonology, AIIMS Delhi. .
He and his team conducted an observational study on patients who regularly attended a Covid clinic over a period of three and a half years. “We are still running it because we have some ongoing projects. We had about 1,426 Covid survivors. 231 of them were followed with us for more than two years. We mapped their symptoms and found that they had persistent dyspnea (shortness of breath and feeling of suffocation). ) and reported worsening lung function,” he says.
What does the study say?
A total of 1,426 patients were enrolled in the post-Covid clinic from 2020 as part of the Long-Covid Multi-System Observational Study. Of these, 231 are still coming to the hospital for follow-up. Most of them had not one but overlapping symptoms. So 36.4 percent had persistent self-reported dyspnea, 48.1 percent had spirometry (measures how much air you can take in and out, and how fast you can breathe) and 70.7 percent of patients had lung expansion (the lungs effectively failing). was exchange gases or move oxygen from the air to the blood).
Who is more susceptible to long term covid? What are the symptoms?
Dr. Mohan included all types of patients above the age of 18 — those with severe, mild and moderate Covid infections and those with no symptoms. In addition to records of hospital physical visits, two-year follow-up was conducted in person or by telephone. “During the physical visit, patients are invited to undergo spirometry, a lung diffusion test and a six-minute walk test,” says Dr Mohan.
Prolonged shortness of breath was associated with those infected during the second wave of the epidemic, when the delta variant was predominant. Elderly people have long-term impairment of pulmonary function due to a decline in the ability of the lungs to repair itself with age.
There was a consistent association of women with chronic lung function abnormalities. Like Ankan, who has now moved to America with his family because Delhi’s pollution worsens his symptoms. 70-year-old Savitri Devi was admitted to AIIMS hospital for four days. “When pollution levels rise in Delhi, it becomes difficult for her to breathe. Post-Covid, she can’t walk for long as she has shortness of breath and bouts of coughing,” says her husband Mahaveer, a resident of Delhi’s Karawal Nagar.
Meanwhile, 48-year-old Mithilesh Kumar says he misses running and brisk walking, which he did before Covid. He cannot walk and talk to anyone at the same time, climb stairs and breathe when his son holds him tightly or hugs him.
Chronic Covid patients also reported dietary changes, psychiatric changes and sleep disturbances, which have been looked at separately in other studies. “Apart from respiratory symptoms, we found patients complaining of fatigue and sleep disturbances. Now we can say that we have a fair idea of what the duration of Covid is,” says Dr. Mohan.
What should patients do next?
According to Dr. Mohan, the study is trying to collect all symptoms of chronic Covid so that patients can get early medical help to address them and prevent complications. “Prolonged covid patients should practice breathing regularly,” says Dr Mohan.
Patient demographics and co-morbidities were collected including date of laboratory test positivity, severity of illness, need for hospitalization, their hospital records, outpatient prescription slips and their details on initial covid infection. Remember the patient.