KOLKATA: Covid-19 cases with “unusual symptoms”, which the union health ministry has spoken about, are on the rise in Kolkata, say city doctors.
The health ministry expanded the Covid symptom list on June 12 to include muscle pain, diarrhoea and loss of taste and smell. A few patients with some of these symptoms, including two employees of a superspeciality hospital and a patient from Bihar, have already been discharged from clinics in Kolkata.
None of them showed the “principal Covid symptom of severe upper respiratory distress”, their doctors said, making the initial diagnosis that much more difficult. One of the three did not even even have fever but all three suffered from diarrhoea for a week; one had lost her sense of smell and another had “minor breathing difficulty” without fever or cold.
“Just 3% of symptomatic patients suffer from respiratory failure and need ventilation. Shivering, cough and breathlessness are the initial symptoms for these patients. But there are atypical symptoms like diarrhoea, vomitting and skin rashes that are not associated with Covid (because they are secondary symptoms). They may be more prominent than the primary symptoms and the challenge for doctors is to gauge them,” AMRI Hospital (Salt Lake) consultant Debashish Saha said.
The 55-year-old Bihar woman, for instance, tested positive but was being treated for Parkinson’s disease and had only a mild, dry cough with no other classic Covid symptom. But her secondary symptoms — loose motion and an occasional loss of the sense of smell — turned out to be more pronounced.
The CEO of a hospital, too, was admitted with severe diarrhoea and later tested positive for Covid. He had low-grade fever but no cough or cold and recovered in a week without any of the common Covid symptoms. Some of the “unusual” symptoms like skin rash, vomitting and diarrhoea can be the lone symptom for several days, doctors said. “In severe cases, patients may have cerebral stroke-like symptoms or venous thrombosis in the lungs or brain. It is the virus that triggers extreme symptoms, depending on the immune response,” AMRI Hospital (Salt Lake) consultant Debashish Saha explained.
Belle Vue Clinic internal medicine consultant Rahul Jain says patients may have marked symptoms of gastrointestinal disorder, pain in the abdomen, nausea, vomitting and diarrhoea prior to respiratory symptoms like cough, sore throat and shortness of breath.
“Some patients may not develop any respiratory symptom at all; these are often detected in routine checks. Physicians may be disarmed by these symptoms and not suspect Covid at all. Anosmia or hyposmia (reduced smell sensation) in the absence of a nose block may be a symptom of Covid,” Jain said.
Asymtomatic patients needed to be diagnosed through contact tracing, Saha felt. “A vast majority of patients will not have symptoms and so it is has to be mandatory,” he said. “Receptors in the lungs and brain get attached to the spike proteins of Covid 19; so very severe symptoms, too, are prevalent but less common,” he added.