KOLKATA: A small proportion — but a significant number — of Covid patients in Kolkata are experiencing secondary infections during the recovery phase, which is often leading to a sudden and unexpected health deterioration, even resulting in death in some cases.
According to private hospitals in the city, the ratio of such patients seeking re-hospitalisation is small — around 4% — but the mortality rate is a steep 20%. Treatment is being done through broad spectrum antibiotics, since the undetected secondary infection could be bacterial, fungal or viral.
Over the last few weeks, scores of Covid patients have been suffering from high fever, joint pain, loss of appetite and severe weakness, all symptoms of an underlying infection, according to doctors. These symptoms have been setting in between the 15th and 20th days of testing positive, in most cases.
“We have had such patients intermittently over the last three months. But now, many are being forced to seek re-hospitalisation with an undetected infection. It’s getting very severe in some cases, adding to the already existing post-Covid complications,” said Rahul Jain, internal medicine consultant, Belle Vue Clinic.
Jain gave the example of an 80-year-old Covid patient, who had to return to hospital twice after having recovered from the viral attack. “In his case and in many others’, the weakness and fever are persisting. These are the most common signs of an underlying infection,” he added.
It’s very difficult to detect the infections, as they could be bacterial, fungal or viral. “In most cases, they strike the elderly with co-morbidities since they are the most vulnerable, due to their lower immunity. Sustained use of medicines, especially steroids, could also lead to infections. It’s important to treat these patients early, as the mortality rate is quite high at 20%,” said Fortis Hospital pulmonologist Raja Dhar.
Secondary infections are usually identified through sputum or blood culture tests and, in some cases, through a bronchoscopy. But in 60%-70% of cases, they remain unidentified. “If the bug or the cause of infection remains unknown, broad-spectrum antibiotics must be administered,” Dhar added.
Some physicians also pointed out that sustained use of steroids on Covid patients has been triggering infections. Used to temper immune response to Covid, steroids often end up reducing immunity and letting underlying infections flare up. “This can be dangerous in the recovery phase, which is why we need to monitor fever and find out the cause even while treating patients for Covid. In Covid cases, it’s often being neglected and infections are being allowed to fester and flare up. So, it’s necessary to do the diagnostic checks and trace the infection. If it can’t be detected, antibiotics should be used as early as possible,” said Arindam Biswas, consultant, RN Tagore International Institute of Cardiac Sciences (RTIICS).
At AMRI Hospitals, the number of Covid patients seeking re-admission has gone up. Two of its employees who had tested positive are among them. “In our hospital, infections have so far been mild and manageable. But the trend is new and has started climbing, though very slowly. It could get more serious for elderly patients with existing co-morbidities,” said AMRI CEO Rupak Barua.
At RTIICS, Covid patients are often seeking readmission with post-recovery symptoms such as a persisting breathing distress or extreme fatigue. “So far, most have been treated at the outdoor, barring a few, who needed admission due to a severe breathing issue,” said zonal director R Venkatesh.