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How Post Covid Complications May Affect Multiple Organs

Covid-19

29 Jul 2021

9 mins

How Post Covid Complications May Affect Multiple OrgansThis pandemic has affected everyone's health and lifestyle. A lot of us must have experienced the same. Most of us or our loved one’s were infected by COVID-19 and developed severe symptoms, then we must be familiar with the post covid complications. It affects multiple organs of our body and also our mental health. Here are few questions which you should ask yourself to keep a check on your health. Are you taking all the precautions to prevent COVID 19 infection? Have you been infected from COVID 19 earlier? How severe was your infection? Do you still face post covid effects even after the recovery? How's your mental health? The novel coronavirus has infected millions of people worldwide. Its mutant variants are increasing the problems of doctors. Earlier, the symptoms of COVID-19 virus infection were fever, cold, cough, and breathing problems. But as the virus is changing its structure, new signs and symptoms are visible like throat pain, stomach pain, vomiting, headache. Even after the recovery, it can have long-term effects on your body. As the second wave passed, many recovered individuals are facing post covid symptoms. How does coronavirus attack your body? The virus enters through your eyes, nose, or mouth. It has spikes on its surface. With the help of these spikes, the virus attaches to the healthy cells and infects the cell. The infected cell then produces more copies of the virus. The virus affects different organs by acting on the ACE-2 [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1287568/] receptors (Angiotensin Converting Enzyme-2 receptors) present in all the vital organs. It damages your lungs first, followed by your heart, then liver, kidney, brain, and others. EFFECTS ON DIFFERENT ORGANS DURING THE INFECTION COVID-19 spares no vital organs of your body. It affects multiple organs during the infection and also has long term effects on these organs: 1. LUNGS Your lungs are the first organs to be affected by COVID-19. As the virus enters through your nose or mouth, it reaches your throat and the lungs. It causes cough, throat pain, and breathing difficulty. It causes pneumonia in most cases where it has long-standing damage to the alveoli (tiny air sacs in the lungs). 2. BLOOD VESSELS COVID-19 can make your blood cells more prone to come together and form clots. Larger clots can cause severe problems like heart attacks and strokes. Smaller clots are even more damaging. These clots can block your capillaries (narrowest blood vessels) and can cause thrombosis [https://mrmed.in/health-library/haematology/low-platelet-count/]. These tiny clots can lead to critical problems like: * Deep vein thrombosis [https://mrmed.in/health-library/haematology/low-platelet-count/] * Disseminated Intravascular Coagulation * Pulmonary embolism * Blood vessels narrowing Suppose the blood vessel which supplies to a vital organ of your body has constricted, that organ gets a lesser blood supply and its cells start dying. Some other effects it has on your blood vessel are endotheliitis, vasculitis. It weakens the vessel wall and increases leaks that cause fluid accumulation in different parts of your body (oedema). 3. HEART Even after months of recovery from COVID-19, lasting damage to the cardiac muscle can also occur. It happened even in people who had only mild COVID-19 symptoms. If you got infected from COVID-19, then the chances of heart disease [https://mrmed.in/health-library/heart-care/diagnosis-of-cardiovascular-disease/] in the future increase. If you have a previous history of any heart ailments, then you are at higher risk. Congestive heart failure, Arrhythmias, Myocarditis, Acute coronary syndrome, Myocardial Infarction are some of the complications that can occur in the long term. 4. KIDNEY Kidney problems arise when the blood supply of your kidneys reduces. Acute kidney injury can take place. Chronic kidney disease can also happen in the long run. 5. BRAIN The virus affecting your central and peripheral nervous system is very damaging. It can increase the risk of strokes, seizures, and Guillain-Barre syndrome - a condition that causes temporary paralysis. It may cause reduced reflexes in the brainstem that maintains the oxygen level in your blood. It also causes dizziness, headache. It may be associated with the danger of developing Parkinsonism and Alzheimer's disease in the long term. These conditions can affect your whole body and reduce your thinking ability, memory, and your bodily movements. In rare cases, it may cause Meningitis and Encephalitis. 6. EYES The virus can affect your eyes also. In one-third of the patients of COVID-19, conjunctivitis occurs. The eyes become red and swollen. 7. GUT Your gut, through which your food passes and gets absorbed, may get affected. You will feel a loss of appetite, nausea, and abdominal pain. Vomiting and Diarrhoea are also common. 8. SKIN When your body gets infected by any virus, some common skin problems can also occur. These are- acne, eczema, rashes, purplish discoloration due to clot formation. 9. BEHAVIOURAL PROBLEMS Suppose you have suffered from severe symptoms of COVID 19 and treated in a hospital's medical care unit, with ventilators to breathe. Then, simply surviving this experience can make you vulnerable to develop post-traumatic stress syndrome, depression, and anxiety after the recovery. People who were severely infected from COVID 19 experience inattention, disorientation, poorly organized movements, anxiety, depression, and post-traumatic stress syndrome even after the recovery. Many people who have recovered from SARS CoV-2 have developed chronic fatigue syndrome. It is a disorder in which you will experience extreme fatigue that worsens with any physical or mental activity. The fatigue doesn't improve with rest. POST COVID COMPLICATIONS It's difficult to predict long-term effects from the new COVID-19 virus. Scientists are watching it, in case of related viral infections. All the virus that causes severe acute respiratory syndrome (SARS) are related to COVID-19. Some common signs and symptoms that persist for a long term post covid recovery are: • Fatigue • Shortness of breath or difficulty breathing • Cough • Joint pain • Chest pain • Memory loss • Concentration or sleep problems • Muscle pain • Headache • Fast or pounding heartbeat • Loss of smell or taste • Depression or anxiety • Fever after covid recovery • Dizziness once you stand • Worsened symptoms after physical or mental activities Multi-inflammatory syndrome or (MIS-C) is another long term complication associated with Covid19 Multi-inflammatory syndrome or MIS is a condition in which some organs and tissues of your body become severely inflamed. Inflammation of any organ or tissue causes swelling of that organ/tissue. It also causes fever and fluid accumulation. Some chemicals released from these affected organs/tissue are called cytokines. Inflammation of many organs causes the release of cytokines in large amounts in the blood. It is called a cytokine storm. Cytokines damage your other healthy organs. It leads to ARDS (Acute Respiratory Distress Syndrome). It can also cause some organ failure and ultimately leads to death. MIS has occurred in children in most cases. Doctors believed earlier that it only affects children. But MIS can also happen in adults. The condition in adults is called MIS-A. None of the doctors or investigations have been able to answer on how long does it take to recover from coronavirus You should recollect that the majority of people that have COVID-19 do not recover quickly. To prevent post covid complications, please follow all the precautions. It includes wearing masks, social distancing, avoiding crowds, getting a vaccine when available, and keeping hands clean.

Dr. Malvika

Covid-19

5 Jul 2021

9 mins

Black Fungus: Myths Vs. FactsIn India, rising medical concern about fatal fungal infection has emerged. After the second wave of COVID-19, black fungus infection has rooted panic among people. Various myths are spreading on numerous platforms on the internet. Let's see some of the facts about black fungus and bust the myths. Here you will get everything you need to know about black fungus. WHAT IS MUCORMYCOSIS? Mucormycosis is a fungal infection caused by a group of fungi known as Mucormycetes. It's a severe but rare fungal infection that can be fatal if not taken care of it. Black fungus is a misnomer [https://en.wikipedia.org/wiki/Misnomer] because the mucor mould is not black. Instead, there are black dots seen between the mould colonies. The infection causes black coloration of the nose and under the eye area. Hence, the name has been given "Black fungus." Mucor moulds infect by their spores. Their spores are present everywhere in the surrounding air and soil. It mainly affects sinuses or the lungs by inhaling the spores from the air. Black fungus on the skin also occurs after a cut, burn, or specific skin injury. HOW DANGEROUS IS A FUNGAL INFECTION? In a healthy person, the immune system can easily prevent fungal infection. There is a wide range of moulds coloration like white, black, orange. If a person has a weakened immunity, even these harmless fungi can lead to lethal results. Fungal infections can lead to death if not taken seriously. They can spread at a very rapid rate after the infection. They can affect the crucial organs of our body like the lungs, brain, eye, oral cavity & GIT tract. BLACK FUNGUS SYMPTOMS AND SIGNS Black fungus infection can elicit different signs and symptoms depending on the site and the organ affected. Some common symptoms are present in the early stage, but they can be fatal if the symptoms remain unchecked and ignored. Here are the early symptoms and signs for Black fungus infection: * Excessive running nose * Swelling on one side of your face * Swelling and pain in your eyes * Dark spots around the nose is a warning sign * Toothache * Eyelid loss and blurred vision * Fever * Headache * Coughing * Shortness of breath * Chest pain * Nausea and vomiting * Blood in vomits * Blood in your stool If you are getting any of the above symptoms, then please don't ignore them. Many patients come to the hospital late, missing the early signs. The infection can spread to the eye. In this case, the eye of the patient has to be removed by surgery. In some cases, doctors have to remove even both eyes, even spreading to the brain. MYTHS ABOUT TRANSMISSION Some misconceptions about the transmission of Black fungus infection have spread in social media. People are in a panic. Let's see some of these myths and the facts: 1. Person to person infection There are certain myths that mucormycosis can spread from person to person contact. The Black fungus cannot transmit from the infected person to a person who possesses strong immunity. It only affects the immunocompromised people. So there is no need to isolate the person because of mucormycosis. The black fungus spores are always present in the air and soil. The spore grows where it gets a suitable environment (warm and moist) like your nasal cavities. But your strong immune system keeps it away, although by way of air it will only affect the person with a weakened immune system only. 2. Face masks can transmit the infection. There are also myths spreading about masks that you should avoid their use. There is no evidence that mucor moulds harbor in them. The use of masks is important but disinfecting them is crucial. Don't use the same mask for weeks. 3. Fungi infect through water, humidifiers, and oxygen cylinders Myths of fungi spreading through water and oxygen cylinders are no less. Though sterilization and regular cleaning of humidifiers are necessary, mucor moulds don't grow in fluids like water. They cannot grow in pure oxygen. 4. Onions can transmit the infection. Some believe that black fungus can grow on onions and can be a source of infection. There is no evidence as such. Please don't blame the onions. The black mould on the onions is Aspergillus niger. POSSIBLE ROUTE OF TRANSMISSION There are many research papers available for the source of infection of Mucormycosis. * Hospital linens from poorly managed laundries can be a source of the infection. * Inhalation of spores in the dust, as in construction workers and contracted air, is a possible transmission route. * Mucor mould can grow on soil, compost, animal excreta, bread, decaying fruits, vegetables, and crop debris. WHY PEOPLE SUFFERING FROM COVID-19 DEVELOP THIS INFECTION? In the present scenario, after the second wave of COVID-19, Black fungus infection affects many recovered COVID patients or patients still suffering from COVID. COVID infection weakens your immune system. Further, doctors give steroids in the treatment of COVID. Steroids are specific chemicals like hormones, dexamethasone which is essential in the treatment of COVID. But, prolonged use of these steroids can weaken the immune system to the extent where even fungal infections can be fatal. Steroids use in severe COVID can save the life of a patient. But misuse of these steroids can be very dangerous. WHO ELSE CAN DEVELOP IT? There are other causes for the infection apart from COVID. Diseases like HIV/ AIDS, uncontrolled diabetes mellitus, and cancer weaken the immune system. Hence, your body becomes susceptible to fungal infection. Black fungus infection can infect patients with prolonged steroid therapy. Voriconazole therapy also does the same. After transplantation, doctors give immunosuppressant to the patients to avoid graft rejection. Hence, the suffering patients can also get Black fungus infection. For a very long time, the person who has stayed in ICU is also prone to Black fungus infection. HOW TO PREVENT YOURSELF? * Use masks everywhere, especially when visiting a dusty site. * It would be best if you disinfect your masks regularly * Avoid using the same mask for weeks. * Regularly cleaning of humidifiers and sterilization is essential. * If you have recently recovered from a COVID infection, wear masks everywhere. * Cover your whole body while working with soil, moss, or manure. * Maintain personal hygiene. * Take a thorough scrub bath. * Brushing and gargling are essential. Don't miss these. * If you are on steroids, keep monitoring your blood sugar level. * Take steroids with caution: correct timing, doses, and duration. * Keep your Diabetes in control. * Use antibiotics judiciously. Don't self-prescribe. * Do not avoid the signs and symptoms. BLACK FUNGUS TREATMENT Black fungus treatment should be swift and effective. There should be no delay as it can be fatal if overlooked for even a concise duration. In most severe cases, surgical removal of the infected area is the only way for treatment. Let's see treatment options:- 1. Doctors give an intravenous antifungal injection of Amphotericin B [https://mrmed.in/medicines/ambilon-50mg-injection/]. This injection is one of the best choices of doctors. It has saved the lives of many diabetic patients who have recovered from COVID. Its doses depend on the physical weakness of the patients. 2. Reduce the use of steroids to their most minor requirement. 3. Discontinue all the immunomodulation drugs. 4. Doctors give antifungal therapy for at least 4-6 weeks. 5. Surgeons remove all the necrotic cells that are infected to prevent the spread of infection. Multi-specialist doctors work together to treat a patient. * Microbiologist * Biochemist * Internal medicine specialist * Dentist * ENT specialist * Surgeon * Intensivist * Ophthalmologist * Neurologist It would be best if you do not ignore the warning signs of black fungus infection. Early diagnosis and treatment are crucial to prevent getting affected by this severe infection. See a doctor if you are having any of the symptoms.

Dr. Malvika