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New Delhi:
Not simply the lungs, COVID-19 can have an effect on virtually all organs and the preliminary signs could also be completely unrelated to chest complaints, specialists at AIIMS mentioned on Wednesday.
They burdened that classification of instances into delicate, average and extreme classes based mostly simply on respiratory signs must be relooked to incorporate different organ involvement.
Experts from the institute, together with its director Dr Randeep Guleria, Dr MV Padma Srivastava, head of division of Neurology, Dr Ambuj Roy, Professor of Cardiology and Dr Neeraj Nischal, Associate Professor within the division of Medicine throughout their their weekly ”National Clinical Grand Rounds” organised in collaboration with NITI Aayog mentioned varied doable extra-pulmonary issues of COVID-19.
Dr Guleria mentioned eight months into COVID-19, loads has been learnt and accordingly methods are being modified occasionally.
From what we considered a viral pneumonia has loads of different manifestations that are past the lungs, he mentioned.
“As we have known more and more about COVID-19, we have realised it causes many extra pulmonary manifestations. This is basically of the fact that this virus enters into cell through ACE2 receptors which although are present abundantly in upper airways and lungs, they are also present in many organs and thus other organs are also affected.
“We have seen many sufferers who introduced with options which aren’t been predominantly pulmonary however additional pulmonary manifestations,” Dr Guleria said.
He said though pulmonary manifestations continue to dominate as far as majority of COVID-19 cases are concerned, there is a significant number of patients who would present with manifestations which may be along with pulmonary manifestations or may be without pulmonary manifestations.
“We as clinicians have to have a excessive index of suspicion throughout this pandemic — when to suspect, deal with and isolate these sufferers in order that we will present them good high quality care,” he stressed.
The experts in the programme presented a number of cases in which the patients were labelled as asymptomatic or mild COVID but had serious life-threatening extra-pulmonary manifestations like stroke and heart blocks.
“What began off as a viral pneumonia is now a multi-systemic illness. However, the jury is out whether or not SARS-COV2 is the wrongdoer in these additional pulmonary manifestations or simply an harmless bystander which occurs to be on the fallacious place at a fallacious time,” Dr Nischal said.
“So the classification of COVID-19 into delicate, average and extreme instances based mostly solely on respiratory signs must be relooked into to include different organ involvement,” he said.
Dr Nischal further underlined that management of such patients with other organ involvement should be as per existing guidelines of that particular complication.
The doctor from the Medicine Department also highlighted the case of a 35-year old man who had headache and was vomiting but was found to have life threatening cortical vein thrombosis.
When tested, he was found positive for COVID-19. He was asymptomatic for COVID-19 as per existing severity guidelines, Dr Nischal said.
“There is an enormous spectrum of neurological manifestations which have been linked to COVID-19. In some sufferers, mind is concerned and it could result in clotting, leading to stroke or may cause an infection and result in encephalitis or different issues which don’t have anything to do with lungs,” Dr Padma said.
Dr Ambuj’s team presented the case of a patient who came with a very low pulse rate, detected COVID-19 positive and required initial support with some medicines to improve heart rate.
“Normally pacemaker is put in such sufferers to enhance their coronary heart fee however based mostly on experiences documented in literature, we realised a few of these could possibly be because of COVID-19, so a pacemaker was not put and her coronary heart fee steadily improved with supportive remedy.
“Sometimes, the electrical pulse system of the heart which gives rise to heart beat can be affected in COVID-19 and it is self-limiting and improves with time. “So these sufferers who would in any other case usually require pacemaker could not evern want it. “However, more evidence is needed to be definitive about this as it is a new disease and limited information and experience regarding it is available as of now,” Dr Roy mentioned.
(Except for the headline, this story has not been edited by NDTV employees and is revealed from a syndicated feed.)
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