Coronavirus Complications Puncturing Patients’ Lungs
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A patient 43, had spent 34 days under hospitalization due to Covid-19. Due to low oxygen saturation, he had to be taken first on BiPAP and then ventilator. On May 12, he breathed his last at a private hospital. The doctors treating him said that he had a severe bout of coughing which proved to be fatal – his damaged lungs got ‘punctured’ due to the stress.

Dr Rajesh Chandra Mishra, critical care specialist and president-elect of Indian Society of Critical Care Medicine (ISCCM), said that the condition is identified as spontaneous pneumothorax in medical parlance. “In general terminology, it can be understood as a leak of air from lungs to the chest cavity or thorax. If it happens between the lungs near the heart, it’s called pneumomediastinum,” he said.

Key reasons for this complication which is now being reported in ICUs across the city is prolonged period on BiPAP which delivers high pressure oxygen to the lungs and use of steroids. "When patients are given oxygen with peak inspiratory pressure (PIP), the positive pressure weakens the lungs," says he added. International journals have indicated higher instances of spontaneous pneumothorax in Covid or Covid-recovered patients as majority patients with hypoxia where patients are given both oxygen with pressure and steroids.

Dr Anil Jain, director of EPIC Hospital, said that the number of patients after Covid recovery with such complications has increased manifold during this wave. "It has near-fatal complications in the majority of the cases," he said. The lungs not only get stiffer but also brittle in such a way that a hard sneeze or prolonged coughing can rupture the lungs.”

It’s also seen in some of the active Covid-19 patients, said Dr Amit Patel, a pulmonologist. “The phenomenon is getting very common among both active and former Covid patients due to the nature of the viral infection. It’s mostly seen in patients on BiPAP for a long time. If the patients’ condition allows, we advise and practice prone positioning in the early phase of infection to improve lung capacity,” he said.

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