covid-19 infection Affects the respiratory system – mainly the lungs – and while most people make a full recovery, some suffer from prolonged symptoms that can last for several months. It is known as ‘tall covid‘, and it can be very harmful to a person’s overall health.
However, a pioneering multi-centre international study has shed light on surgical intervention in patients who have thoracic complications due to COVID. This has been done in collaboration with Italy, USA, UK, Brazil and India.
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A thoracic complication is defined as any thoracic condition that is a “direct or indirect consequence of COVID-19”, the study said.
speak with indianexpress.comDr Nasir Yusuf, a cardiothoracic surgeon in Kochi – who was involved in the research – explained that as tsunamis come and then disappear – leaving behind a trail of death and destruction – COVID-19 Disables people too. While some die, others manage to survive.
Some others, however, are left with complications. “They are either lying in bed or living on oxygen. Or they have frequent infections, cough, chest pain, fever, coughing up blood.
Yusuf said that the mainstay of treatment covid There is medical treatment, cautioning that the infection damages the lungs where blood clots can form in the later stages of COVID. When medical management fails, and both lungs are affected, surgical intervention may be considered.
Elaborating on the research, the doctor said that he found that both lungs of a patient can be affected by COVID – one lung is working much better than the other – a part of one lung can be affected significantly, causing blood There may be cough, localized pneumonia, pus in the chest, etc.
Dr Yusuf said some “high-risk” patients, however, may not benefit from surgery if they have co-morbidities. (Photo: Getty/Thinkstock)
The doctor shared a list of situations in which a patient may benefit from surgery for lung complications post covid:
1. Cracked lung (bronchopleural fistula)
2. Bulla (a blister-like formation on the surface of the lung that may be larger: 10 to 12 cm, and may cause severe respiratory distress)
3. Non-resolving Pneumonia
4. Pus in the chest cavity (empyema)
5. Bronchiectasis (hives appearance of the lungs), leading to recurrent infections
6. Fungal infection (aspergilloma), which causes hemoptysis
7. black fungus (mucormycosis of the lungs)
8. Pulmonary infarction, where the blood supply to a part of the lung is cut off due to clots, as a result of which that part does not function.
“It was an idea: if we can deal with that one diseased/destroyed area of the lung, why not have surgery and take it out? That was the logic. There was no prior reference to it,” shared Dr. Yusuf.
For the study, a total of 83 patients from the departments of intensive care, pulmonology and internal medicine at various levels of care were enrolled. All of them were still positive for SARS-Cov-2 RT-PCR at the time of surgery.
In 30 days from surgery, 23 patients died, 45 survived and were discharged and the remaining 15 were still recovering in the hospital; 5 patients died after 30 days during hospitalization; None of the discharged patients died at home within 30 days. Of the 23 patients who died within 30 days, 13 (16 per cent) died due to postoperative complications, while 10 (12 per cent) died from causes not clearly related to surgery and rather underlying covid -19 or were associated with a pre-existing disease. Before the intervention, the study said.
Since the paper was published, the effectiveness of surgical methods has increased, the doctor said, adding that more patients are now coming in.
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Dr Yusuf said some “high-risk” patients, however, may not benefit from surgery if they have: comorbidities, Patients who may not do well on extracorporeal membrane oxygenation (ECMO) – an artificial lung. Older people over the age of 70 may not show desired results after surgery, as well as those who have kidney failure and those who are on-going dialysis,
“Other comorbidities are fine, eg diabetes, hypertension, mild heart disease; they can be managed,” he concluded.
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