A number of patients who had undergone treatment for COVID-19 are being diagnosed with vascular complications at the post-COVID clinic of the Rajiv Gandhi Government Hospital (RGGGH). Though this was a cause for concern, doctors said that proper follow-up, early detection of symptoms and timely medical help would prevent complications.
Vascular complications in patients during the post-COVID period were not new. According to doctors, there were patients who developed vascular complications in the first wave too. But now, the cases were slightly more in a shorter duration, and severity was high with more involvement of the arteries.
Multiple symptoms
E. Theranirajan, Dean of RGGGH, said around 2,500 people had been attended to by the post-COVID clinic till now. “We are receiving many patients with vascular complications. If we miss the symptoms early, it will lead to complications. We have seen patients with limb ischemia, mesenteric artery occlusion presenting as acute abdominal pain and pulmonary embolism,” he added.
In the post-COVID clinic, the hospital has received 182 patients with vascular complications. “We have seen vascular complications in both waves. While there were 90 patients in the first wave during the one-year period, we have seen 92 patients in the last few months of the second wave. The severity is more. In the first wave, we had more patients with clots in their veins compared to the second wave — a condition called deep vein thrombosis. Now, we are seeing more involvement of the arteries,” N. Sritharan, professor and director of the Institute of Vascular Surgery, RGGGH, said.
He added that in the post-COVID period, any swelling in the legs and severe pain should not be ignored. The pain would be unbearable, and as a result, persons would not be able to sleep. This means that they need to get immediate medical help, he said.
Lack of awareness
“There is no awareness among patients and some of them ignore the early symptoms. Some come to the hospital in advanced stages, in which there is discolouration of skin or gangrene. The first six hours of symptoms are crucial as we need to restore blood circulation,” he explained.
Dr. Sritharan added that they were able to save the legs of many patients as they were better prepared to tackle emergencies. “We now have a better understanding of the disease process, and the treatment protocols have evolved. We have set up a separate ward for patients with vascular complications. Postgraduates of the department monitor patients round-the-clock. This has helped in better treatment outcomes,” he said.
Dr. Theranirajan said a few patients, who had undergone renal transplant, had developed nephropathy as a result of vascular complications. “Apart from vascular complications, we are seeing patients with neurological complications and myocardial infarction in the post-COVID period. Myocardial infarction seems to be predominant in a number of them,” he said.
This was why doctors stressed on the need for patients to come for a review after 28 days, he said, adding: “At the post-COVID clinic, they can consult with doctors of various specialities and get tested as per their symptoms. We check for rhythm disturbances, lipid profile and fibrosis in the lungs. In case of symptoms of vascular complications, a Doppler Study is done. It is important to exclude symptoms and undergo a complete medical check-up,” he said.
