(Trinidad Guardian) – More people without comorbidities are dying of COVID complications and patients are becoming younger.
Critical care physician Dr Hariharan Seetharaman disclosed this, during an interview last night on CNC3’s extended newscast.
“I work with the ICU, we have plenty of patients who are coming in who do not have any other attributable factors like age—the first variant, the elderly were much more affected. The people who had comorbidities were much more affected but now because it’s spreading all over the place we are getting younger patients, patients without comorbidities getting into the critical care units and getting the severe form of the virus,” Seetharaman revealed.
He noted such patients were between the ages of 35 to 55 years old, an age demographic that was rarely seen during the country’s first wave. And where there was the sporadic event of one or two becoming infected, they did not require critical care service or succumbed to the disease.
“Last night (Thursday)…I must report, that last night we lost a 55-year-old and I cannot think of any comorbidities in her. It was really sad for me but we couldn’t do much,” Seetharaman lamented.
He said the current variant throughout the world has changed its transmission from older people to younger people.
Referring to the deadly B.1.617 variant also known as the Indian variant, which has been the cause of a steady increase in daily cases and deaths in India, Seetharaman said it was also affecting young children.
He said the P.1 or Brazilian variant, which T&T suspected was the current variant the nation was battling, needed to be confirmed through genomic studies to ascertain exactly what type of variant the country had.
“Biologically, every single disease, when it stays in the population for an extended period of time, the virus will always mutate and we would have variants.”
Stating that the variants were not unusual and there was no current evidence that the virulence of this particular mutant variety of the virus had increased to cause a much more severe form of the disease, Seetharaman however, admitted the transmissibility of the current variant had increased and that was the reason for more people becoming infected.
Seetharaman said as it stands, 2.5 people of all infected individuals would end up in a critical care unit as when the number of infected people increases, the number of people requiring critical care would also increase.
Responding to Guardian Media’s question about the challenges in treating COVID-19 patients particularly those requiring ICU admittance, Seetharaman said the increase in numbers was at the top of the list.
“The numbers are really, really going up. When we can admit a patient to an ICU a bed is not only a bed. A patient can lie on a bed but we need to provide care. We do have oxygen, there is no shortage of oxygen, we do have medications to treat them, unfortunately, we do not have the human resources at present,” Seetharaman admitted.
During his interview, he also dismissed rumours of a fixed criterion for ICU admittance, which included age, and level of comorbidities. He said while there was an overwhelming number of patients, what was taking into consideration, was the patient deemed moribund and the patient who could actively benefit from ICU care.
He admitted the decision-making process was a difficult one. But as critical care physicians, medical futility was the measuring stick—which was assessing which patient was moribundly ill and would not benefit from ICU care and those were the only type of patients that were not currently admitted to ICU, but they still received high dependency care.
Regarding persons who were asthmatic being worried of being at greater risk of contracting COVID-19, Seetharaman said there was no medical evidence to support such, however, patients with chronic obstructive pulmonary disease (COPD), or chronic bronchitis, were more susceptible, because of their already damaged lungs. He said such persons needed to be careful as once the virus is contracted there is the possibility of them developing severe pneumonia, however, Seetharaman said, it was no a death sentence.
“We can still treat them if we catch them at the right point of time,” he assured.
Seetharaman also addressed concerns of lingering lung problems in patients who have recovered from the virus. He said in those instances the patient is referred to as COVID long-haulers, which meant patients who were still experiencing symptoms and problems up to 12 weeks after recovery.
He noted the most important organ systems, which were affected in long-haul COVID-19 patients, were the neurological system and the respiratory system.
“Neurologically, they can have a post-ICU syndrome, they can have what we call brain fog, which is a confused state, neuropathy memory loss, post-traumatic stress disorder, and continuous dizziness and delirium,” Seetharaman explained.
Respiratory-wise, he said patients could develop fibrosis of the lungs where the lungs are shrunken causing vital capacity to decline.
“I even read a report where they had to do a lung transplant in a patient who had severe fibrosis due to COVID.
But Seetharaman said such complications depended on the severity of the infection and how intensely it affected the patient.
Other long-term symptoms he listed, include muscle pain, nausea, vomiting, diarrhoea, gastro-related complications, ear, nose, and throat problems, and persistent skin rashes.
He advised anyone experiencing long-term symptoms after recovery, 12 weeks and beyond, should visit their healthcare provider immediately to determine if the problem was in fact as a result of having had the virus or if it could be the development of a new medical problem.
