How Covid triggered rise in lung illnesses 

Medical experts have reported an increase in the number of patients presenting with lung complications that cannot be explained, about four years after the Covid-19 outbreak.

Dr Ivan Kimuli, the head of clinical services at Makerere University Lung Institute, said such patients, after thorough examination, are often found to have suffered from Covid-19.

“The effects of Covid-19 continue to be with us, both in the health sector and other sectors. In terms of health, there is a condition we call post-Covid syndrome or long Covid,” he said. 

“If you have these symptoms that are presumed to have no other cause but because of the exposure being the previous suffering with Covid for more than three months, that is termed as long Covid,” he added.

Among the common symptoms that patients with long Covid present with are chronic cough, chest pain, shortness of breath and chronic fatigue syndrome, according to the institute. These are similar to what has been reported in other parts of the world.

“We are seeing at least a patient a day who comes in with features suggestive of long Covid. Particularly in the lungs, there are patients that have continued to cough and there is no explanation for their cough. There are patients that have chest pain and there is no explanation,” Dr Kimuli revealed.

“We have moved from seeing 600 patients a year to seeing more than 1,000 patients a year in the past five years. This in a way shows that the burden of long complications is increasing over time and therefore the need for intervention should also be reconciled,” he added.

Dr Hellen Aanyu Tukamuhebwa, the acting deputy director of Mulago Hospital, said the exact numbers of people struggling with long Covid in the country are not yet known.

“When the disease came, we didn’t know what would come [later]. Having realised that there is long Covid, we are working on establishing the follow-up clinics and looking for these patients,” she said. 

“When this is done, we shall know the [exact/estimate] numbers we are dealing with because only a few patients are followed up and for those who come to centers like this,” she added.

An April 2022 study report by United Kingdom’s Leicester University researchers indicates that only a third of the 804 Covid-19 survivors that they followed, were totally healed after one year.  

“The proportion of patients reporting full recovery was unchanged between five months (501 of 1965) and one year (232 of 804). Factors associated with being less likely to report full recovery at 1 year were female sex, obesity and invasive mechanical ventilation,” reads the report published on April 23 in the scientific journal The Lancet. 

According to the report, fatigue, aching muscle, poor sleep, breathlessness, joint pain or swelling, slowing down in thinking, general body pain, short-term memory loss, and limb weakness were the commonest symptoms that persisted in 2,320 participants discharged from the UK hospital between March 7, 2020, and April 18, 2021.

Uganda, according to official statistics submitted to the World Health Organisation, has reported 171,829 confirmed cases of Covid-19 with 3,632 deaths. 

Dr Kimuli on the other hand explained that chronic fatigue means the way oxygen is being utilised in their body is being compromised. He said they see “multiple presentations of patients with long Covid.”

“These Covid symptoms are many –they do not only affect the lungs. They can also affect the heart, and nervous system or manifest as psychosocial disturbance because of what happened during Covid –that is still part of long Covid,” Dr Kimuli added.

Interventions

Dr Rony Bahatungire, the acting commissioner for clinical services at the Health ministry, told this newspaper in a brief comment that the Lung Institute and the ministry are in “the process of developing the National Long Covid care plan.”

Dr Kimuli revealed that guidelines would be rolled out around the beginning of next month. “We shall teach health workers how to manage some of these complications. The guidelines are still in draft form,” he said.

“We have seen patients that continue to need support. [Some] Patients need painkillers because of chronic pain, [some] patients need inhalers because of shortness of breath and patients need cough syrups to make their coughing less problematic. These may predispose you to other infections,” he added.  

However, the Institute said the majority of the patients they are seeing are asthma patients and those who come are having difficulties controlling the condition.

“And then we are seeing a number of patients with chronic obstructive pulmonary disease (COPD) and then the other disease that is high is post-TB lung disease. Patients that have suffered tuberculosis before, come in with complications in the lung that are because of the scar tissues. Other conditions [like lung cancer] are managed along with Uganda Cancer Institute,” Dr Kimuli added.