Surgery an option for patients with post-Covid lung ailment, say experts

Even those who underwent treatment at homes due to mild symptoms can develop lung complications.
Surgery an option for patients with post-Covid lung ailment, say experts

KOCHI: Much like a tsunami battering the best coastal defences, a Covid infection can wreak havoc on the human body. Persistent breathlessness, cough, chest pain, fever, and recurrent infections, including pneumonia, even after the infection is overcome, can leave one’s respiratory system crippled.

While a majority of such cases can be cured through medications, there are certain patients who would benefit greatly from surgical intervention, say experts.

So far, more than 36 lakh people have been infected with Covid in Kerala, and more than 18,000 deaths recorded officially.

According to experts, many lung complications can be triggered during the post-Covid phase, including lung fibrosis, bronchiectasis, empyema, bullae, pulmonary infarction, and cavities.

“For up to weeks and sometimes even months after testing negative, people are left with persistent symptoms. Those patients with post-Covid lung complications, seen as specifically localised infections in CT scans, can undergo early surgery and recover. Currently, there is no data available on patients who require surgery. Scientists, researchers, and the medical world is still learning about the novel coronavirus and its treatment. Not many are aware of the possibility of surgery. However, some cases that we have attended to and found fit for surgery, underwent surgeries successfully,” said Dr Nasser Yusuf, cardiothoracic surgeon in Kochi . 

In one such case, a 52-year-old native of Beypore in Kozhikode with empyema (a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall) recovered after surgery. 

According to doctors, months of reliance on antibiotics, discomfort, and risk of further deterioration due to the underlying issues, as well as money spent on medications, can be saved through surgery.

“Medical intervention, identifying the infection and complications at the right time, and knowing what to do about them are the key factors in saving a patient. Even a common man should be able to understand his options, rather than giving up at an early stage,” said Dr Nasser.

It is not only patients admitted for Covid treatment at hospitals who are at risk. Even those who underwent treatment at homes due to mild symptoms can develop lung complications.

“The symptoms will be the same for all lung complications. Lung fibrosis leading to breathlessness is one of the common symptoms. Subsequent to the viral infection, bacterial infections pose a large threat. Earlier, when respiratory complications such as cavities, bullae, and empyema were observed, surgeries were performed. Why not do the same when such cases are triggered by Covid?” asked Dr Nasser. 

“For the surgery, preferably, the patient must have tested negative at least two weeks prior. The patient should be fairly stable. Also, the surgery can be conducted only after consulting a surgeon. Video-assisted thoracoscopic surgey an be perfomed, with minimal pain, leading to quick recovery,” he added.

When do you need surgery

When medication fails to help, surgery can be a means for lasting relief. A rundown of some symptoms to look out for...

Symptoms

Persisting symptoms like cough, breathlessness, coughing out blood, fever, chest pain, and recurrent pneumonia may indicate that the lungs are damaged despite medications. These leave one’s respiratory system crippled. 

Localised pneumonia/infection

If pneumonia sets in, one or more specific parts of the lungs become irreversibly damaged. Removal of the diseased segment through surgery can bring relief. Once the affected part is taken out, then there is space for the rest of the lung to expand. However, if the infection spreads to the whole lung, surgery is not an option. If both the lungs are affected gravely, lung transplant is the only option. 

Empyema

Empyema is a condition in which pus gets formed and collected in the space between the lung and the inner chest wall. Although the pus can be cleared with medication & aspiration, sometimes when the pus remains beyond two weeks it hardens and medication will not help. This causes compression of the lungs. Once this is removed, the lungs start to function healthily. 

Cavity 

Lung cavities can cause bleeding and when the cavities are large, the rest of the lungs get compressed. Sometimes, fungus starts to grow in these cavities. Surgery is an option here as this can otherwise lead to fatal bleeding.

Bullae

Due to Covid, sometimes the surface membrane of the lung becomes weak and balloon-like structures are formed. In certain situations, these bullae rupture  & lead to a life-threatening condition that causes collapse of the lungs and pressure on the heart. 

Bronchiectasis

In some, after recovery from infection, a portion of the lung is permanently destroyed by bronchiectasis (multiple small cavities that appear like a honeycomb). If it is confined to one area, this can be treated successfully only by surgery.

Pulmonary Infarction

Due to the formation of blood clots in the lungs, there will be no blood supply to a particular portion and as a result, the lung function is lost and permanently damaged. These clots can be removed through surgery.

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