Background illness worsens after contracting Covid-19 – VnExpress

Patients with cirrhosis of the liver, pulmonary hypertension, diabetes, stable treatment but after contracting Covid-19 leads to complications of respiratory failure, heart failure, kidney failure.

Mr. Nguyen Duc Ngoc (54 years old, Ba Dinh, Hanoi), suffering from pulmonary hypertension, type 2 diabetes, hepatitis C, cirrhosis at the same time, must take medication according to the doctor’s regimen. From October 2021, Mr. Ngoc gradually dropped the schedule of regular check-ups because of the stressful situation of the Covid-19 epidemic. He bought his own medicine for infusion, breathed oxygen on his own, injected insulin under the skin twice a day.

In early April, Mr. Ngoc contracted Covid-19 with symptoms of dry cough, runny nose, and mild fever. About 3 weeks after being infected, he had difficulty breathing, high fever, enlarged legs, urinating less in both frequency and volume of urine. When his health deteriorated, his family took him to Tam Anh General Hospital in Hanoi for treatment.

According to master, doctor Dang Thanh Do – Department of Respiratory Internal Medicine, at the time of admission, the patient’s SpO2 index was only 85%, showing signs of pneumonia. After a clinical examination, the doctor concluded that Mr. Ngoc had respiratory failure, severe pneumonia, pulmonary hypertension with heart failure, kidney failure on the background of cirrhosis ascites and diabetes.

“Complications appearing at the same time may be because the patient has interrupted the monitoring and treatment of the underlying diseases for a long time (6 months), while diabetes, cirrhosis or pulmonary hypertension are all the same. Because of the lack of follow-up, the treatment regimen used by the patient is not suitable for the progression of the disease, “doctor Do said.

Lung injury image of patient Ngoc. Photo source: Tam Anh General Hospital

The patient was treated for respiratory failure with oxygen to maintain vital functions. In parallel with the treatment of pneumonia, heart failure with antibiotics, oral and intravenous diuretics, infusion to treat underlying cirrhosis, blood sugar monitoring, insulin injections to control diabetes.

After 12 days of intensive treatment, the patient’s cough, shortness of breath, swelling of the limbs, SpO2 96-97%, respiratory failure, pneumonia improved well, so he was discharged. The doctor specifically advised Mr. Ngoc to take the medicine exactly as prescribed, and to have regular check-ups once a month to control chronic diseases well.

According to Dr. Dang Thanh Do, in the context of the Covid-19 situation reducing heat, Tam Anh General Hospital received many cases of underlying diseases such as bronchial asthma, chronic obstructive pulmonary disease, diabetes, increased blood pressure, pulmonary hypertension… serious complications. This is partly due to the effects of the post-Covid-19 sequelae. Most of the worsening of the underlying disease is due to the patient dropping out of follow-up visits for a long time, buying drugs on their own according to old prescriptions, using them for many months, or even arbitrarily adding or reducing drugs according to their emotions.

“Patient Ngoc’s case is an example. The patient injected himself with insulin twice a day with the old dose prescribed by the doctor, the initial dose may be correct, but after many months, the disease process changes. , it is necessary to adjust the dose of the injection to match the blood sugar level.Injecting too much insulin can lead to a very dangerous hypoglycemic event,” warned Dr. Do.

Master, Doctor Dang Thanh Do advises a patient with post-Covid-19 sequelae.  Photo source: Tam Anh General Hospital

Master, Doctor Dang Thanh Do advises a patient with post-Covid-19 sequelae. Photo source: Tam Anh General Hospital

In addition, another cause leading to poor control of the underlying disease is that patients often tend to worry too much about the disease, leading to arbitrarily stopping drugs and using functional foods of unknown origin. or change the diet to focus on increasing resistance against Covid-19. While chronic diseases such as cardiovascular disease and diabetes need a suitable diet, regular medication, and periodic check-ups. This explains why some cases of Covid-19 can trigger acute exacerbations of chronic diseases.

Doctor Dang Thanh Do recommended that, although currently the number of Covid-19 cases in our country is controlled with a small infection rate, it is still not certain that the pandemic will end completely because there is still a risk of occurrence. new variants of the Sars-CoV-2 virus. Therefore, those at risk such as people with chronic diseases should strictly follow the schedule of regular check-ups and do not arbitrarily take drugs without a doctor’s prescription. Patients have a regular diet and lifestyle to control the underlying diseases, prepare for good health to cope with possible outbreaks of disease.

Hoai Pham


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