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Senior citizens testing positive for COVID-19 are seeing new symptoms, warn doctors

For almost 10 days before Mahadeo Deole the former mayor of Mumbai was admitted to the Kokilaben Hospital, he had been feeling lethargic, was sleeping excessively and felt in a dazed state while awake. By July 8, he had slight fever, cough and was a wee bit short of breath. Three days later he got admitted to the hospital where he tested postive for COVID-19.

I did not know what was happening to me. There was no reason for me to fall asleep just like that. I couldnt stay awake. I didnt know it was COVID because for over a week I didnt have any fever or cold. Deole tells Mirror.

Tests revealed that he had pneumonia and had also suffered multiple strokes. When he tested positive for COVID, we realised the virus had caused neurological complications. Even after he came out of the coma he had no recollection where he was and why he had come to the hospital, says Dr Annu Aggarwal, neurologist with Kokilaben Hospital. We have to be very careful with the elderly patients. They may not always develop fever.

At the Kokilaben Hospital, for example, in these five months around 350 COVID patients have been attended to who had developed neurological problems, a majority of them being cases of encephalopathy and multiple strokes.

When the pandemic started, it felt the virus affected only the lungs. But now we know it can affect any organ and that makes the virus a very unpredictable and complicated one, she says.

The United States Centers for Disease Control and Prevention (CDC) has identified the following as symptoms of COVID-19 fever or chills, cough, shortness of breath or difficulty breathing, fatigue. As well as muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting and diarrhea.

Among the physical conditions that the CDC has shortlisted that require emergency medical attention includes trouble breathing, persistent pain or pressure in the chest, confusion, inability to wake up or stay awake and bluish lips, face, fingers and nails.

The 80-year old Deoles fatigue, sleepiness and confused state of mind all indicated that his physical capabilities were under attack from the virus, but none of these were immediately identified.

Our advise to patients of all the age groups, especially the elderly, is to keep a check on whether there has been any sudden change in their routine for which no reason can be identified. Like falling asleep at odd hours despite a good sleep in the night or being tired throughout the day, says Aggarwal. Anything happening to the body that is unusual should ring alarm bells. We have even treated young people who came with multiple clots.

Now we know the virus can affect any organ and that makes it very unpredictable and complicated

Dr Annu Aggarwal, neurologist Kokilaben Hospital

Staying indoors and wearing the mask properly outdoors are the only two ways that can be suggested till a vaccine is out, says Aggarwal. Most people are careless about the way they are using the mask. Whenever outside they should keep their mouth and nose covered and not leave the mask hanging on the chin. Precaution must be taken not to touch the mask even after stepping indoor. Before removing the mask, one should first wash their hands with soap and water.

The blame for the virus spreading fast through the nasal and throat passage goes to the respiratory and also the digestive tracts, which contains a receptor ACE2 that makes it easier for the virus to attack the cells.

Doctors believe the virus interferes with the coagulation system and makes the blood clot that leads to stroke. What we dont know yet is whether the virus is travelling to the brain after finding a way in through the nasal cavity, says Aggarwal.

Another problem area that the doctors treating Covid-19 patients in Mumbai have identified is the interference of the virus in the hormonal balance. Patients with no history of blood sugar have come for treatment with either a drastic fall or sharp rise in the sugar levels, the cause of which is still unknown.

With businesses and shopping establishments on reopening mode, the doctors feel the elderlies should assess the risks before stepping out of their homes and avoid activities where it isnt possible to keep people at a distance.

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It plays with the mind - Bangalore Mirror