By Health In Five Writer
The coronavirus pandemic is showing no signs of slowing down in India and now the added threat of dengue fever is also emerging.
Last week, Delhi’s deputy Chief Minister Manish Sisodia, who is already getting treatment for Covid-19 at LNJP Hospital, also tested positive for dengue fever. The 48-year-old Aam Aadmi Party (AAP) minister need to be shifted to ICU of Max Hospital in Saket in New Delhi.
Medical director of Rajiv Gandhi Super Speciality Hospital (RGSSH) B L Sherwal said both the diseases have no specific treatment, which makes it even difficult for treating doctors of such patients.
“Both Covid-19 and dengue need symptomatic treatment and in some aspects the treatment is kind of contradictory and thus tricky. In Covid-19, we inject heparin drug subcutaneously which ultimately reaches the blood stream, and this is done to prevent embolism in these patients which can prove fatal,” Sherwal was quoted as saying by news agency PTI .
Embolism is sudden blocking of an artery which can obstruct flow of oxygen, and that is why some patients get complications even after treatment, the doctor said. RGSSH is a dedicated Covid-19 facility run by the Delhi government.
“In dengue, on the other hand, platelets infusion is needed in cases where its count has fallen to dangerously low level. So, it’s kind of opposite. And, therefore, we can’t inject heparin if a Covid-19 patient has dengue too,” Sherwal added.
So, for a treating doctor it is like “walking a tight rope” and a very “finely balanced approach” is needed, he said.
Vikas Maurya, Director and Head of Department for Pulmonology, Fortis Hospital Shalimar Bagh, also feels a balanced approach is needed in tackling the “double infection” of Covid-19 and dengue.
“One will have to also see which disease takes preponderance in such a patient, and the course of treatment will depend accordingly. Both are spread by virus, so it is quite an unusual scenario for a doctor as well as the patient,” Maurya told the news agency.
Maurya also referred to a “study done by a university in Brazil along with an American varsity”. “Though the study is yet to be peer-reviewed, one of its findings was that in patients who had suffered dengue infection earlier had developed anti-bodies, and in some patients, a false positive result was coming for Covid-19, even with RT-PCR test. But it is too early to say anything,” he added.
Rajesh Rautela, Medical Superintendent of GTB Hospital, said a doctor “will have to be like a juggler, balancing two things at the same time”. “So, best way is to take precautions and preventive measures to avoid stagnation of water where mosquitoes can breed. No medicinal cure is there for either of the two ailments, just symptomatic treatment, so people should be alert,” he said.
LNJP Hospital is the largest hospital under the Delhi government and a dedicated Covid-19 facility. “The patient’s age, condition, comorbidities and other factors are taken into account for treatment of both the ailments,” a source said.
Asked if there are any side effects of treatments in cases of a “double infection”, the source said, “Any treatment can have a side effect, but the treating doctor decides the methodology for it”. A dengue patient, if his or her platelets level falls dangerously below the normal level, needs external platelets infusion. A normal platelets level is considered in the range of 1.5-4.5 lakh, according to doctors.
