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Sanjeev Kumar Patro

News Highlights

  • Covid-19 positive patients also go through a nasty second wave during the infection period

  • Days five through 10 of Covid-19 have proven to be particularly worrisome for patients with underlying medical conditions such as obesity, diabetes, or high blood pressure

  • In a healthy and younger adults, serious symptoms develop around 10th -12th day from the day of manifestation of symptoms

Bhubaneswar: It's not that countries world over have witnessed the second wave of coronavirus, which has been very severe. Even, the Covid-19 positive patients also go through a nasty second wave during the infection period, and doctors say it is the time when the 'second-week crash' happens leading to mounting up of the toll graph in a State or country. Odisha today recorded 42 deaths.

"People with mild Covid-19 symptoms recover in about one week. But if the recovery didn't come through in the first week, and a patient slips down to second week, at that point the severe second wave in a patient starts. In the second wave of the disease, severe respiratory symptoms, including shortness of breath and pneumonia have been clinically observed. Also, oxygen saturation level falls to dangerous level in the second week only," explained Dr Biswanath Padhi, senior medicine specialist, DHH, Khordha.

WHY DAY COUNT IMPORTANT IN COVID19?

As per Dr Padhi, days five through 10 of Covid-19 have proven to be particularly worrisome for patients with underlying medical conditions such as obesity, diabetes, or high blood pressure. But in a healthy and younger adults, serious symptoms develop around 10th -12th day from the day of manifestation of symptoms, he added.

It is around days 7-10, when deterioration in the conditions of most patients have been observed," he informed.

THE DOC'S PRESCRIPTION

"Don't treat Covid-19 as any other illness. Rather, a patient has to observe his/her well being in the first week itself. A patient need to monitor keenly, whether there has been a regular fall in the wellbeing feeling between day 1 to day 5. If patient goes for hospitalisation after experiencing shortness in breath, then it will be too late," cautioned Dr Padhi.

WHY CRASH HAPPENS IN WEEK NUMBER 2?

As per research studies published in Lancet, patients develop acute conditions in the second week probably due to fight back by the body's immune system. The over stimulation of the immune system is considered as the reason behind crash of the patient by the 10th day of the disease, it noted. Besides, studies also show many patients collapse due to heart attacks and strokes.

WHY HEART ATTACK OR STROKES OCCUR IN YOUNGER POSITIVES?

"The Covid-19 infection creates a whole lot of complications in the body. Due to this infection, patients witness an elevated level of D-Dimer protein in blood plasma that causes clotting of blood in arteries and tissues. Blood clotting may trigger heart or brain stroke or clotting in lungs. Clotting in lungs will result in severe complications like shortness of breath," Dr Padhi explained.

Unless a patient goes for D-Dimer test in lab, it is difficult to identify the elevated level of d-dimer in blood as no outward symptoms will be noticed, he emphasised.

HOW D - DIMER's RISE IN COVID INFECTION?

As per a study by National Center for Biotechnology Information (NCBI), the rise in the level of D-dimer is linked with the life-cycle of the SARS n-CoV.

" The apoptotic processes target the endothelial cells (inner lining of body organs) of the vascular structure resulting in triggered coagulopathy and the ultimate result of increased D-dimer," says NCBI and further explained that Apoptosis is a programmed cell death and has a critical role in the life cycle of viruses.

Note: Viruses need a host cell to survive. After replicating, they kill the host cell.

HOW TO AVOID SECOND WAVE IN INFECTION?

If one has a very mild symptoms (fever below 101 deg F), and after taking antipyretics, no progression in symptoms have been observed and the oxygen saturation level remaining above 95, then the recovery may soon start in the patient.

In case, a patient has very high fever (over 102 deg F) and oxygen level remains above 94, then the patient is advised to go for a series of blood tests like - Total Blood Count, Erythrocyte Sedimentation Rate (ESR), C-reactive protein in  blood, D-dimer and ferritin. These host of blood tests will identify the underlying conditions that can later progress to complications like heart or brain stroke or clotting in lungs in the second week," said Dr Padhi.

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