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Q. My mom got recovered from COVID-19 infection. Will she require O2 support for lifetime?

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 03, 2020 and last reviewed on: Dec 10, 2020

Hi doctor,

My mom got admitted to the hospital. Initially, she was fine, and her CT score was 7/20, and she started to deteriorate from that. She was on O2 support, and then she had CT severity 16/20 for COVID-19 pneumonia. I have attached the report. And then, she was on BiPAP for a week and slowly recovered and now discharged. She is at home O2 with 3 to 4L at home. All treatments are given except plasma-like Remdesivir, Lasix, and antibiotic. Now the doctor says she may need O2 for a lifetime, the possibility of pulmonary fibrosis. He asked us to wait for three months. If not improved she have to be on O2 support. Please help.

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Hi,

Welcome to icliniq.com.

I can understand your concern. According to your statement, you have been suffering from COVID-19 pneumonia. She has done HRCT of the chest, and the report has revealed that multifocal patchy ground-glass opacities were noted involving peripheral and posterior segments of bilateral lungs with a superimposed interlobular septal thickening. Scattered areas of sub-pleural interstitial thickening and fibrosis were noted predominantly bilateral upper and lower lobes. Peribronchiolar thickening with patchy consolidation was noted in bilateral lower lobes suggestive of COVID-19 pneumonia.

I have gone through her investigation reports (attachment removed to protect patient identity) and found that her cholesterol, triglycerides, and LDL are high, and her HbA1c (glycated hemoglobin) is 8%, which indicates poor control of her blood sugar levels for the last two to three months. Fenofibrate should be added to her treatment protocol. Strictly controlling of DM should be needed.

I think broad-spectrum antibiotics and antiviral medications should be added to her treatment protocol for subsiding here COVID-19 pneumonia. Monitor her oxygen saturation level by pulse oximeter and then do as needful.

Thank you doctor,

She has 83 to 88 O2 readings in the in-room atmosphere, and with 3L to 4L O2 support, she can maintain 95. (18 days back, she was on 6L to 10L of O2 at home slowly week by week stepped down from NRBM, facemask and then to nasal) when she walks to the restroom, it drastically drops to 65 and getting restored with O2 support. She does not have a cough, her fatigue reduced better, and now she is walking slowly, weight is also improving. But she got frustrated about continuous support and scared about lifetime usage of O2. She was given Rosuvas 5 mg. Shall I give Femi fibrate from tomorrow and how many days after reduced to the only morning session of Dexa 4 mg tablet? Her sugar levels are now under control. Maximum 200 pp. I am now worried about O2 support and developing pulmonary fibrosis.

#

Hello,

Welcome back to icliniq.com.

Fenofibrate is for reducing triglyceride levels. According to the lipid profile, her triglycerides level are very high. I think Fenofibrate should be started instead of Rosuvastatin 5 mg. Again, she should be taken Dexamethasone in injectable form instead of oral tablets.

Again her pulmonary fibrosis and consolidation may result from COVID-19 pneumonia or as a complication of COVID-19 infections. As she can take medications orally, she can take both the antibiotics and antiviral medications as follows.

Tablet Ceftas, Hifen, Secef (Cefixime and azithromycin) 400 mg 1+0+1 for 14days, tablet Flugaurd, Avigan, Vergiflu 200 mg 8+0+8 on day 1, followed by 3+0+3 from day 2 to day 5.

By taking the medications mentioned above, she may be able to subside her pneumonia and reduce her oxygen therapy dependency. Do repeat HRCT of the chest after 14 days later.


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