New Delhi: Two years since the first cases of Covid-19 were detected in India, patients from the first wave are still dealing with the ravages of the virus in their bodies, doctors have told ThePrint.
One post-Covid complaint that has emerged as a particular cause for concern is tinnitus — a buzzing sound in the ear — which, if left untreated, can even cause hearing loss.
Some of the more common long Covid symptoms are persistent fatigue, heart palpitations and gastrointestinal problems.
Doctors say that there has been a five-six fold increase in patients reporting sudden sensory hearing loss and many of them are those who had Covid in the first or second waves.
While it may still be too early to understand the long-term complications associated with the Omicron infection, there does seem to be a correlation between the severity of the disease and the duration of long Covid.
However, tinnitus is being reported even by people who only had mild disease. It does not feature in the guidelines for long Covid management brought out late last year by the Union ministry of health, though there is some medical literature available on this.
The document defines long Covid as: “In the absence of universally accepted definition, Post-Covid Syndrome by consensus is defined as signs and symptoms that develop during or after an infection consistent with Covid-19 which continue for more than 12 weeks and are not explained by alternative diagnosis.”
Recent literature also divides post-Covid patients into subacute or ongoing symptomatic Covid (4-12 weeks beyond acute Covid-19) and chronic Covid or post-Covid syndrome (symptoms persisting beyond 12 weeks of onset of acute Covid-19).
Also read: What is ‘Long Covid’ and why some patients who have recovered continue to feel ill for months
Tinnitus more common after Covid
Dr S. Chatterjee, medicine consultant at Indraprastha Apollo Hospitals, listed myocarditis and lung issues as among the more common long-lasting Covid sequelae (symptoms), but the first one that he talked about was tinnitus.
“Quite a few people have recovered but among the symptoms that are persisting is this buzzing sound in the ear, called tinnitus. This is much more common post Covid. There are also cardiac symptoms like palpitations etc that can last for six weeks to three months for those who had mild disease, but for severe cases it can last up to six months.”
“The other issue,” he added, “is of the lung, especially in people who suffered severe fibrosis. Symptoms like exhaustion and breathing problems can last for 1-1.5 years.”
“For Omicron, we still do not know that much about long Covid, but we are getting people with high pulse rate and shortness of breath till about three-four weeks after the disease,” Chatterjee said.
A ENT professor in a Delhi government hospital said that because of intermittent shutting of OPDs, there is not enough documentation on post Covid tinnitus, but there does seem to be a strong association.
“It has come to a stage that we ask any patient who comes to us with tinnitus whether he/she has had Covid. It can lead to hearing loss too. But the good thing is patients sometimes get acclimatised,” he said.
“Sometimes they report lack of sleep because of the noise. We ask them to sleep with a white noise — either keeping a ticking clock under the pillow or leave a tap dripping. That helps cancel the noise,” he added.
Nephrological, neurological problems after Covid
A senior government official who suffered from Covid in September 2020 told ThePrint that gastrointestinal symptoms from the disease and fatigue continue to persist.
“My appetite is down and I still feel tired. I have lost weight. It is getting better but I am still not back to my former self,” she said.
The Union ministry of health also lists nephrological and neurological problems as among the possible symptoms of long Covid.
Acute kidney injury is associated with Covid in about 46 per cent cases, the ministry estimates. Neurological symptoms could appear in 10-87 per cent patients, the ministry says, quoting various studies.
Untreated tinnitus can cause hearing loss
Dr Sumit Mrig, head of the department of ENT at Max Smart, told ThePrint that normally in a year his department sees between 30-40 patients of sudden sensory hearing loss, but now that is up to 200-300.
“Patients who had Covid through all the three waves are experiencing tinnitus, which is caused by damage to the hair cells in the inner ear. This can be treated if treatment starts within 24 to 48 hours of onset, but the problem is that because of lockdown etc many patients got to hospitals late,” he said.
Once the hearing loss happens, added Dr Mrig, there is little that can be done.
“Many doctors have come to me complaining of tinnitus post vaccination also. One important factor in this is anxiety so people need to go for options like yoga and pranayam,” he said.
Like the ENT professor, Dr Mrig also noted that some patients have difficulty in sleeping because of the constant buzzing.
Studies put the estimated prevalence of tinnitus post Covid infections at 8 per cent.
“No consistent patterns were found regarding the presentation of tinnitus or additional factors that could have tinnitus developing in the disease impact studies. For the pandemic impact studies, the associated stress and anxiety of the pandemic were consistently suggested to contribute to tinnitus experiences,” US researchers wrote in a review article in July 2021 in the Journal of Clinical Medicine.
“The pooled estimated prevalence of tinnitus post Covid-19 was 8 per cent (CI: 5 to 13 per cent). Medical professionals should be aware that tinnitus might be more problematic following the pandemic or after having Covid-19,” the article said.
(Edited by Saikat Niyogi)
Also read: What doctors know so far about the lingering symptoms of Covid-19