Kolkata: A 24-year-old woman in Kolkata has recovered from Covid-19 after spending 12 days on Extracorporeal Membrane Oxygenation (ECMO), with her doctors telling ThePrint that this is the first such case in the country.
The ECMO is an invasive procedure in which an artificial lung is set up outside the body to pump oxygenated blood into it, allowing the heart and lungs to rest. It is similar to the heart-lung bypass machine used in an open-heart surgery,
The 24-year-old woman who underwent the procedure was discharged from the AMRI hospital in Dhakuria Monday. Hospital authorities, in a statement, claimed that she spent over 300 hours on the ECMO.
This is the second such “miracle Covid-19 recovery” in Kolkata — in May, a 52-year-old diabetic patient recovered from Covid-19 after spending over a month on ventilator support.
Apart from being unique, the two recoveries have a common thread running through them — Dr. Saswati Sinha. A senior consultant with the critical care unit at AMRI, Dr. Sinha led the teams that treated both patients.
Also read: How one Bengal village’s Covid fear has stalled ‘Rs 2,000-crore’ India-Bangladesh trade
A 24-year-old without comorbidity but was sinking
The 24-year-old patient from Kalighat area, a south Kolkata locality where Chief Minister Mamata Banerjee resides, was admitted on 17 May with high fever and acute respiratory distress syndrome.
In its statement, the hospital said when she was first brought to the emergency department, doctors noted that her oxygen saturation had gone down to 34 per cent, a cause for serious concern as anything less than 90 per cent is considered to be low blood oxygen.
She was initially put on ventilation but it failed to pump oxygen back to the system. AMRI doctors ThePrint spoke to said the case was unusual as the patient was very young and did not have comorbidity issues. They added that she weighed around 90 kg, which put her in the clinically obese category.
It was a ‘delayed response’ in terms of reporting the problems she developed. The patient had been suffering from high fever for a week and then developed severe breathing distress, the hospital statement said.
According to her father, she had been suffering from high fever and sore throat since 10 May. Even though her fever subsided within a day, her temperature again shot up and she started having severe respiratory distress, said the hospital statement.
Also read: First flush gone in lockdown, Bengal and Assam tea industries face Rs 2,100 cr loss
‘The miracle doctor’
The case comes as a second major success for Dr. Saswati Sinha. She had treated Netai Mukherjee, the 54-year-old with severe comorbidity who defeated the virus after remaining on ventilator for over a month.
As for the 24-year-old woman, Sinha said it was the first such case in the country.
“According to the best of our knowledge, she is the first such survivor in the country,” Sinha told ThePrint. “We tried to do maximum adjustment through the ventilation process but the oxygen saturation level remained below 50 per cent. Her lungs were just not able to pump enough oxygen. This was when we decided to put her on ECMO support. Her family members agreed and supported us fully.”
She added that such complications at such a young age was new and it was perhaps caused by the obesity factor or a weak immune response. “She was also brought to us a bit late, which made things more critical and worse,” the doctor said. “She was having a high fever and was vomiting. her viral load was also very high. She did not venture outside, but might have come to contact with someone who carried the virus.”
Apart from Sinha, two other senior doctors — Dr. Soham Majumdar, ECMO specialist and Dr. Mahuya Bhattacharya, Senior Consultant, Critical Care & Internal Medicine — supervised the treatment.
“Like normal ECMO procedure, we drew in blood from her body and re-oxygenated it by increasing the oxygen levels in her blood and re-infused it into her body to improve saturation. She was on ECMO for around 300 hours,” Majumdar said.
“It is not always possible to clinically manage respiratory distress in Covid-19 positive patients with just ventilator support,” Bhattacharya said. “Sometimes putting the patient on ECMO support becomes a crucial step. In the case of the 24-year-old, ECMO support was absolutely necessary and it helped us bring her back from a near-death situation.”
According to the AMRI statement, one Covid-19 positive patient at AIIMS, New Delhi, and another patient at a private hospital in Chennai were put on ECMO support but their lives could not be saved.
What is ECMO?
ECMO in medical terms is a system or a machine that is similar to the heart-lung bypass machine used in open-heart surgeries. It pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest.
“It is an invasive procedure. Through this procedure, we set up artificial lungs outside the body to pump in the oxygen while the native lungs can be put on rest to recover,” Sinha explained.
ECMO is a rare and expensive machine and is not easily available. The AMRI group has one ECMO machine for three hospitals, Sinha said.
“While putting her on ECMO, we also explained the consequences to her family,” she added. “We told them that we might lose her too in the process but we got overwhelming support from the family. The rest was a team effort and God was with us again.”
According to hospital sources, the first day of putting the patient on ECMO may cost around Rs 3 to 4 lakh. After that, the daily charge may go up to Rs 70,000 to Rs 80,000, which will include the ECMO, ICU and other charges.
“The survival rate for a Covid positive patient on ECMO is also not very high internationally. So it was risky, but the only option left then to revive the patient,” Sinha said.
Also read: Netaji’s grandnephew Chandra Bose dropped as Bengal BJP V-P for ‘speaking up against CAA’