Mr Bhikham Chand Story of Recovery
This is the survival story of 66 years old Mr Bhikham Chand, who beat all the odds and survived in the simultaneous fight against COVID 19, acute complicated falciparum malaria, severe malarial hepatitis and acute kidney failure.
Geriatric population is vulnerable to many diseases like diabetes mellitus, hypertension, infectious diseases etc. COVID 19 disease has taken its own toll in causing devastating lung failure in this vulnerable population.
Mr Bhikham Chand from Chennai, a diabetic, hypertensive and hypothyroid on medical care, was admitted with fever and breathlessness requiring oxygen support in a private hospital on August 6th 2020. His CT chest revealed moderate COVID 19 disease related changes. He had severe jaundice and minimal urine output. Suspecting COVID 19 disease with multi organ dysfunction, he was referred to MGM Health care for further diagnosis & treatment.
On initial evaluation, COVID RT PCR was positive. His blood investigations revealed dangerously decreased platelet counts(15,000cells/ Cu.mm), severe jaundice (total bilirubin of 19 mg/dl), elevated liver enzymes, severe blood acidosis ( pH 7.1) and blood creatinine of 8.6 mg/ dl, suggestive of acute severe liver injury and acute kidney injury.
Later his peripheral smear was found positive for mixed Plasmodium vivax and falciparum malarial parasites. A diagnosis of Complicated malaria with multiorgan dysfunction and mild COVID 19 disease was made.
He was admitted in the designated COVID ICU under Dr Selvakumar, Head of Dept.of Liver transplantation & Liver intensive care suspecting impending liver failure as he also had persistently low blood sugar levels requiring continuous glucose supplementation.
Under his able guidance, Dr Nandakumar R, Liver Intensive care physician in consultation with other specialists including Infectious disease experts and COVID ICU physicians initiated close monitoring of his vital parameters and organ functions.
He was administered oxygen supplementation, intravenous anti-malaria drugs with careful fluid resuscitation to revert acute kidney injury. Platelet and RBCs were transfused to maintain optimal haemoglobin and platelet counts.
Close monitoring for worsening of COVID 19 disease was undertaken with supportive management like adequate nutritional support.
- After 15 days of intensive monitoring and treatment for complicated malaria, liver and kidney injury, he was active and alert.
- Fever and difficulty in breathing had resolved.
- His creatinine decreased to 1.9 mg/ dl and bilirubin to 2.2 mg/dl. Platelets increased to 450000/ Cu.mm and haemoglobin stabilised at 9 gm/dl.
His kidneys recovered without need of hemodialysis. Previously elevated inflammatory markers due to COVID 19 had normalised. Subsequently, he was discharged on 21st August 2020 with home isolation for a week.
Today, Mr Bhikham Chand is back to his happy routine with his family members.
