Mumbai: Fatal immune response seen in patients after 12-15 days in hospital – Times of India

MUMBAI: A delayed cytokine storm or an immune response in which the body attacks its own cells has been responsible for some Covid deaths in the city lately, especially among patients hospitalised for 12 to 15 days.Daily Covid-19 deaths in Mumbai have significantly declined in the past three weeks. The first week of May, for instance, saw an average of 75 every day. It dropped to 64 in the second, 54 in the third and 40 in the last week of May. In the first week of June, the daily average dropped to 23.
However, Dr Niteen Karnik, head of medicine at Sion Hospital and a member of the state Covid taskforce, said in quite a few cases now, delayed cytokine storms contribute to deaths. The cytokine storm is an immune response caused when the body starts to attack its own cells and tissues rather than fighting the virus.
“We have had cases where a delayed cytokine storm was seen from day 12 to day 15. The progression was rapid after that. Patients who were on 2litre oxygen in the morning went on to need five times more by evening,” he said, adding it has been seen in younger patients too. Deaths now are mostly in those who have spent more than 10-14 days at the hospitals, he said. Dr Rajesh Bhadade, medical ICU in charge, BYL Nair Hospital, agreed with the assessment. “We have seen deaths in patients with a HRCT scan score of 10, while those with scores above 20 have gone home. Besides cytokine, post Covid complications are also responsible for deaths now,” he said.
The hospital recently had a case where a patient recovered and was sent to a ward one notch below the ICU. However, a few days later, the patient passed away. “Without an autopsy one can’t be sure. It could be a cardiac arrest or pulmonary embolism, but we have to be mindful of these complications,” Bhadade added.
In the first wave, doctors said they would typically see signs of cytokine storms in which inflammatory levels would increase, mostly by the eighth or tenth day. This had prompted experts to stress on closer monitoring in the second week of the infection.
An official said severity analysis shows most have not taken treatment or undergone a Covid test till the seventh or eighth day. “Importantly, deaths in patients with comorbidities have dropped under 60% which means there is a corresponding increase in deaths among healthy individuals probably due to late hospitalisation,” he added .