Rectal bleeding in COVID-19 recovered patients
After fungal infections, the threat of the Cytomegalovirus has emerged for patients of COVID-19. Five cases of Cytomegalovirus (CMV) – related Rectal bleeding in COVID-19 recovered patients were reported in Sir Ganga Ram Hospital, Delhi after 20-30 days of their recovery from COVID-19.
One of the five patients died due to massive bleeding and severe COVID-19 related chest disease.
Until now post COVID-19 complications affects immunocompromised patients,post transplant, cancer, AIDS etc. but this is the first time in India that cases of CMV- related rectal bleeding in COVID-19 recovered patients were immunocompetent before COVID-19, which means that they did not suffer from any condition which lowered their immunity.
What is Cytomegalovirus ?
Cytomegalovirus (CMV) is usually present in the body of 80-90% of the Indian population in asymptomatic form as our immunity is strong enough to make it clinically asymptomatic, but it develops into a disease when a person’s immunity is lowered after COVID-19 infection.
Transmissibility-
Usually once a person is infected with this virus, the person retains it for life. It spreads through an infected person’s blood, saliva, urine, semen, vaginal fluids or breast milk. The virus spreads quickly in areas that have a lot of young children, Such as day care centers or prenurseries.
Symptoms-
As it only effects people with weakened immunity, most people who get Cytomegalovirus don’t know it. The primary symptoms of the infection includes –
• Sore throat
• Muscle aches
• Fatigue
• Swollen glands
• Fever
On the other hand, some serious complications of CMV can have an impact on lungs, liver, oesophagus, stomach, intestines and brain.
COVID-19 recovered patients should pay attention towards symptoms immediately as it could be serious very soon.The symptoms are-
• Abdominal pain
• Blood in the stool
• Low lymphocyte count
Possible cause of becoming immunocompromised from immunocompetent –
COVID-19 infection itself and the medicines used for its treatment (like steroids), do suppress the immunity of patients and make them susceptible for uncommon infections with varied presentations.
Diagnosis-
Cyomegalovirus colitis was confirmed by –
• PCR testing for CMV
• Blood test
• Urine test
• Tissue biopsy from the large intestine
Treatment-
Doctors said that two patients had massive bleeding and one required emergency lifesaving surgery in the form of removal of right side of the colon. One of them died due to massive bleeding and severe covid chest disease.
Other three patients were successfully treated with antiviral therapy with ganciclovir.
Mucormycosis, white fungus and cytomegalovirus are opportunistic infections and they always look for people with weak immunity therefore the recovered patients from COVID-19 should build their immunity especially by taking healthy diet and doing Yoga and pranayama.
In such cases, a high index of suspicion and timely intervention in the form of an early diagnosis and effective antiviral therapy can save many precious lives.
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