01 April,2021 05:09 AM IST | Mumbai | Anurag Kamble
Pramod Kulkarni with Dr Sanjith Sreedharan
Doctors at a private hospital were able to successfully save a patient from COVID-19 from a cytokine storm in a 31-day roller coaster hospitalisation. Pramod Kulkarni, 64, was admitted to SL Raheja Hospital in Mahim with COVID-19 and was also found to have a perforation in his intestine, followed by a blood clot. Meticulous planning and monitoring by the doctors led to Kulkarni recovering well.
Kulkarni, a resident of Mughal Lane in Mahim, works as an insurance advisor and legal consultant. On January 24, he felt uneasiness in his stomach which aggravated to severe pain. At his family doctor's advice, he took medicines and felt better for a couple of days. But the symptoms returned again. Seeing his blood reports, his doctor recommended a COVID-19 test.
After testing positive, he got admitted at SL Raheja Hospital where 72 per cent of his lungs were damaged. He was rushed to the ICU on January 31. His abdominal pain returned in a couple of days.
Chief Intensivist, SL Raheja Hospital, Dr. Sanjith Saseedharan said, "He was brought in with respiratory failure with markers, high inflammation, high temperature, blood pressure variations and a deteriorating kidney function called the âcytokine storm'."
Photo Source: SL Raheja Hospital
"The patient had hypertension which is associated with poor outcomes. His COVID was severe - evident from the spike in inflammation and hence, deterioration in virtually every organ system," Dr Saseedharan added.
While doctors were trying to stop the cytokine storm, another diagnosed the cause of the stomach pain as intestinal perforation. Kulkarni's wife, Rohini, who also tested positive, said, "It was a blow to me. COVID had done enough damage to his body and then he got a perforation too. I told the doctors to do their best."
The perforation was treated within a few days and the doctors heaved a sigh of relief, but the challenge hadn't ended. Doctors then found blood in one of the drains put to remove accumulating water from Kulkarni's body.
He had developed a clot in the intestine and surgery was performed by laparoscopic surgeon Dr. Gaurav Mishra to remove it.
Dr Mishra said, "We went over recent COVID literature, which showed almost 100 per cent mortality in similar patients at places like Spain, Italy, New York and Seoul. This patient was one of the most challenging cases among thousands. The literature reviews downed our spirits, but the team continued to fight all along."
Kulkarni lost 7 to 8 kg of weight and his haemoglobin level dropped from 14.5 to 8.5. His will power and medical care helped him recover and he tested negative on February 22 and was discharged on March 4.
"My husband had never had any health issues. And now he had to be admitted for over a month, during which he was in immense pain and all alone. It will take another month for him to fully recover but he's doing fine. I am indebted to the doctors and staff who took care of him and literally saved his life," Rohini added.
Cytokines are substances released by certain cells of the body and have an effect on other cells. When released in normal amounts, they have an important role in normal immune responses. But a large number of them all at once, that is, a cytokine storm, can be harmful. The storm is brought on by infections, autoimmune conditions or other diseases and has a host of symptoms like fever, inflammation, fatigue and nausea. Sometimes, it leads to multiple organ failure and can be fatal. In Pramod Kulkarni's case, the storm manifested in respiratory failure with markers, high inflammation, high temperature, blood pressure variations and a deteriorating kidney function, as explained by Dr. Sanjith Saseedharan .
