A diabetic Covid-19 patient has urged people with chronic conditions to insist on a coronavirus test if symptoms of fever and cough persist and to seek admission to hospital. Manoj MP, an aircraft maintenance engineer, was administered antibiotics at two clinics for a fever that lasted 10 days and was admitted to hospital only after he coughed blood. The Dubai resident admits he initially didn't believe his condition was serious only for his health to swiftly deteriorate. Doctors have warned that people with pre-existing health conditions including asthma, high blood pressure, diabetes, heart disease and weakened immunity are at increased risk. “I took it lightly in the beginning because I thought the cough and fever would subside. But it was after I saw blood that the clinic took an X-ray and saw my lungs were in bad shape,” said the 50-year-old who battled for 20 days on the ventilator. “I didn’t realise how bad my condition was but when I bent to pick up a paper at the clinic, I realised something was seriously wrong. I was not able to get up and couldn’t breathe and then I knew it was more than fever.” Mr Manoj was in a critical condition and barely able to breathe when taken by a friend to Emirates Hospital Jumeirah on April 2. He was discharged on May 3 after a month in the intensive care unit. He is recuperating at home in Dubai and has been advised rest until he fully recovers. "This has been a traumatic experience that I wish nobody should experience," the father of two told <em>The National</em>. “I want to tell people with any underlying condition that you must insist on being checked in a hospital if you have continuous fever. “You cannot go to the clinic and just wait for your test because you don’t have that much time. Your lungs get infected so if you have fever for a few days you must get a Covid-19 test done.” Dr Maan Jamal, a consultant pulmonologist said if a swab test had been administered sooner, deterioration in the type 2 diabetic's condition could have been avoided. “His treatment was delayed because he came to us after 10 days of being sick,” Dr Jamal said. “My message to people with co-morbidities is to seek medical attention as soon as possible if you have any signs suggestive of Covid-19. This means you should take care of diabetes, hypertension, cardiac disease, chronic lung disease and make sure to take medication as directed by your physician.” Mr Manoj was administered hydroxychloroquine, antiviral favipiravir, antibiotics including meropenem and targocid, a blood thinner clexane and anti-inflammation drug tocilizumab. “Mr Manoj’s condition was constantly fluctuating, he needed full oxygen support,” Dr Jamal said. “At one stage he was found to have a cytokine storm. This is when the patient's clinical condition deteriorates and there was a worsening of his chest x-ray and increase in demand for oxygen. “He slowly improved with continued treatment during the third week.” A cytokine storm, an overreaction of the immune system, is often a major factor behind organ failure and death in critically ill coronavirus patients. When this happens, substances called cytokines or small proteins attack the lungs and tissues of the patient instead of protecting them. “When a patient requires very high ventilator support, many can lose hope and think the patient is going to die,” said Dr Mohamed Gamal Abousaleh, head of the intensive care unit, about Mr Manoj. “But we shouldn’t lose hope on any patient whatever his condition because as some point he will improve like Mr Manoj.” Speaking to his family who live in Australia on the ipad from the ICU was an emotional experience for Mr Manoj. “We cried for a long time before we could even speak. For more than a month they could only get information about me from the hospital,” he said. “Physically and mentally this has taken a big toll on me and I want to tell people with health conditions not to lose time if they fall ill.”
