Post-TB lung disease more common than Covid in SA

Millions of people in South Africa are suffering from post-TB lung disease, which is far more common than Covid and the most common cause of pulmonary disability in the country, according to experts.

UCT professor of respiratory medicine Keertan Dheda, who established the post-Covid lung disease clinic at Groote Schuur Hospital in July 2020, said most of the patients attending the clinic because of ongoing difficulty in breathing, shortness of breath, chest pain and fatigue, have post-TB lung disease.

Although the most common and severe symptoms are respiratory, many patients suffer a range of symptoms, like musculoskeletal pain and fatigue, reports the Sunday Times.

Dheda, professor of mycobacteriology and global health at the London School of Hygiene and Tropical Medicine, added that TB remains the most common cause of death in South Africa, with about 400 000 new patients every year.

Post-ICU syndrome, other respiratory conditions

Pre-existing lung disease, structural damage to the lung and post-ICU syndrome can also contribute to distressing respiratory symptoms, making treatment complex.

“Post-ICU syndrome is a form of PTSD (post-traumatic stress disorder) characterized by weakness, fatigue, difficulty in breathing and other symptoms,” he said.

“It remains unclear how many of these chronic symptoms, both respiratory and non-respiratory, are exclusively due to Covid or may be seen in other severe infections and diseases, and especially those who have been in the ICU for whatever reason.”

Research test gives clue in long Covid diagnosis

Traditional lab tests cannot readily pick up long Covid, but a research test – developed by Stellenbosch University physiologist Professor Resia Pretorius and her team – offers hope to patients suffering devastating symptoms for months, even years, after being infected with the virus.

The test reveals abnormal microclot formations with inflammatory molecules trapped inside them, with the potential to diagnose long Covid.

Pretorius collaborated with Harvard, Yale, MIT and Mount Sinai and the findings have been published in a number of peer-reviewed scientific journals.

She said the lingering tiny microclots and hyperactivated platelets (involved in clotting), found in the blood of long Covid patients, could be damaging tiny blood vessels and starving the body of oxygen, triggering a range of disabling symptoms.

Early in the pandemic, Pretorius started analyzing the blood of acutely ill patients. In healthy adults, microclots in the blood show up as a few green specks under the fluorescent microscope.

A galaxy of green flared in the blood samples of long Covid patients.

This microclot test, now patented, has potential therefore as a biomarker to diagnose long Covid.

For patients who test positive with it, Pretorius said that anticoagulant and antiplatelet regimens, and a dialysis-type treatment, are showing promising results.