Dubai: Mohammad Abdul Basheer was semi-comatose on a ventilator and suffering seizures, but in what seemed like a miracle he walked out of hospital on his own without any oxygen support.
The 52-year-old Dubai Airport porter is a textbook case of a critically ill COVID-19 patient who is fortunate to have survived.
Being a diabetic with hypertension and high cholesterol, Basheer grew from being moderately ill to severely ill with a cytokine storm in his lungs and clots in his brain.
“I am so thankful and merciful to God that I am perfectly fine today after being in a dark tunnel for over a month-and-a-half,” he said. “I have hardly any memory of those days as I was sedated. Whenever conscious, I thought I would not survive and meet my wife and children again, in Bangladesh. My deepest gratitude goes to the doctors and nurses at the Intensive Care Unit of the COVID ward of Prime Hospital, who literally pulled me out of the jaws of death with such around-the-clock care,” he added.
On April 6, Basheer went to his supervisor and asked for a second COVID-19 test as he had classic symptoms of fever and breathlessness.
“In my job as a porter, I am exposed to international passengers and so many people each day. I had the onset of symptoms in the first week of April, but my earlier tests were negative. However, by April 6, I was feeling distinctly tired and breathless and had fever. This time, the test result that came in on April 8 was positive and my condition had further deteriorated. I was taken to hospital,” said the father of three.
Dr Dirar Abdallah, the head of ICU and consultant in Internal Medicine at Prime Hospital, said: “While we followed the medical protocol as per Dubai Health Authority (DHA) guidelines, there is no way of knowing what really worked in the case of Basheer. When he came in on April 8, we tried to keep him out of the ICU and mechanical ventilator by providing him oxygen support through a canula. But Basheer not only had diabetes, hypertension and high cholesterol, but he also had a respiratory condition called sleep apnea, whereby he required special assistance during the night when he slept. The next day, his condition got worse and we had to shift him to the ICU, sedate him and intubate him for mechanical ventilation. Until then, hydrochloroquinine was an acceptable medication and we gave him that, plus some antivirals. But what really saved him was the immune suppressant injections as he was undergoing a cytokine storm. Normally, these injections are given to patients of Rheumatoid Arthritis when their immune system goes into an overdrive. In Basheer’s case, his lungs were under attack by his own immune system and the injections helped subside the storm.”
Dr Abdallah added that a combination of balanced nutrition and hydration given to the patient through a tube, plus around-the-clock management of his acute conditions were the keys to his recovery. Basheer was weaned off the ventilator, but then he suffered brain seizures.
In 12 days, he finally looked like he was recovering. However, within a week, he suffered a seizure again. An MRI revealed a clot in his brain. This is again a classic symptom of COVID-19 as patients find blood clot formation on their limbs, in the lungs as well as in the brain.
“We did not put him on the ventilator, but worked on his blood clots. One of his sides had gone lax like in a stroke. But he recovered in the next ten days,” added Dr Abdallah.
By May 10, Basheer had a marked improvement. He had tested negative for COVID-19, but was on a long road to recovery.
His muscles had weakened, but the medical team had taken care to provide physical rehabilitation, emotional support and the right nutrition and hydration along with oxygen support through a canula.
Dr Abdallah added: “We discharged him on May 22 after 45 days and it was an absolute delight to see him walk out of the hospital on his feet. He came in for a consultation on May 28 and though weak, was stable and on the road to recovery.”
Basheer is on sick leave until June 20.
“My friends in my room are very helpful and are cooking for me,” he said. “If flights reopen, I might visit my home in Bangladesh and meet my family as my wife and children have been worried. I will overcome this and regain my strength and be back picking up luggage soon,” he added.
What is a cytokine storm?
Cytokines are proteins in our immune system that are programmed to destroy any alien invasion. However, in many cases, when the immune system is overwhelmed, it produces more of these protein bodies than required and these turn rogue, turn invaders and attack the healthy cells of the body. This happens in autoimmune diseases such as lupus or Rheumatoid Arthritis. In COVID-19 positive cases, it happens very easily. During a severe COVID-19 infection, doctors report cytokine storms or over-production of this protein. The immune system literally goes on a rampage, invading the healthy tissues in the lungs. This leads to inflammation, fluid retention, inability of the blood vessels to carry oxygen, bleeding and clotting in the capillaries and veins that deprive major organs of blood and oxygen supply, resulting in a drop in blood pressure, organ failure and possible death.