• Published on: Jul 14, 2021
  • 1 minute read
  • By: Raj Dwivedi

Telemedicine, COVID-19 And Liver Diseases

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  • For liver diseases, there have been successful experiences with the use of different modalities of telemedicine [i.e. asynchronous telemedicine (analysis of patient's data by a single physician or multidisciplinary team), synchronous real-time patient management and tele-education]
  • Our Telemedicine program showed successful results as the sustained virologic responses achieved by those patients treated in primary care settings under the expert guidance.
  • Currently, this type of care is considered a vital tool for the goal of global elimination of HCV infection.In addition to HCV management, telemedicine offers opportunities for a better management of patients with chronic liver diseases by increasing their access to tertiary care, thus improving efficiency of healthcare delivery at reasonable cost .
  •  We forsee expansion of telemedicine into other areas of hepatology is desirable and hold potential for improving management of pre- and post-liver transplant patients, patients with hepatocellular carcinoma (HCC) and patients with both compensated and decompensated cirrhosis.
  • It is important to note that in liver transplant setting existing data suggest that use of telemedicine may expedite evaluation and listing of patients referred to liver transplant centers and could improve outcomes (hospital readmissions, and quality of life) after liver transplantation.
  • In the case of HCC, telemedicine aslo offers the possibility of multidisciplinary evaluation in virtual tumor boards leading to tailored and more effective treatments . Finally, in cirrhosis, telemedicine may enhance self-care and facilitate HCC surveillance eventually preventing readmissions in recently hospitalized patients.
  • With the onset of COVID-19 pandemic everyone has forced the implementation of telemedicine actions for many liver patients.
  • Major international societies have released recommendations encouraging the use of remote care to manage patients with all liver diseases, particularly liver transplant patients.
  • However, the crisis will seriously impact cirrhosis care with social distancing and isolation causing major delays in elective procedures and routine care with potential overwhelm of medical centers managing postponed and potentially decompensated patients in the upcoming months.
  • Developing robust telemedicine programs and revamping remote care initiatives in hepatology will be critical during COVID times. The next challenge will be how to integrate telemedicine into routine clinical care beyond the COVID-19 pandemic.
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breath

Shortness of Breath Causes: From Common Triggers to Serious Health Conditions

Shortness of breath, medically known as dyspnea, is a symptom that ranges from mild discomfort during exertion to a distressing sensation of not getting enough air. In India, increasing air pollution, lifestyle diseases and respiratory infections have made breathlessness a frequent complaint across age groups. Understanding shortness of breath causes is essential to identify when it is harmless and when it signals a medical emergency.

 

What Is Shortness of Breath?

Shortness of breath refers to difficulty breathing or a feeling of air hunger.

It may present as:

  • rapid breathing

  • shallow breathing

  • tightness in the chest

  • inability to take a deep breath

The sensation can develop suddenly or gradually.

 

Common and Benign Causes of Shortness of Breath

Physical Exertion

During exercise, the body demands more oxygen.

Temporary breathlessness during:

  • climbing stairs

  • running

  • heavy physical work

is normal and resolves with rest.

 

Anxiety and Panic Attacks

Stress and anxiety alter breathing patterns.

Symptoms include:

  • rapid breathing

  • chest tightness

  • dizziness

These episodes often resolve with calming techniques.

 

Respiratory Causes of Shortness of Breath

Asthma

Asthma causes airway narrowing and inflammation.

Symptoms include:

  • wheezing

  • chest tightness

  • breathlessness during exertion or at night

Asthma is a leading cause of chronic breathlessness.

Chronic Obstructive Pulmonary Disease

COPD includes chronic bronchitis and emphysema.

Risk factors include:

  • smoking

  • indoor air pollution

  • occupational exposure

WHO identifies COPD as a major cause of breathlessness in adults.

 

Respiratory Infections

Infections such as pneumonia and bronchitis reduce lung capacity.

Breathlessness may be accompanied by:

  • cough

  • fever

  • chest pain

Severe infections require urgent treatment.

 

Heart-Related Causes of Shortness of Breath

Heart Failure

The heart fails to pump blood efficiently.

This leads to:

  • fluid accumulation in lungs

  • breathlessness on exertion

  • breathlessness while lying flat

ICMR data shows heart disease as a major contributor to unexplained breathlessness.

 

Coronary Artery Disease

Reduced blood supply to the heart can cause:

  • breathlessness

  • chest discomfort

  • fatigue

This may occur even without chest pain in some individuals.

 

Blood and Metabolic Causes

Anemia

Low hemoglobin reduces oxygen delivery.

Common symptoms include:

  • fatigue

  • breathlessness on mild activity

  • pale skin

NFHS-5 highlights anemia as highly prevalent in India.

 

Thyroid Disorders

Hyperthyroidism increases metabolic demand, causing breathlessness.

Hypothyroidism may contribute indirectly through weight gain and reduced stamina.

 

Lung Circulation Disorders

Pulmonary Embolism

A blood clot in the lungs causes sudden, severe breathlessness.

This is a medical emergency and may be accompanied by:

  • chest pain

  • coughing blood

  • fainting

Immediate treatment is critical.

 

Lifestyle-Related Causes

Obesity

Excess body weight restricts lung expansion.

Breathlessness occurs due to:

  • increased oxygen demand

  • reduced lung volumes

Weight management improves breathing efficiency.

 

Sedentary Lifestyle

Poor physical conditioning reduces respiratory muscle strength.

Even mild exertion may cause breathlessness.

 

Environmental and Occupational Factors

Air Pollution

Pollutants irritate airways and reduce lung function.

Urban populations experience higher rates of breathlessness.

Workplace Exposure

Dust, chemicals and fumes increase respiratory risk.

Protective measures are essential in high-risk occupations.

When Shortness of Breath Is a Warning Sign

Seek urgent care if breathlessness:

  • starts suddenly

  • worsens rapidly

  • occurs at rest

  • is associated with chest pain, bluish lips or confusion

These may indicate life-threatening conditions.

 

How Shortness of Breath Is Diagnosed

Evaluation may include:

  • physical examination

  • chest imaging

  • blood tests

  • lung function tests

  • heart evaluation

Diagnosis focuses on identifying the root cause.

 

Preventive Measures and Lifestyle Care

Prevention includes:

  • regular physical activity

  • pollution protection

  • smoking cessation

  • weight control

  • managing chronic conditions

Preventive healthcare reduces long-term risk.

 

Importance of Early Medical Evaluation

Delayed diagnosis can worsen outcomes, especially in:

  • heart disease

  • lung infections

  • anemia

Early care improves treatment success.

 

Conclusion

Shortness of breath causes range from temporary exertion and anxiety to serious heart, lung and blood disorders. While occasional breathlessness may be harmless, persistent or sudden symptoms should never be ignored. Understanding the underlying causes and seeking timely medical evaluation can prevent complications and save lives. Paying attention to changes in breathing is an essential step toward protecting overall health and wellbeing.

 

References

  • Indian Council of Medical Research (ICMR) – Respiratory and Cardiac Health Reports

  • World Health Organization (WHO) – Breathlessness and Chronic Disease Guidelines

  • National Family Health Survey (NFHS-5) – Anemia and Respiratory Health Data

  • Lancet – Dyspnea Evaluation and Outcomes Research

  • NITI Aayog – Non-Communicable Disease Prevention Reports

  • Statista – Respiratory Disease and Air Pollution Trends

See all

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