Ronak Kubawat, the brave son of a hawker from Porbandar, is possibly the most severe pediatric case of post-Covid complications; the teen has lost an eye but not the smile on his face.
When 16-year-old Ronak Kubawat was diagnosed with Covid-19 on April 20, his parents, hawkers living in Porbandar in Gujarat, hardly imagined that Covid was not the only deadly disease their son was going to battle and his life was about to change forever.
Over the next few weeks, the boy lost his right eye to mucormycosis, and barely gained use of his left leg with the help of painful physiotherapy after a brain stroke caused by blood clotting from Covid. From his hospital bed, Ronak still raised his right hand to flash the victory sign when asked how he was doing, because even though he is possibly the most severe post-Covid pediatric patient in the country, he is ‘the boy who lived’.
Hitendra Kubawat, Ronak’s father, owns a snack stall selling gathiya in lshwariya village of Kutiyana taluka of Porbandar and makes about Rs 500 a day.
He said, “We never imagined this kind of thing could happen to our child; that he would lose an eye to the disease. We are almost at breaking point mentally and it is only the treatment being given here that gives us hope and strength.”
Ronak is currently battling mucormycosis, plus acute necrotising pancreatitis which has damaged 50% of his pancreas, and ischaemic brain stroke which has led to partial paralysis in his left arm and leg.
Ronak’s is perhaps the first and most severe case in India where a paediatric patient has suffered blood coagulation, organ inflammation and opportunistic fungal infection post-Covid, all at the same time. His father said, “At the couple of hospitals we went to in Porbandar and Rajkot, nobody knew what was happening to Ronak.” Mirror confirmed Ronak had no medical history of adolescent diabetes or any other co-morbid conditions.
A few days ago, Dr Abhishek Bansal at Apple Children’s Hospital operated on another 15-year-old child with severely progressed mucormycosis but no other reported complications.
The team of doctors at Asian Superspecialty Hospital in Ahmedabad, where Ronak Kubawat has been admitted since May 10, were initially very concerned by his prognosis and were further dismayed after they tried and failed in saving his eye from mucormycosis infection. However, the fact that he has now regained some movement in his formerly paralysed leg has rekindled hope that Ronak may survive this onslaught of multiple diseases after all.
Less than a fortnight after being discharged from Porbandar District Hospital on April 29 after receiving oxygen and steroids for Covid-19, he developed nasal blockage, numbness in his right cheek and progressive palsy in the right side of his body. He was first taken to a private hospital in Kutiyana, then to a private hospital in Rajkot, then to Ahmedabad Civil hospital where they were told there was a lack of Amphotericin B anti-fungal medication. They finally admitted Ronak to Asian Superspecialty Hospital in Ahmedabad on May 10.
However, already dealing with two post-Covid complications, doctors at Asian said Ronak developed severe abdominal pain and vomiting shortly after admission. It was diagnosed as the life-threatening condition called acute necrotising pancreatitis with a severity score of 10/10, the worst it can get.
Speaking on this, Dr Ronak Vyas, an oncosurgeon1 who is also his treating doctor, said, “Acute necrotising pancreatitis is a life-threatening condition where severe septicemia, internal bleeding and multi-organ dysfunction can occur at any time. Complete bowel rest and high IV fluid support and high antibiotics are required for this disease. After Covid, idiopathic acute pancreatitis has been reported in very few case studies affecting less than 0.05% of Covid cases. “This diagnosis rendered his mucormycosis debridement surgery on the same day impossible. But by this time, the fungus was closing in on his right eye and the prognosis was not looking good for the young man.
However, the debridement surgery took place on May 11 and doctors, looking at the patient’s young age, decided to not remove his eye and see if the fungus recede’. “That was not to be. Even after our best efforts, his vision did not improve, the swelling in the right eye did not decrease and since there was a chance of fungus spreading underneath the brain parenchyma, we decided to remove his right eye on May 20,” said oculoplastic surgeon Dr Sapan Shah.
After his first surgery on May 11, Ronak faced another major medical complication. In spite of being on higher antibiotics, Amphotericin B, and constant intravenous fluid therapy as well as blood thinners, he developed left upper arm and lower limb paralysis because of ischemic brain stroke. “As of May 23, he has recovered some control over his left leg and can move with some help, but he still cannot move his left hand from the elbow down,” said Dr Vyas, who also works at the AMC-run LG Hospital.
Mirror could not speak to the boy’s mother Kiran Kubawat as she was busy looking after him.
Notably, in spite of selling all their gold and getting some financial help from relatives, the Kubawat family has racked up a debt of Rs2.S lakh. However, the hospital has waived all fees except medication costs, which is also not a small amount given the exorbitant price of Amphotericin B.
