Long COVID-19 Pandemic: Pain After Being Bitten

One source of concern is the long covid that afflicts a significant proportion of the population that survived acute infections. (Representative image: Reuters)

Dr (Lt Gen) CS Narayanan,

The Covid-19 pandemic, unlike other events in recent human history, has affected the lives of so many people around the world. The spark that began in Wuhan, Hubei Province, China in late 2019 was a fierce fire that shook vast nations, both rich and poor.

One of the hallmarks of this tragedy is the delay in peaking in different countries. This brought some self-satisfaction to the first response of these countries, which settled down to believe that the problem was too far to affect them. When the Italian and Spanish health systems collapsed in March 2020, US leadership downplayed the possibility of a pandemic reaching the American coast. Of course it wasn’t. The United States quickly overtook all other countries in the world with a number of infected people and those who succumbed to severe Covid-19.

Another characteristic of pandemic is its tendency to decline and flow with periodic waves. Just as the Indians survived the first wave relatively intact and wondered if they were somehow immune to the virus, in February 2021 the second wave swallowed them like a tsunami. That’s right. -The end of the pandemic.

Currently, most Western governments are fully confident in their medical measures and successful vaccination strategies to lift the obligation to wear masks and enable close social interaction. Economists are busy predicting a “post-pandemic boom” that will show unprecedented economic growth in these rich countries.

The celebration may be trivial and premature, as the pandemic and its sequelae are inadequate.

One source of concern is the long-term infectious disease that afflicts a significant proportion of the population that survived the acute infection. Shortness of breath, fatigue, and lack of concentration (“brain fog”), which are characteristic of this condition, impair the functioning of more than half of those affected by long covids. As officially called, Long Covid or Post-Covid Syndrome (PCS) is defined as a symptomatology that affects any part of the body for more than 3 months after a Covid attack. Small physical tasks can make a person short of breath and tired. PCS is severe enough to limit sedentary work and even daily chores in about one-fifth of those affected. Loss of odor (anosmia), a typical feature of Covid-19 infection, can turn into a condition called parosmia in survivors. People with parosmia report that everything smells unpleasant, rotten, or unpleasant. Fruits may smell like chemicals, or even worse, like rotten meat. Symptoms are more pronounced in the elderly and in people with existing medical disorders such as asthma, high blood pressure, and heart disease. It has been suggested that women are less likely to develop severe acute COVID than men, but are more likely to develop long-term COVID. This can be due to hormonal differences, chromosomal genetics, gender differences in immune system behavior, and non-biological factors.

There are approximately 160 million confirmed cases of Covid-19 worldwide. A preliminary study by the Office for National Statistics estimates that long-term covid affects 14% of people who recover from an acute infection. These numbers are staggering, but they may be just the tip of the iceberg due to the lack of access testing for the majority of the population. In addition, the recovery of acute cases in developing countries such as India, where pandemics are still rampant, could lead to further rapid growth in the future.

Experts are just beginning to understand the magnitude of the long-term Covid’s impact on the country’s health and economy.

The condition is well recognized, but the exact reason for the syndrome is not yet understood. Plausible causes are persistent viral infections, chronic autoimmune processes, or residual damage to various organ systems in the body. Some people have traces of the SARS-CoV2 protein in their bodies for several months after recovering from an acute Covid-19 infection, according to a study published in the reputed scientific literature. This persistent viral load after recovery from an acute illness resembles some well-known disorders such as chronic viral hepatitis. Autoimmunity refers to collateral damage to organs by defense mechanisms attached to the body to eliminate the virus. The violent inflammatory response that occurs during SARS-CoV-2 virus infection can then leave scar tissue on many parts of the body. This can cause havoc long after the virus is removed from the body. Lung fibrosis alters nerve connections, and the damage to blood vessels caused by this process may explain many of the symptoms of long Covid. The combination of all these mechanisms is very likely to contribute to the symptoms of a punctured individual.

Many of the long Covid’s symptoms, such as fatigue and fog in the brain, may be ambiguous, but they are still debilitating. This resembles another mysterious condition called Chronic Fatigue Syndrome (CFS). People who are suffering can strain the medical system by moving from one specialized clinic to another in search of treatment.

Without established guidelines for the management and rehabilitation of people with long covids, some young individuals at the peak of their careers may be forced to drop out of the workforce altogether.

In addition to the magnitude of the problem, many people with these symptoms may not have been tested for SARS-CoV-2 infection or its antibodies that support the formal definition of those symptoms. is. It has been established that long covids occur not only in patients with severe infections that require hospitalization, but also as a sequela of mild infections. False claims about malingering and disability will exacerbate the problem.

Currently, long-term patient management focuses on physical rehabilitation, breathing, meditation, and yoga. Support groups, counseling, and flexibility in the work environment help many people suffering from this condition.

Elucidating the exact mechanism of postcovid syndrome through ongoing research will hopefully yield results in the form of targeted antivirals and immunomodulators. The virus catches us unprepared and continues to make enormous sacrifices during several waves of acute infection. We need to learn our lessons and be prepared to tackle the consequences of the long, insidious but equally devastating Covid.

(The author has a 39-year military career and heads the Department of Neurology at Manipal Hospital in New Delhi. He is uniquely awarded the Vishisht Sewa Medal for three outstanding services by the President of India. It has characteristics. It is personal and does not reflect the official position or policy of Financial Express Online. Contact: [email protected])