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Long COVID may not be as fatal as acute COVID-19 but can worsen existing ailments, say experts

The criteria to objectively define long-COVID is still evolving, but WHO recently described it as a post-COVID-19 condition in individuals with a history of probable or confirmed SARS CoV-2 along with symptoms lasting for at least two months and cannot be explained by an alternative diagnosis.

October 17, 2021 / 11:57 AM IST
Representative image

Representative image

Long-Covid may not be as fatal and hard-hitting as acute COVID-19 and mostly improve over time but it can worsen existing ailments such as diabetes and kidney diseases, healthcare experts said.

The criteria to objectively define long-COVID is still evolving, but WHO recently described it as a post-COVID-19 condition in individuals with a history of probable or confirmed SARS CoV-2 along with symptoms lasting for at least two months and cannot be explained by an alternative diagnosis.

Dr. Khan Amir Maroof, Professor at Department of Community Medicine, and Coordinator of Medical Education Unit, University College of Medical Sciences and GTB Hospital, Delhi, said some patients were getting readmitted even after recovery or seeking OPD consultation for Covid-related problems.

''We know that it (long-Covid) is a real entity which we have to keep a track of in our research and clinical practice in the long run. Its effect on the quality of life and the economic status of a family and a community is also to be understood better,'' Dr. Maroof told PTI.

He said various terms -- post-COVID, post-acute-COVID syndrome, chronic-Covid -- are being used to identify COVID-19 manifestations which either persist for two to three months and longer or develop later.

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COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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About the repercussions of the long-COVID, he said it is not as fatal and hard-hitting as acute COVID-19 and mostly found to improve over time.

''The symptoms are usually mild to moderate, such as fatigue, shortness of breath, difficulty in concentrating, joint pains, hair loss, and others.

''But the deterioration of quality of life of these patients is worrisome. From a public health perspective, the disability-adjusted life years burden and economic repercussions could be high, which needs to be studied more,'' he said.

Dr. Shibu Vijayan, Global TB Technical Director at Programme for Appropriate Technology in Health, said long-Covid is not worse than COVID-19 but can worsen existing ailments like diabetes and kidney disease or result in precipitation of these diseases or infectious diseases like tuberculosis.

''We are seeing more TB cases post-COVID. The Government has issued guidance to target and aggressively look for tuberculosis among post-Covid,'' he said. Dr. Vijayan said from Indian studies, it looks like around 30 percent of the hospitalized cases had long-Covid symptoms, such as fatigue, cough, chest tightness, breathlessness, palpitations, myalgia, and difficulty focus. ''It could be related to organ damage, post-viral syndrome, post-critical care syndrome, and others,'' he said.

About the effectiveness of vaccines against long-COVID, Dr. Arunesh Kumar, senior consultant and head of pulmonology at Paras Hospitals in Gurgaon said about half of people with long-COVID reported an improvement in their symptoms after getting the vaccine. ''Getting a jab can reset immune response in long-COVID or help the body attack any remaining fragments of the virus,'' Dr. Kumar said.

Dr. Maroof also said that preventing Covid will prevent long-Covid too. ''So, in a way, a vaccine is the key intervention for long-Covid too. Furthermore, some recent studies have shown that those vaccinated have lower intensity and duration of long-COVID as compared to the unvaccinated. So, initial results are promising,'' Dr. Maroof said.

About the line of treatment of long-COVID, Dr. Kumar said a specific treatment in near the future is expected when the actual reason or mechanism of the disease is known. ''However, the treatment should be multidisciplinary in nature, including primary care provider as well as relevant specialist rehab professionals, social care workers, psychosocial workers, mental health professionals,'' he said.
PTI
first published: Oct 17, 2021 11:58 am

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