New Covid-19 study worries experts

A doctor examines a Covid patient’s CT scan report in Wuhan. Pic/AFP

The long-term consequences of Covid are greater in women than men, says a new study, alarming healthcare experts. Survivors of the viral infection are likely to report general weakness, oxygenation troubles, anxiety and depression, found the study published in Lancet on August 28. The data for the research was collected between January and May last year from a hospital in Wuhan, which had reported the first Covid case in October 2019.

As per Dr Subhash Hira, Professor of Global Health at the University of Washington-Seattle and an invited member of WHO-Geneva Review Forums on Covid, 2,469 survivors were chosen for follow-up at 6 and 12 months. "Of 1,276 survivors who did both visits, the median age was 59 and 681 [53 per cent] were men," he said.

The expert said, "The adverse features occurred in long-Covid at 6- and-12 months' follow-ups in 50-70 per cent individuals. These were mainly related to metabolic diseases that manifested with muscle pain/ weakness/fatigue; mental health conditions that manifested with anxiety, frustration and depression; and obstructive diffusion illnesses in the lungs. Epidemiologists following long-Covid manifestations are a worried lot due to the exponential increase in the burden of chronic illnesses in the world as it will have a direct bearing on deteriorating the health systems."

Dr Hira said, "Women had 1.4 times significantly higher risk of fatigue or muscle weakness/pain, 2 times significantly higher anxiety or depression among women, and 3 times significantly higher lung diffusion impairment. Furthermore, matched Covid-19 survivors at 12 months had more problems with mobility, pain or discomfort, and anxiety or depression, and had more prevalent symptoms than the controls had." He said overall, most of the survivors had a good physical and functional recovery during the 1-year follow-up, and they returned to their daily life.

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A woman who recovered from Covid being disinfected in Wuhan. Pic/AFP

"The data suggests that full recovery after 1 year is not possible for some patients, especially the radiologic lung changes. Additionally, information about health-care use, increased burden of health systems, and work quality during the first year after Covid affliction among these patients is scarce," he said.

Dr Ketan Vagholkar, Professor of Surgery, D Y Patil Medical College, said Covid has a multitude of newer presentations with unpredictable outcomes. About the Wuhan study, he said, "Fatigue characterised by malaise and muscle weakness was a common sequel in recovered Covid patients. Pulmonary complications still continue to be the biggest challenge in treating recovered patients. Worsening of comorbidities such as diabetes, renal disease and more so thromboembolic events need serious attention." The expert added, "Citizens must report to their physicians if they experience any new symptoms after recovery from Covid at the earliest."

Underscoring the importance of the findings, Dr Wiqar Shaikh, Professor of Medicine, Grant Medical College and Sir J J Group of Hospitals, said, "Every major medical institution in the country urgently needs to have a post-Covid outpatient clinic to manage long-Covid." He also said that there is a need to carefully look after women and children to prevent long-term complications of the disease. The potential third wave of the pandemic could hit in September-October and will likely have more hospitalisations and higher deaths than the first two waves in India, said Dr Shaikh. Kids and more women will likely be hit, he said.

Dr Shaikh quoted a Canadian study published in JAMA Pediatrics on August 16 that divided children into age groups of 0-3 years, 4-8 years and 9-13 years. It concluded that younger children may be more likely to transmit the virus than older children. The study observed the highest transmission was in kids of 0-3 years.

Dr Wiqar Shaikh, professor of medicine, Grant Medical College and Sir JJ Group of Hospitals

Dr Shaikh also cited a UK study published in Lancet Infectious Diseases on August 28 which concluded that the Delta variant will likely double the rate of hospitalisation. He added, "This is a matter of great concern since the third wave in India is likely to be dominated by the Delta variant. India urgently needs to ramp up its medical infrastructure, particularly in rural and semi-rural areas and the government needs to ban all mass gatherings, including political and religious functions, as well as severely crackdown on inappropriate Covid behaviour."

Citing the Wuhan study, Dr Santosh Bansode, HOD of Emergency Medicine, Wockhardt Hospitals, Mumbai Central, said, "People who were hospitalised and recovered may suffer breathing difficulty, anxiety or depression and muscle fatigue or weakness but most of them will return to their original work and life. Some may have lower health status even after 1 year of recovery."

He added, "People who are not infected yet by this virus should take maximum care. People who are recovered also should do regular breathing exercises and have good nutrition that will help them normalise their health status."