New Delhi: As we step into the third year of COVID-19 pandemic, there is a significant amount of data being recorded about the virus to help understand the disease in a better way. One of those aspects of the pandemic is Long COVID or post COVID-19 condition. Dr Janet Diaz, Team lead – Clinical Management, Infectious Hazard Management, World Health Organization explains the learnings from post COVID-19 symptoms.
Question: What have we learnt so far in the third year of the pandemic about the symptoms oF the post COVID conditions?
Dr Janet Diaz: We have learnt quite a bit. If you reference our most recent publication on the definition of the post COVID-19 condition, we had three common symptoms there – fatigue, shortness of breath and Cognitive Dysfunction. People who were very active before contracting COVID, now observe shortness of breath. And Cognitive Dysfunction is a fancy term for what is referred to as brain fog. This means people are having trouble with their attention, with concentration, with recalling or memory, sleeping, executive functioning. These are the types of symptoms that people have been reporting. There are over 200 such symptoms described in the literature by people who have post COVID symptoms, but these three are the most common.
Question: Can you tell us a little more about Cardiovascular symptoms?
Dr Janet Diaz: The cardiovascular symptoms present in different ways, they can present as shortness of breath. They can present as heart palpitations when the heart is racing. Other cardiac symptoms can BE myocardial infarctions. Now there has been a recent report that was looking at patients who had COVID-19 and it followed them a year after. This report was coming out of a cohort in the United States and they found an increased risk of cardiovascular complications in that cohort those complications are described as having had a stroke, acute myocardial infarction which means heart attack or other causes of thrombosis or blood clots and including death. So they did report an increased risk of death in that one year after the acute COVID-19 infection.
Question: When should people start worrying that they may have long COVID?
Dr Janet Diaz: In our case definition, we say people should start worrying about three months after their acute COVID-19 illness. That gives some people the time to recover from the acute infection, even if they’ve had a mild disease or more severe disease. After 3 months, that’s when we say if you have one of these symptoms, then be concerned that you could have post COVID-19 condition and get evaluated.
Question: How long do these symptoms last?
Dr Janet Diaz: In our case definition, we say at least 2 months. So perhaps you may have a symptom that you’re concerned is long COVID. But if it goes away after a week or a couple of weeks or a month, then we don’t consider it to be long COVID. Now if lasts more than 2 months, then we start to say, we are concerned that this is a long COVID condition. At that point, patients may experience symptoms for up to six months and there are reports of people experiencing protracted symptoms for up to a year or more than a year.
Question: What are the treatments recommended for long COVID?
Dr Janet Diaz: Because I’ve described the conditions as being different types of symptoms that affect multiple systems of the body, then the treatment is not one treatment for all patients. The treatment has to be patient-centered and focused on the symptoms the patient is presenting with. We don’t have any drugs for post COVID-19 interventions AS such but we do have interventions such as rehab interventions or self-management techniques in order to help people improve their quality of life while they still have these symptoms that have not yet fully recovered.
For example one of these self-management techniques could be that if you have fatigue, then don’t over-exert yourself when you are feeling fatigued, try to do your activities at a time in the day that you don’t feel fatigued. If you have cognitive dysfunction, don’t multitask. Don’t have many screens up at the same time or try to do too many things. Try to focus on the one activity that you’re working on. If you have insomnia, trouble sleeping, then as well work on sleep hygiene techniques and interventions. So there are a series of these types of interventions that can be done as well as rehab interventions.
WHO recommends that the care of patients with post COVID-19 conditions be done in a coordinated, integrated way. At the center of that care, model should be someone who knows you, your primary care physician, a general practice clinician that knows you. Then they can reach out to different specialists in an integrated way, in case you need evaluation by a specialist. That can include a neurologist, a cardiologist or a pulmonologist or a mental health specialist, among others. Together, this type of care model, we think is most optimal for patients who are living with post COVID-19 conditions.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.