Tag Archives: Coronavirus

COVID19 Delta variant is 60% more transmissable than Alpha variant

Citing reports, Dr Chandrashekhar T. says this mutant has been responsible for several complications cropping up among patients even after recovery.

The Delta COVID19 variant is the new villain that has taken center stage. It is believed to be 60% more transmissible than the B.1.1.7 variant (or Alpha variant) and may be associated with an increased disease severity such as hospitalization risk. Several reports from across the country indicate that this mutant has been responsible for several complications cropping up among patients even after recovery. Here is what you know about the variant.

WHAT IS THE DELTA VARIANT? Variants are mutations of the Coronavirus. Scientists say viruses constantly mutate naturally as they replicate and circulate in their hosts. Sometimes these mutants disappear; other times, they persist. The Delta variant, known as B.1.617.2, is gaining ground worldwide and is said to have contributed to the country’s recent surge. Sometimes we can see a mutation in the mutated variant; this are called as double mutation.

According to WHO and CDC, the viruses prevalent in the United States, Europe, South America, and another part of Africa and the Asian region are of different mutants. The variant prevalent in the US is called Alfa, Beta, and Theta was prevalent in South America and Africa. Theta and Gamma were prevalent in European countries. Delta was prevalent in India and Asia by large, which has now spread to other nations too. Kappa variant was prevalent in Australia. Now, people should know that the Delta wave hasn’t come in the second wave only. It was there in the first wave as well. However, Coronavirus is an RNA virus and is in constant mutation with increasing transmissibility and virulence.

HOW DANGEROUS IS THE DELTA VARIANT? To begin with, it is important to know what variants of concern (VOC) are. There is evidence of an increase in transmissibility, more severe disease, significant reduction in neutralization by antibodies generated during previous infection or vaccination, reduced effectiveness of treatments or vaccines, or diagnostic detection failures are termed as VOC.

The Delta variant was under investigation/variant of Interest (VOI) even in the first wave, as it was termed as the variant of concern by the WHO. Therefore, WHO, ICMR, and other government agencies in India are closely watching its mutations. Therefore, the Delta virus falls under the category of a variant of concern as it is more transmittable, more virulent, and causes many complications.

HOW DOES THE DELTA VIRUS IMPACT HUMAN HEALTH? Now, we all know that COVID19 can cause multiple problems in the body. First is the clotting problem causing a brain stroke or a heart attack or a particular vessel getting blocked, causing gangrene of the limbs, legs, or hands or blood clots causing pulmonary embolism or even gangrene in the intestine. 

Apart from blood clots in the arteries of limbs, heart, and brain, COVID19 patients are coming with intestinal clots that are causing gangrene of the GI. Similarly, clotting can cause pancreatitis as well.

The other problem is the inflammation problem called that Systemic Inflammatory Response Syndrome. This causes symptoms including fever or Hypothermia, Tachycardia, Tachypnoea, and a change in blood leucocyte count. Cytokine Release Syndrome (CRS) is another issue. CRS occurs when the immune system responds too aggressively to an infection. It causes a variety of symptoms, including fever, headaches, and nausea.

IS VACCINATION MY ANSWER? Yes, the vaccines available to us in our country — Covishield, Covaxin, and Sputnik put up a good defence against this variant and hold an excellent efficacy rate. So, you might wonder if vaccines work, then what is the problem. The problem is that not everybody has been vaccinated. And the variant is at its peak when the rate of vaccinations nationally has slowed down. The vaccination program will soon ramp up. Apart from this, staying at home and following all necessary COVID19 safety protocols — social distancing, wearing a mask, and hand hygiene are essential.

(Dr Chandrashekhar T. is Chief Intensivist, Fortis Hiranandani Hospital, Vashi)

COVID19: DRDO’s 2-Deoxy-D-Glucose drug decoded

Dr Rahul Pandit talks about the drug that was approved for emergency use as an adjunct therapy in moderate to severe COVID19 patients by the Drugs Controller General of India early this month.

Mumbai, May 17, 2021: Adding another ammo to our battle against COVID19, the Government of India has introduced a promising anti-COVID19 drug called 2-deoxy-D-glucose (2-DG). The drug has been developed by the Institute of Nuclear Medicine and Allied Sciences (INMAS), a lab of Defence Research and Development Organisation (DRDO), in collaboration with Dr Reddy’s Laboratories (DRL), Hyderabad. The drug was approved for emergency use as an adjunct therapy in moderate to severe COVID19 patients by the Drugs Controller General of India (DCGI) early this month.

WHAT IS 2-DEOXY-D-GLUCOSE (2-DG)? 2-Deoxy-D-Glucose drug has historically been extensively tested for treating Cancer but is so far an unapproved drug. However, for COVID19, the drug shows promise. The drug comes in powder form in a sachet, which is taken orally by dissolving it in water. It accumulates in the virus-infected cells and prevents virus growth by stopping viral synthesis and energy production. Its selective accumulation in virally infected cells makes this drug unique. The Institute of Nuclear Medicine and Allied Sciences (INMAS), a lab of the DRDO, in collaboration with Dr Reddy’s Laboratories (DRL), Hyderabad, has been studying this drug in the context of radiation therapy for cancer.

The primary mechanism of the drug involves inhibiting glycolysis or one of how cells break down glucose for energy. While used to starve and kill cancer cells, this approach could also work in inhibiting virus cells too that were dependent on glycolysis for replication. When the pandemic broke out in India, INMAS, DRDO, and DRL switched their effort to explore the possibilities to use this drug to defeat COVID19. Tests at the Centre for Cellular and Molecular Biology, Hyderabad, last year indicated that the drug demonstrably killed virus cells after which it progressed to trials in people. 

2-DEOXY-D-GLUCOSE DRUG CLINICAL TRIAL: GATHERING CLINICAL EVIDENCE AND EFFICACY. In April 2020, INMAS started experimental examinations in Hyderabad with the Centre for Cellular and Molecular Biology (CCMB). After which, the Central Drug Standard Control Organisation (CDSCO) and the Drug Controller General of India (DCGI) jointly granted permission for Phase-2 trials in May 2020. Between May to October 2020, the institute started initial trials on how COVID19 patients would respond to the drug. The drug worked well with no side effects, and the patients recovered quickly. Further on, the Phase 3 clinical trial was conducted between November 2020-March 2021 in Delhi, UP, Bengal, Gujarat, Maharashtra, Telangana, Andhra, Tamil Nadu, and Karnataka. The results were favourable.

THE EFFICACY FACTOR: Clinical trial results have shown that this molecule helps in faster recovery of hospitalised patients and reduces supplemental oxygen dependence. The drug will be of immense benefit to the people suffering from COVID19. As per clinical data for efffficacy trends, the patients treated with the 2-DG drug showed faster symptomatic cure than Standard of Care (SoC) on various endpoints. A significantly higher proportion of patients improved symptomatically and became free from supplemental oxygen dependence (42% vs 31%) by day-3 compared to SoC, indicating an early relief from Oxygen therapy/dependence.

ACTING WITH RESPONSIBILITY: This drug comes when our nation is grappling to cope with the impact of the devastating second wave of COVID19, which has stressed our infrastructure and resources to its limit. I see a ray of hope, that with the availability of this drug, we may be able to reduce the burden of COVID19 and save as many lives as possible. Having said that, precaution is a must. No COVID19 medication should be taken without a doctor’s prescription. Moreover, hoarding drugs is a crime, and as responsible citizens of the nation, we must ensure that these medicines should be available and accessible to those who need it.

(Dr Rahul Pandit is Director-Critical Care, Fortis Hospitals Mumbai & Member of Maharashtra’s COVID Taskforce)

‘Post-COVID recovery may take longer than expected’

A patient should speak to doctor using tele-medicine option/over a call so that post-COVID recovery is assessed regularly and properly. The doctor will also be able to indicate if a patient needs to undergo any tests, make any lifestyle changes or recalibrate medication. So a patient shouldn’t miss on doctor appointments, eat healthy, take prescribed medication, and stay positive.

Dr Rahul Pandit

It was in December 2019 that the first human cases of COVID-19, the disease caused by the novel coronavirus causing COVID-19, subsequently named SARS-CoV-2, were first reported by officials in Wuhan City, China. As we come close to completing a year since the outbreak of COVID19, let’s understand the repercussions of this infection that has impacted the lives of 9.74 million Indians over the past 12 months and its impact, that may extend to not just a few weeks or months, but a year or more. This phenomenon is called ‘Long COVID’, which has had debilitating effect on patient’s lives.

Across the globe so far, the focus has been on saving and enriching lives during the COVID-19 pandemic, but the infection’s long term consequences are now gaining attention, and people continue to reel under its incapacitating impact. While more research is required to understand why certain patients bear the brunt of ‘Long COVID’, a more crucial question that needs to be answered is ‘is complete recovery on the horizon?’

While there is no textbook definition of ‘Long COVID’, patients who experience post-COVID symptoms lasting over six months are known to be suffering from this condition. These patients are not just those who have had lengthy stay in the Intensive Care Unit, but also those who have had mild symptoms and may or may not have needed hospitalization. Most common symptoms of ‘Long COVID’ include fatigue, breathlessness on least amount of exertion, persistent cough, muscular & joint pain, drop/ inaccuracy in hearing and sight, persistent loss of smell and taste. Many patients with ‘Long COVID’ are also noted to have mental health problems, including anxiety and depression.

The Journal of the American Medical Association recently published a study (on 143 patients) conducted by the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Italy, which assessed post-COVID patients who came into the hospital’s OPD. Analysis revealed that of the patients who had recovered from COVID-19, 87.4% reported at least one symptom, nearly 2-3 months post recovery.

‘Will there be 100% recovery?’ is a question asked by many, but there is no clear answer for this question. Studies are being conducted worldwide to understand the long-term impact of COVID19, however there are increasing concerns that even after making complete recovery, a section of patients may face lifelong implication.

Most of the symptoms of Long COVID fortunately need symptomatic care, and rehabilitation forms an important aspect of care. The respiratory rehab and cardiac rehab programs aimed at gradually building the exercise capacity back, and also allowing time for gradual improvement are important. Mental health assessment and stability forms a large aspect of recovery and need a lot of attention.

To conclude, it is important to remember that you must speak to your doctor (using tele-medicine option/ over a call) periodically so they can assess you post-COVID recovery. Your doctor will also be able to indicate if you need to undergo any tests, make any lifestyle changes or recalibrate medication. So don’t miss on your doctor appointments, eat healthy, take prescribed medication, and stay positive.

(The author is Director-Critical Care, Fortis Hospital, Mulund)

(Featured Image by Gerd Altmann from Pixabay)