Doctors in India are grappling with the challenge of diagnosing and treating long-running Covid patients due to the lack of clear medical guidelines and extensive research. As the world focuses on recovery from the pandemic, the focus is now on the persistent and unexplained symptoms seen in many people COVID-19 Survivors Although the World Health Organization (WHO) declared the end of COVID-19 as a global health emergency in May 2023, Long COVID remains a significant concern globally, including in India, as the condition affects millions of people. Is influencing people.

Long Covid refers to a series of long-term symptoms that persist beyond the acute infection phase. Common symptoms include fatigue, muscle and joint pain, brain fog, difficulty concentrating and respiratory problems such as a persistent cough. These symptoms can affect different parts of the body and have a significant impact on a person’s quality of life, even after the initial COVID-19 infection has been cured.

Global and regional impact of Long Covid

Globally, studies suggest that about a third of people who have experienced moderate or severe COVID-19 infection may suffer from long-term COVID. However, the prevalence of this condition varies in different regions. According to a study by researchers at Harvard Medical School, about 31 percent of people in North America, 44 percent in Europe and 51 percent in Asia have experienced it. Long lasting Covid symptomsThe study published in the International Journal of Infectious Diseases in September 2023 shed light on long COVID-19 With limited guidelines for diagnosis and treatment, health care systems are overwhelmed.

In India, the situation is particularly challenging due to the lack of studies on Long Covid. A landmark study conducted by Maulana Azad Medical College in New Delhi examined 553 patients who recovered from COVID-19 between May 2022 and March 2023. The findings showed that 45 percent of participants continued to experience persistent fatigue and prolonged symptoms. Dry cough is the most common. A study published in Curious in May 2023 emphasized the need for further research. Long-term effects of COVID-19 Develop effective management strategies and optimize healthcare delivery.

Lack of understanding and diagnosis challenges

In India, the understanding of Long Covid is still evolving, with many health care professionals acknowledging the difficulty in diagnosing and treating the condition. According to Dr Rajesh Sagar, professor of psychiatry at the All India Institute of Medical Sciences (AIIMS), New Delhi, the current state of research on Long Covid in India is inadequate to provide a clear understanding of the condition. “It is too early to say that we fully understand how to diagnose or treat long Covid,” Dr Sagar said.

The need for research focused on long-term neurological complications of COVID-19 is also important. Animesh Samant, assistant professor in the School of Natural Sciences at Shiv Nadar University, Greater Noida, said some studies in India have shown that long-term Covid patients experience neurological symptoms, but the underlying causes, particularly neuroinflammation, are not known. More research is needed to understand. ,

Doctors across the country have reported an increase in the number of patients who are presenting with symptoms they never had before being infected with COVID-19. For example, individuals who never had asthma are now experiencing prolonged cough, shortness of breath, and wheezing after recovering from COVID-19. According to Dr Neetu Jain, senior consultant, who runs the post-Covid care clinic at Pushpawati Singhania Hospital and Research Institute, New Delhi, these patients often require the use of inhalers or nebulizers to manage their symptoms.

Another worrying trend is the increase in stroke cases in young patients without any known risk factors such as diabetes, high blood pressure or obesity. Dr Arun Garg, chairman of neurology and neurosciences at Medanta-The Medicity in Gurugram, said the incidence of encephalopathy, characterized by brain swelling and confusion, has also increased. These patients often experience confusion after a mild fever, yet their MRI scans show no abnormalities.

Diagnosis and treatment interval

One of the biggest hurdles in managing long-term COVID-19 is the absence of standardized diagnostic tests. Currently, doctors rely on non-specific tests and questionnaires to assess a patient’s “quality of life” and detect potential long-term Covid symptoms. “We do not have any definitive test for Long Covid, although it is recognized as a clinical diagnosis,” Dr Jain said. “We diagnose long-COVID in people who had moderate to severe infection and have not regained their pre-COVID quality of life.”

Blood tests to check for inflammatory markers such as C-reactive protein (CRP) are commonly used to support the diagnosis of long-term COVID-19. In some cases, doctors are finding rare antibodies in patients that were not present before their COVID-19 infection, suggesting that these antibodies may be linked to long-term effects of the virus.

Persistent inflammation is believed to play a key role in long-term Covid. However, there are no tests specifically designed to measure the immune response that induces this inflammation. Researchers globally are working to develop diagnostic tools, such as a fluorescent probe developed by a team at Shiv Nadar University, which detects nitric oxide levels in brain cells. Elevated levels of nitric oxide in microglia cells, which are immune cells in the brain, have been linked to SARS-CoV-2 infection and may indicate ongoing inflammation.

Need for more research and clinical trials

Despite some progress in understanding Long Covid, there is still much to learn. According to a Harvard Medical School study, 587 clinical trials on long-term COVID-19 have been conducted across the world, of which 55 trials have been conducted in India. However, only 11 of these trials have published conclusive results. The researchers stressed the need for more studies on interventions targeting sleep disorders and other biological processes associated with long-term COVID-19.

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