Unravelled effects of Covid – Attention sought

 

It is 5 years since Covid Pandemic started and 3.5 years since the third phase. This article is based on observation and validation based on outpatient interview of symptoms and signs identified during clinical examination.

According to this, total of 314 persons with history of Covid was identified out of which 210 were from general outpatient department and 104 were from Noncommunicable Disease clinic.

Various symptoms reported in isolation and combined, after 1 year of Covid occurence, were Upper respiratory symptoms, Lower respiratory symptoms, exacerbation of Asthma/ Chronic obstructive pulmonary diseases and non specific symptoms like intractable cough, new onset breathlessness, generalised myalgia, arthralgia, gastric symptoms, conjunctivits, headache, dermatitis, new onset chest pain, new onset hypertension and dyslipidemia, menstrual variations. Out of these, most frequently reported was upper respiratory symptom.

Recent observation and follow-up, shows that morbidities of Covid are present unidentified in many of the people who had Covid, contacts of Covid and who had a false negative Covid testing result. Above symptoms were validated and confirmed in most with laboratory results with high values, X- rays with image like interstitial lung disease, restrictive lung disease and cardiac enlargement. But, the persons are asymptomatic or have not noticed the symptoms unless probed into. The symptoms have changed into either new onset exercise intolerance or heaviness in the chest. Electrocardiographic changes like bradycardia, blunting of all the waves, and prominent QRS complex with longer positive R wave. There is also exaggeration of previous ECG changes like Diabetic, Myocardial infarction and Chronic obstructive pulmonary changes.

The above observations were actively made as a follow-up of the findings of 2022 observational findings. Many studies across the world, published in open source, peer reviewed research journals and magazines of scientific communities have concluded these findings in isolation. Many clinicians have made Covid infection as part of their history and examination of patients.

But, there is a need to clear the symptoms and ensure well being of those affected till the last phase and wave of Covid Pandemic along with prevention of occurence of new infection and it's spread. After, a phase it becomes one of the organisms of Influenza like illness and would not be in the mainstream for testing. Keeping a check on its incidence and prevalence, is important to prevent another outbreak and epidemic. Herd immunity, presumably will protect us from another outbreak. Endemicity should also be monitored as part of the epidemiologically pursuit. Being loose about the infection which panicked majority of the people in Country, with a death toll and morbidity on young people too, should be under surveillance to ensure a healthy future generation.

History of Covid or Covid like occurence in a patient should be part of history-taking.

In a primary health care setting, awareness on post Covid symptoms and resources for the mangement of post covid symptoms has to be strengthened. Severe Acute Respiratory Infections, Influenza like illnesses, Chronic obstructive pulmonary diseases should be screened every 6 months or 9 months for Covid antigen and sentinel surveillance till the development of adequate immunity to resist an infection is required. Active health monitoring and health care seeking should be encouraged from the citizens who had a history of Covid infection and those who do feel the need for health care and attention. 

In the same manner, postcovid management should be part of non communicable diseases management with assessment of pulmonary function and pulmonary rehabilitation. There should be monitoring for recurrence and a permanent solution like other obstructive and restrictive pulmonary diseases management should be provided.