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Coronavirus

Extreme fatigue persists even post-COVID-19 recovery

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With COVID-19, evidence is mounting that some people who have had relatively mild symptoms at home may also have a prolonged illness. It is estimated that nearly 75% of patients complain of prolonged signs and symptoms for weeks or months after making a full recovery (testing COVID negative).5 Long haulers, as they are being called, can experience mild to severe symptoms. Support groups on social networking sites have a lot of long-haulers, comprising COVID-19 survivors, who talk about and discuss the struggle to get out of bed, or to work for more than a few minutes or hours at a time, making this a real problem with COVID-19 survivors.

Overwhelming fatigue, palpitations, muscle aches, pins and needles and many more symptoms are being reported as after-effects of the virus. Over the past nine months, an increasing number of people have reported crippling exhaustion and malaise after having the virus.1 Professor Paul Garner2, of The Infectious Diseases Division at Liverpool School of Tropical Medicine, described his experience of COVID-19 as a roller coaster of ill health, extreme emotions, and utter exhaustion. A recent study published in Journal of American Medical Association found that in patients who had recovered from COVID-19, 87.4% reported persistence of at least 1 symptom, particularly fatigue and dyspnea.3 Post-viral fatigue was also seen in a quarter of those infected with the original severe acute respiratory syndrome (SARS) virus in Hong Kong in 20034 which makes it important to understand the post-COVID-19 fatigue. Evidence from previous coronavirus outbreaks, especially the SARS epidemic, suggests that these effects can last for years.1

A study3 from Rome with people post-COVID-19 recovery found that 53% had reported fatigue and 43% had shortness of breath an average of 2 months after their symptoms started. Similarly, a report6 from China showed that 25% had abnormal lung function after 3 months, and that 16% were still fatigued.

Speaking on the subject, eminent clinician and Past President of the Indian Medical Association, Dr. KK Aggarwal mentioned that while cytokine fatigue occurs in the first 9 days and continues up to 28 days, fatigue from COVID-19 is being seen to last for up to 3 months leading to signs of Chronic Fatigue Syndrome, which is a severely debilitating condition. He further added that this could start with the first signs and symptoms of COVID-19 or right after the patient recovers and could be due to prolonged exacerbation of symptoms after physical, cognitive or orthostatic exertion or stress e.g. unrefreshing sleep after sleeping for many hours. calculations, reasoning short memory, spatial disorientation are also some of the signs. Worsening of symptoms after maintaining an upright posture can also be seen in these patients. Details can be accessed on https://www.facebook.com/watch/?v=898525210554041 When it comes to treating chronic fatigue, the emphasis previously has been on effective treatment of the underlying disease, with the understanding that tackling the root cause would help ease the fatigue. However, for most viral infections, there is no specific treatment, and because COVID-19 is so new, research is still underway in its prevention and treatment.

Source:

1.Nature 2020;585, 339-41.
2.https://blogs.bmj.com/bmj/2020/05/05/paul-garner-people-who-have-a-more-protracted-illness-need-3.help-to-understand-and-cope-with-the-constantly-shifting-bizarre-symptoms/
4.JAMA. 2020;324(6):603-05.
5.Arch Intern Med. 2009;169(22):2142-2147.
6.https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/coronavirus-symptoms-why-7.breathlessness-and-fatigue-are-two-most-post-covid-common-symptoms/photostory/78632446.cms
8.EClinicalMedicine 2020;25, 100463.

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Coronavirus

As soon as you get vaccinated, you can get right back to normal life

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We at Health Patrol have been flooded with queries about how soon people can go back to their pre-COVID pandemic life after getting the vaccine. Two doses of vaccine, 28 days apart, are needed. This needs to be taken by all to complete the vaccination schedule. Protective levels of antibodies will generally develop two weeks after receiving the second dose of Covid-19 vaccine. While the news is encouraging and Indian vaccination schedule has begun on 16th January 2021, experts still believe the pre-COVID times will take time to resume.

As we covered recently,a report1 published in the New York Times carried information stating the new vaccines will probably prevent you from getting sick with COVID-19, butno one knows yet whether they will keep you from spreading the virus to others so until that information is clear, it is pertinent to maintain the same social distancing, hand hygiene and mask measures, that we have been following since the pandemic, because some vaccinated people could get infected without developing symptoms, and could then silently transmit the virus — especially if they come in close contact with others or stop wearing masks.

Another report2 published in the Business Insider also emphasizes that avaccine is the first step to helping us return to pre-COVID normality, but it is still not the end-all. Experts have projected that aspects of pre-COVID life will begin to resume in spring 2021 and inch closer to the old normal by the year’s end.

If vaccinated people are silent spreaders of the virus, they may keep it circulating in their communities, putting unvaccinated people at risk.Experts are not yet sure how long the vaccine will be effective, and at this time the recommendation is to get both doses and then continue to wear a mask and practice social distancing and good hygiene.Moreover, trials that have been conducted on and around the vaccines have shown that the vaccine could prevent people from becoming sick, but whether people who have been vaccinated can still transmit the virus, is still not researched in detail.

Which is why eminent cardiologist and Padma Shree Awardee, Dr. KK Aggarwal emphasizes in each of his weekly shows that we need to continue with the social distancing and hygiene measures that we have been carrying out since the beginning of 2020. The Ministry of Health & Family Welfare also states that after receiving the COVID-19 vaccine, we must continue to take all precautions like use of face cover or masks, hand sanitization and ‘do gajkidoori’ – physical distancing of at least 6 feet.3

Health Patrol carried out an extensive report on wearing masks even after the vaccination. Access the report on https://healthpatrol.in/2021/01/13/do-i-still-need-to-wear-a-mask-after-the-vaccine/

Source

1 https://www.nytimes.com/2020/12/08/health/covid-vaccine-mask.html
2 https://www.businessinsider.in/science/news/what-you-can-and-cant-do-after-getting-the-coronavirus-vaccine/articleshow/79652928.cms
3 https://www.mohfw.gov.in/pdf/FrequentlyAskedQuestionsonCOVID19vaccineFLWEnglish.pdf

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Coronavirus

COVID vaccines will make you sick

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No. None of the authorized and recommended COVID-19 vaccines or COVID-19 vaccines currently in development in India contain the live virus that causes COVID-19. This means that a COVID-19 vaccine cannot make you sick with COVID-19. There are numerous COVID vaccines in development and each of them teach our immune systems how to recognize and fight the virus that causes COVID-19. Sometimes this process can cause symptoms, such as fever, but these are symptoms that are expected and are a sign that the body is building protection against the virus that causes COVID-19.

It typically takes a few weeks for the body to build immunity (protection against the virus that causes COVID-19) after vaccination. That means it is possible a person could be infected with the virus that causes COVID-19 just before or just after vaccination and still get sick. This is because the vaccine has not had enough time to provide protection.

The COVID-19 vaccination will help keep you from getting COVID-19 and efficacy results have been very promising for each of the approved and authorized vaccines thus far. Based on the current knowledge about the vaccines for other diseases and early data from clinical trials, experts believe that getting a COVID-19 vaccine may also help keep you from getting seriously ill even if you do get COVID-19.

Getting vaccinated yourself may protect people around you, particularly people at increased risk for severe illness from COVID-19, like patients with comorbid conditions, pregnant women, elderly and other at-risk population.

COVID-19 vaccination is a safer way to help build protection, that is much needed now since COVID-19 can have serious, life-threatening complications, and there is no way to know how COVID-19 will affect you. And if you get sick, you could spread the disease to friends, family, and others around you. Getting COVID-19 may offer some natural protection, known as immunity. Current evidence suggests that reinfection with the virus that causes COVID-19 is rare within the 90 days after initial infection.

However, experts don’t know for sure how long this protection lasts, and the risk of severe illness and death from COVID-19 far outweighs any benefits of natural immunity. COVID-19 vaccination will help protect you by creating an antibody (immune system) response without having to experience sickness.

COVID-19 vaccination is a crucial tool to assist stopping the pandemic. Wearing masks and social distancing help reduce your chances of being exposed to the virus or spreading it to others, but these measures are not enough. Vaccines will work along with your system to better fight the virus if you do get exposed. The combined effort of getting vaccinated and continuing to follow the social distancing and hygiene measures offer the most effective protection from COVID-19.

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Coronavirus

If I have already had COVID-19 and recovered, do I still need to get vaccinated with a COVID-19 vaccine?

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Health Patrol has carried out numerous reports on the possibility of reinfection and severe health risks associated with COVID-19.1Due to these health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, you should take the vaccine irrespective of whether you already had COVID-19 infection.

At this time, experts do not know how long someone is protected from getting sick again after recovering from COVID-19—which is also because the immunity someone gains from having an infection, called natural immunity, varies from person to person. Some early evidence suggests natural immunity may not last very long. As the system learns to fight back the infection, it develops COVID antibodies. Right now, from what studies have shown, it has been suggested that antibodies may last anywhere between 3-6 months for a person, after which they can start to wane. Asymptomatic persons and those with milder cases of infection are thought to have lower immunity than others.

A recently discussed publication in this regard has been the one by Harvey et al. that concluded that antibody positivity to SARS-CoV-2 is associated with a decreased risk of future infection. The study, currently unpublished, states that using real-world data from more than 3 million people, National Cancer Institute researchers have found that people who have had evidence of a prior infection with the deadly Coronavirus, appear to have some degree of protection against being reinfected with the virus.2

Another recent study3 published on January 06, 2021 in the journal Science, reports COVID-19 patients who recovered from the disease still have robust immunity from the coronavirus up to eight months after infection. The result is an encouraging sign that the study authors interpret to mean immunity to the virus probably lasts for many years, and it should alleviate fears that the COVID-19 vaccine would require repeated booster shots to protect against the disease and finally get the pandemic under control.

We still do not know how long immunity produced by vaccination lasts until we have more data on how well the vaccines work. Both natural immunity and vaccine-induced immunity are important aspects of COVID-19 that experts are trying to learn more about, and we at Health Patrol will keep you updated, as new evidence becomes available.

Source

1 https://healthpatrol.in/2020/10/22/is-there-a-possibility-of-reinfection-in-covid-patients/
2 Harvey RA, Rassen JA, Kabelac CA, et al. doi: https://doi.org/10.1101/2020.12.18.20248336
3 Dan JM, Mateus J, Kato Y, et al. Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science 06 Jan 2021: eabf4063. DOI: 10.1126/science.abf4063

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Coronavirus

Vaccine is safe for women desirous of getting pregnant

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Earlier this week, Health Patrol published a report on vaccines being safe for pregnant women.1 Since then, we have received a few queries from women in their reproductive age desirous of getting pregnant and whether they should get the vaccine once it is available for them. The answer is YES.

However, it is pertinent to be aware of the usual body responses to the COVID-19 vaccine. Studies have shown that COVID-19 vaccination can cause fever in some patients (up to 16% of those vaccinated and mostly after the second dose); however, the study further reiterates that this risk should not be a concern when deciding whether to vaccinate a patient desiring pregnancy. Additionally, the most common symptom of COVID-19 infection itself is fever (83-99% of affected patients). Patients who experience fever following vaccination should take an antipyretic medication, such as acetaminophen pr paracetamol.2

According to the December 2020 Update3 from the American Society for Reproductive Medicine (ASRM) Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic, patients who conceive in the window between the first and second dose of the vaccine should be offered the second dose of the vaccine at the appropriate interval.

The CDC4 has also added to this information saying that, “Routine testing for pregnancy before COVID-19 vaccination is not recommended. Women who are trying to become pregnant do not need to avoid pregnancy after receiving an mRNA COVID-19 vaccine.”

Source

1 https://healthpatrol.in/2021/01/11/covid-vaccines-are-safe-for-pregnant-women/
2 Polack FP, et al. Safety and Efficacy of the BNT162b2 mRNA COVID-19 Vaccine. New Engl J Med. Dec. 10, 2020 (DOI: 10.1056/NEJMoa2034577).
3 Update 11. December 16, 2020. https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/covid-19/covidtaskforceupdate11.pdf
4 https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html#:~:text=Routine%20testing%20and%20pregnancy,an%20mRNA%20COVID%2D19%20vaccine.

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Coronavirus

Surgical masks can be reused

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Most face masks available for public use, especially the surgical ones, are disposable and are for one-time use only. Ideally, face masks should not be used once they are soiled, or the inner lining gets moist. This is also important to note because masks can rarely be sterilized to a permissible extent. If you want to reuse fabric masks or surgical masks that are triple layered, it should be kept dry so that it can last long. Therefore, one way of ensuring this could be to properly wash it, disinfect it, dry it and only then reuse it.

Another important aspect of masks reuse is that they should never be drawn down to your chin, as is commonly seen in people either eating out, or driving or talking on the phone. Because they believe the mask is a hinderance for talking or eating, they draw the mask down and keep it on the chin, which is worse, because this would then let the germs on the face or chin be stuck to the mask and when you put the mask back on, the germs enter your nose and mouth.

In a recent session, eminent cardiologist and Padma Shree Awardee, Dr. KK Aggarwal spoke on the issue of reusing masks and that it is incorrect to remove the mask and keep in the pocket, as was seen in a news clipping of Donald Trump, the President of USA. For further details on this, please check the link here: https://fb.watch/2SBvyni1fx/

Health Patrol has covered masks usage in other news stories in further detail, which can be accessed on https://healthpatrol.in/?s=mask

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