“A negative swab test for COVID-19 is not necessarily a signal of well-being”

December 5, 2020 0 By S Harachand

Dr Aashish Contractor is currently the Director of Rehabilitation and Sports Medicine at the Sir HN Reliance Foundation Hospital, Mumbai. He is also the Vice-Chair of the ICCPR- International Council of Cardiovascular Prevention and Rehabilitation, consisting of 40 countries.

In an interaction with FM, Dr Aashish says that the varied, long-lasting symptoms which COVID-19 survivors are suffering from are yet to be defined and documented and we need to be forever alert when dealing with this virus.

Edited excerpts:

There is growing recognition that some COVID-19 symptoms can last for weeks and months post-recovery. How are these symptoms of ‘chronic COVID’ or ‘long COVID’ clinically defined?

A negative swab test is an important landmark for the vast majority, suggesting they got over the infection. However, in many patients, that is not necessarily a signal of well-being, as some symptoms and lassitude often remain for much longer. A recent study, known as the COVID Symptom Study looking at more than 4 million people in the US, UK and Sweden after a COVID-19 diagnosis, defined post-acute COVID-19 as the presence of symptoms lasting more than 3 weeks from the initial onset of symptoms and chronic COVID-19 as extending beyond 12 weeks. These cases have colloquially been labelled as ‘long-COVID’. The long-term effects tend to occur in four main body systems: pulmonary, cardiac, neurologic and mental health.

One of the possible long term consequences of COVID-19 is pulmonary fibrosis. Symptoms of breathlessness may persist, with diminished respiratory muscle strength and abnormalities in lung function tests.

Myocarditis is a common condition affecting people who have recovered from COVID-19. Studies show that myocarditis is seen even in those patients who had mild or no symptoms.

Neurological manifestations such as memory problems often labelled as ‘brain fog’ are frequently seen in people recovered from COVID-19. Loss of smell, accompanied by loss of taste, often lasts for several months. Stroke and seizures are rare but do occur. Infection with SARS-CoV-2 tends to act as a precipitating factor for strokes in those who are already at high risk for it.

This illness has taken a huge toll on mental health across the world. Besides the physical burden of the disease, stigma and social isolation has led to a large number of survivors grappling with issues such as anxiety and depression.

Mortality from SARS-CoV-2 infection is comparatively low in India. How common is post-COVID illness in the country?

I don’t think that ‘post-COVID’ illness is documented and statistically compiled.

Are ‘long COVID’ symptoms reported in India similar to those found in the US or Europe? In what ways do they vary?

To be honest, these are early days yet, and there have not been many published studies on the topic. Anecdotally, they seem to be similar.

There is a view that the mental health problems associated with COVID-19 are not getting due attention. Your comments?

Overall, healthcare is delivered at many levels across the country, starting from primary to specialised care. Mental health certainly needs a lot more attention, but there are individual hospitals and caregivers who are putting great emphasis on mental health care.