Post-Covid ailments may last for life: Dr Randeep Guleria, Pulmonology specialist and AIIMS Director

Pulmonology specialist and AIIMS Director Randeep Guleria is at the forefront of anti-Covid treatment in the country. He tells ET Magazine that reinfection is a reality now and a lot of research is being done to understand it. Edited excerpts of the interview:

More people have started complaining about post-Covid ailments and health issues. What is causing these issues?
Covid is a viral infection which we initially thought predominantly involves the lungs. But now we are also seeing a lot of extra pulmonary involvement of various other organs. The initial part of the pandemic was about saving lives. But now we are coming to a stage where the recovery rate is good and a lot of people are going home. In a lot of recovered patients, we are realising post-Covid sequelling and residual illness. This may last for weeks or months; sometimes the damage may be lifelong. Predominant symptoms based on various studies are fatigue, body ache, joint pain, dry persistent cough, which occurs in 50-60% of patients. Also, some are not able to concentrate.

Is it a cause of concern? Are there more severe health issues as well?
Such issues get resolved in about six weeks in most cases. We advise them to exercise, have a diet with green leafy vegetables and multivitamins. But there is a small percentage who have serious damage. We have seen post-Covid fibrosis, wherein if you have pneumonia in your lungs, it leads to scarring of the lungs and the lungs do not recover. The organ has limited capacity to extract oxygen from air and give it to the body. If they exert themselves, they get breathless and need oxygen. In one recovered patient in south India, his lung was so damaged that it had to be transplanted.

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Sometimes there is poor cardiac functioning, too. In a small percentage of people, strokes can occur. Neurological complications have also been reported in some.

Many hospitals have started post-Covid clinics and OPDs. We were doing post-Covid care through teleconsultations and OPDs of various departments. But now we are coming up with a facility where patients with multiple problems can be treated at one place.

India, like the rest of the world, has seen a few cases of reinfection. What are its causes and is it a cause of great concern?
A lot of discussion is going on. Things are not clear. Reinfection rate is miniscule but it needs to be looked into. We need to know if it is reinfection or residual infection. Is it caused by the weakening of immunity or is it something to do with the immune system or immune memory? Cases are just emerging and a lot of research is going on.

Are there any studies to show what is the average immunity period after infection?
Data is still emerging. Some argue that this may last for 6-9 months. I have a feeling it varies from person to person depending on the immune response of the body.

What are the chances of an asymptomatic person spreading the infection?
If you get reinfected and start shedding the virus, you can spread infection. If you are symptomatic, the virus can infect others when you cough or sneeze. It is important for those who have had the disease to take all the protections possible for that person’s own safety and for the protection of others.

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Have we been sequencing the genomes of those who have been reinfected?
A lot of centres are working on it. The National Institute of Virologist, Pune; Institute of Genomics & Integrated Biology, New Delhi, and a few others are sequencing the genomes. AIIMS is also setting up a project to do that. It will help in answering a lot of research questions.

When can we expect vaccines in India for mass deployment?
There are two parts to this: One is vaccine development. If everything works on time, we should hopefully have it by the end of this year or early next year. The second component is the doses. We may not have enough doses for a long while. We will have to strategise and prioritise as to who needs it more. Our population is so large that we will need crores and crores of dosage units. This may take time.



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