

In this week’s column, the queries have been answered by Dr Govindrajan Padmanaban, President of India’s National Academy of Science and Former Director of Indian Institute of Science, Bangalore. Pandmanaban has addressed questions on COVID-19’s long term effect on human organs, the mutant strain of COVID-19, and side effects of the vaccines.

What kind of long-term effects can COVID-19 have on human organs? What should patients do to mitigate such effects?

It is difficult to predict the long-term changes at this stage, although the virus is capable of infecting all organs of the body since the cells carry the ACE2 receptor. Changes in lifestyle have to be a new normal, where better hygienic practices have to be adopted and propagated. In fact, our ancestors practised many elements of hygiene, which were lost due to modern lifestyles. We need to go back to our roots. The elements that need to be managed are Food, environment pollution, crowding, the pace of life, stress, lifestyle including sleeping schedule.

Can COVID-19 impact patients’ brains? Can it aggravate dementia or other brain disorders?

COVID-19 can infect many organs including the brain, although many get cured on their own in the milder states. In serious cases, such as after recovery from ICUs, there can be concerns about changes in memory etc. The practice of Yoga can help.

Is persistent hiccups a sign of COVID-19? The list of symptoms has been ever-growing ever since the pandemic began. Why is that the case?

Persistent hiccups are considered to be an atypical symptom and such patients should be watched for COVID. There are reports where eventual CT of the chest has revealed ground-glass opacities scattered throughout the lungs. Typical symptoms include cough, shortness of breath or difficulty in breathing, fever, myalgia and sore throat. Apart from lung cells, the virus can also infect almost all organs, since the ACE2 receptor is present in different types of cells. Therefore, any persistent atypical symptoms should also be watched.

Do the two vaccines which have been rolled out in India have any side effects?

Both the vaccines are considered to be safe and may lead to standard side effects, which are seen generally in any vaccination. India is reaching close to 70 lakh vaccinations. No particular emergencies or major side effects have been reported. There could always be rare cases of major side-effects and this happens with any vaccine administration. Companies provide a big list of side effects as a matter of routine and for protection.

How is the mutant strain of coronavirus different?

The strain that was detected originally in Wuhan, China is referred to as L strain. In February 2019, a mutation D 614 G, where D stands for aspartic acid and G for glycine, was recognized. This was the G strain and spread all over the globe. SARS-2 is an RNA virus and these keep on mutating. We do not recognize them because most mutations are benign. The UK mounted a massive effort by forming consortia to sequence 10 % of the patient isolates and sometime in November 2019 they analysed close to 150,000 sequences and detected a new mutant strain with almost 23 mutations, including deletions. Basically, the alphabets (AUGC in various permutations and combinations) in the RNA (total close to 30,000 bases) undergo changes. This UK strain seems to have spread all over the UK, and many other countries, although there is no clear data on whether it is more pathogenic, despite a concern that it may cause severe disease.

India seems to have imported the UK strain, maybe around 150 cases. There are two other variants of COVID-19: South African and Brazilian. The South African variant is proving to be worrisome, since the mRNA vaccine (Moderna), and Astra-Zeneca vaccine seem to be less effective in neutralizing the virus. The short answer is that it is an evolving situation and needs to be closely monitored.

Are osteoporosis patients more susceptible to COVID-19?

I would like to quote what John Kanis, Professor and IOF Honorary President, Director of the Centre for Metabolic Bone Diseases, University of Sheffield have said about this. Kanis said, “The drastic reduction in FRAX (Fracture Risk Assessment Tool) usage underscores widespread concern that the COVID-19 pandemic is having a detrimental impact on the medium to long-term management and outcomes for many NCDs (Non-communicable diseases) with serious repercussions for individuals who are not able to access timely testing and treatment, including for osteoporosis.”

Which vaccine do people prefer more?

I am not aware of any such preference. Covaxin is a vaccine based on the inactivated virus as such. Covishield is based on Spike protein, expressed using an adenovirus (chimp) platform. Their actual performance will be known only when the populations are vaccinated. At this stage, it is better to take either of the two vaccines. It is important to remember that a second booster dose is needed and should be the vaccine that was used for the first dose.

Can a patient who is 70-years-old and on Clopidrogel take the vaccine?

I am just quoting published statements that should clarify the above-mentioned query. Serum Institute of India and Bharat Biotech have approached the DCGI to make necessary changes in the vaccine factsheet to allow those on blood thinners to get inoculated against COVID-19.

Do you have questions about Coronavirus? Or the vaccines? Send us your questions: Tweet with #AskADoctor. Every week, we will have a public health expert to address your concerns through this column.