Opinion Express View: Mapping Long Covid

A research paper published by the Indian Council of Medical Research (ICMR) has revealed that 6.5 per cent of the patients who were hospitalised following a moderate or severe bout of Covid died the following year. This is significant because it is the first time that the country’s premier medical research agency has put a figure to mortality amongst people who couldn’t fully recover after contracting Covid. The WHO estimates that 10 to 20 per cent of Covid patients develop prolonged symptoms. The ICMR study is more conclusive — it reported that more than 17 per cent of patients who were hospitalised after September 2020 experienced “post-Covid” conditions. These conditions included fatigue, breathlessness, cognitive abnormalities and brain fog. The ICMR study shows that the risk of death in the year after discharge was greater among men, senior citizens and people with underlying health conditions.

The ICMR commenced its study before the WHO came out with details of post-Covid complications, also known as “Long Covid”. Unlike the Indian agency, which zeroed in on hospitalised patients, the premier global health body maintains that Long Covid can arise irrespective of the severity of the infection or the patient’s age. Symptoms can appear in patients who were previously healthy. The WHO’s conclusions are largely based on factsheets collected from its European wing. And the global health agency has, on more than one occasion, underlined the need to understand Long Covid in other parts of the world. It has also acknowledged that there are gaps in its understanding of post-Covid complications. Plugging them is not always an easy task because the virus affects multiple parts of the body and researchers and clinicians worldwide have identified numerous post-Covid symptoms — brain fog, for instance, does not manifest in only one way. Some experts, including in India, talk of cardiac involvement in Covid. But that is difficult to quantify as only a small section of Covid survivors undergo detailed evaluation. That said, Long Covid is now a topic of detailed research in several parts of the world. For instance, a study commissioned by the National Institutes of Health (NIH) in the US reported in May that Long Covid is more common and severe among people infected before Omicron became the dominant variant in 2021. Earlier this month, the NIH began a study to evaluate treatments for Long Covid symptoms such as brain fog and heart-related problems.

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The WHO suggests that governments and health services should undertake evidence-based interventions to come to terms with Long Covid. The ICMR study is a beginning for India. More detailed studies are required to understand the extent to which post-Covid complications have affected patients in India.