Need a long-term healthcare roadmap for Covid-19

By: |
August 29, 2020 6:30 AM

SARS-CoV-2 causes long-term damage to the body; a registry of recovered patients could help track for future healthcare needs

With the novelty of the pathogen and its effect on human physiology still to be completely unravelled, predicting the exact course and nature of the after-effects is difficult at this early stage.With the novelty of the pathogen and its effect on human physiology still to be completely unravelled, predicting the exact course and nature of the after-effects is difficult at this early stage.

Eight months into the Covid-19 pandemic, it looks likely that the toll on human health could be far greater than previously imagined. Long-term physiological damage from the virus to various organs and organ systems, manifesting after recovery, is now being reported in alarming numbers. As the number of recovered increase, there may be a surge in the number reporting anything between minor to debilitating after-effects of the infection. It has been clear for some time that Covid-19 is more than just a respiratory disease—as this paper has discussed before, the multiple sites of the attack reported by hospitals across the globe has experts concerned that the pathogen is capable of a multi-system onslaught on the body. With ACE2—the receptor protein that SARS-CoV-2’s spike protein fits like a key to a lock—common in many vital organs, this, some scientists have said, may not have been completely unexpected. Indeed, organoid studies—virologists using lab-generated organ-simulating tissues to study the virus’s systemic impact—show it is as capable of attacking the cholangiocytes of the liver (the site of bile production) as it is of attacking the epithelial lining of blood vessels. Now, an astonishing array of lingering effects are being reported—a clutch of studies talk about abnormalities of the cardiovascular and pulmonary systems, such as breathlessness, cardiac arrhythmia, hypercoagulation of blood & related embolisms, and hypertension, and survivor records from across countries feature brain fog (inability to remember/recollect and think) and other neurocognitive/neuropsychological effects. Apart from intermittent fever and continuing fatigue, recovered cases have also reported localised muscular pain, renal dysfunction and depression. Scientists are even studying the link between the virus and patients developing type-1 diabetes.

With the novelty of the pathogen and its effect on human physiology still to be completely unravelled, predicting the exact course and nature of the after-effects is difficult at this early stage. These need to be studied over time, with proper tracking and record-keeping. Indeed, AIIMS director Randeep Guleria, The Indian Express reports, had underscored the importance of long-term follow-up of patients to map the pathologies that follow the infection. While the Directorate General of Health Services is collecting data on after-effects from prominent hospitals across the country, the need is to establish a centralised patient registry so that recovery cases can be tracked and studied in the long-term—not just to formulate a strategy to deal with the possibility of a large chunk of the Covid-19 cases suffering from lingering debilitating conditions, but also to collaborate and coordinate with other nations to build a global knowledge bank. This paper has talked about how the SARS-CoV-2’s multi-front attack on the human body has made it difficult to treat—from anti-retrovirals and anti-malarials to cortico-steroids and monoclonal antibodies, may interventions have been tried, with varying reports of efficacy; this makes having an effective anti-SARS-CoV-2 drug or vaccine that much more important. Governments worldwide need to prepare for post-Covid health complications—in terms of what this will mean for the healthcare burden, as also the social support that needs to be put in place.

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