Doctors Baffled As COVID Long-Haulers' Symptoms Go On And On, Antibiotics Worsen Crisis

One of the largest studies of Covid-19 ¡°long haulers¡± has proved what many doctors suspected: Not only are many patients suffering a raft of health problems six months after infection, they¡¯re also at significantly greater risk of never recovering.

A year on, symptoms linger on

One such case is of Tasha Clark who tested positive for COVID-19 on April 8, 2020. The Connecticut woman, now 41, was relieved that her symptoms at the time -- diarrhea, sore throat and body aches -- didn¡¯t seem particularly severe. She never got a fever and wasn¡¯t hospitalized. So she figured that if the virus didn¡¯t kill her, within weeks she¡¯d go back to her job and caring for her two children. She significantly miscmiscalculated. More than a year later, she¡¯s a textbook example of a Covid long-hauler.

AFP

Today, Clark suffers from an array of disabling symptoms including blowtorch-like nerve pain and loss of sensation in her arms and legs, spine inflammation that makes it difficult to sit up straight, brain fog, dizziness and a soaring heart rate when she stands. She takes steroids and nine other prescription medicines, and says, "I never in a million years thought that a year later my life would be reduced to what it has been."

Clark who lives with her husband and two school going daughters added, "Not knowing if I will ever recover is scary."

CDC to finalise new guidelines for long-haul COVID

On 22nd April, 2021, a research in the journal Nature reported that survivors had a 59% increased risk of dying within six months after contracting the SARS-CoV-2 virus. The excess mortality translates into about 8 extra deaths per 1,000 patients -- worsening the pandemic¡¯s hidden toll amid growing recognition that many patients require readmission, and some die, weeks after the viral infection abates.

Reuters

Following which on April 28, the CDC said new guidelines are being finalised for doctors on long-haul COVID-19. The guidelines, which were developed in collaboration with newly established long-haul COVID-19 clinics and with patient advocacy groups, it had said will ¡°illustrate how to diagnose and begin to pull together what we know about management,¡± of the complex condition, said John Brooks, MD, a medical epidemiologist in the CDC¡¯s Division of HIV/AIDS Prevention.

Meanwhile, excessive use of the world¡¯s most potent antibiotics has stoked drug-resistant infections in India for years. Now the country¡¯s Covid crisis has put the calamity into hyperdrive. A first look at how many patients hospitalized during India¡¯s first coronavirus wave also developed bacterial and fungal infections found that a small but alarming proportion harbor germs that resist multiple drugs.

PTI

Antibiotics adding to the crisis

Doctors battling to save lives amid a dearth of effective treatments are turning to the medicines they have on hand -- often antibiotics that aren¡¯t used in other countries for Covid-19. What¡¯s more, the chaos of overrun hospitals means staff can¡¯t always take precautions to ensure infections don¡¯t spread from one patient to the next.

The use of antibiotics -- especially some that the World Health Organization (WHO) recommends reserving for the most difficult-to-treat cases -- may be ¡°adding fuel to the fire of the already alarming antimicrobial resistance levels,¡± Kamini Walia, a microbiologist with the Indian Council of Medical Research (ICMR), and colleagues said in a study. ¡°Fear of missing a secondary infection and lack of specific therapy for Covid-19 leads to over-prescription of antibiotics," Walia said.

AP

¡°The culture of over-medicating through antibiotics predates the pandemic,¡± Walia said. She noted a tendency for doctors to prescribe intensive-care patients three or four antibiotics while they wait for lab results that would indicate if the medications are needed.

It¡¯s often done ¡°to plug the gaps¡± in infection control and prevention, she said. ¡°Antimicrobials are a shield,¡± Walia said. ¡°And as long as the patient is feeling better, doctors don¡¯t want to de-escalate the antibiotic regimen. And the price for that comes three to six months down the line.¡±