Why COVID-19’s long-term health effects are a cause for concern

The effects of the coronavirus on the human brain are ‘variable,’ according to one specialist, but can be dramatic. (AFP)
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Updated 11 August 2020
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Why COVID-19’s long-term health effects are a cause for concern

  • Survivors could face a number of ailments given the disease’s multi-organ effect on the human body
  • Latest strain of coronavirus has been described as an invisible enemy, slowly revealing new symptoms

DUBAI: What was first identified as another respiratory disease akin to the common flu has taken the lives of over 600,000 people around the world in just six months.

The latest strain of the coronavirus has been described as an invisible enemy, slowly revealing new symptoms as the global scientific community continues investigations into it.

Since the first outbreak of the coronavirus disease (COVID-19), traced to a wet market in Wuhan, China, in late 2019, the infection quickly developed into a full-fledged pandemic, with over 15 million cases reported to date. Symptoms have multiplied, leaving puzzled experts determined to find a cure.

Findings published this month appear to confirm growing concerns about the infection’s link to serious and potentially fatal brain disorders as well as cardiovascular complications.




Chief Scientific Officer Dr. Jeff Drew carries out research into the virus at the Stabilitech laboratory in the UK. (AFP)

“We’re seeing things in the way COVID-19 affects the brain that we haven’t seen before with other viruses,” said Michael Zandi, a consultant neurologist at the National Hospital for Neurology and Neurosurgery in London, after the publication of new research in the scientific journal Brain.

Common flu-like signs such as fever, dry cough and sore throat were the first set of symptoms reported at the start of the pandemic. However, the list rapidly expanded to include shortness of breath, loss of taste and smell, nausea and several more symptoms just months later.

Today, the biggest concern among health professionals is the virus’ insidious impact on the brain, with more than 300 studies of COVID-19 patients worldwide showing neurological abnormalities.

One study published in Brain involving 43 patients — 24 males and 19 females — confirmed a range of neurological complications in mildly affected and recovering patients.

Commenting on the new findings, Gregory Poland, an infectious diseases and vaccine expert at the Mayo Clinic in Rochester, Minnesota, said the virus’ impact on the brain is “variable” and can range from having no visible impact to causing “large vessel occlusions,” known more commonly as “very large strokes.”

With the virus refusing to discriminate based on age or color, severe cases have been reported among young and relatively healthy individuals as well as those with pre-existing conditions and the elderly.




Gregory Poland, an infectious diseases and vaccine expert at the Mayo Clinic in Rochester, Minnesota

“Obviously, the risk goes higher the more severe the disease; large vessel occlusions in young people have occurred with moderate to severe COVID-19 cases. But it can happen to people anywhere along that spectrum,” Poland told Arab News.

In the neurologic realm, the study’s findings showed that patients suffered from encephalopathy; stroke; inflammation of the central nervous system; peripheral nerve problems; cognitive and mental health issues, with delirium, psychosis and several cases of Guillain-Barre syndrome, an immune reaction that attacks the nerves and causes paralysis.




Dr. Taoufik Al-Saadi, chief medical officer and chair of the Neurology Department at the American Center of Psychiatry and Neurology in the UAE

Other symptoms included depression, anxiety and brain fog as well as a loss of smell, taste and sleep in mild and asymptomatic patients.

Another study, “Neurological associations of COVID-19,” published on the Lancet Neurology website, confirmed that a growing number of case reports and series from around the world described the same array of neurological manifestations, noting the virus is of a scale not seen since the 1918 influenza pandemic.

According to Poland, “health care systems are recognizing that there’s going to be a greatly enhanced need for rehabilitation and recovery centers after the COVID-19 pandemic” as a result of the latest outcomes.

His views are echoed by Dr. Taoufik Al-Saadi, chief medical officer and chair of the Neurology Department at the American Center of Psychiatry and Neurology in the UAE, who pointed out that although most individuals are inclined to experience a mild or asymptomatic disease course, some have required ventilatory support.

Data suggest that “one in five infected individuals are hospitalized, and one in 10 individuals are admitted to the intensive care unit (ICU), requiring ventilatory support, due to acute illness in response to this infection,” he said.

“The main issue in survivors of these cases is the physical, cognitive and mental impairment that may persist for several years beyond hospital discharge. Indeed, 80 percent of ICU survivors with confirmed COVID-19 may follow that course,” Al-Saadi told Arab News.

Cases of memory impairment, depression, anxiety, post-traumatic stress-like disorders have all been reported in up to 30 percent of these patients and may last up to several years following hospital discharge, said Al-Saadi.

“These complications would certainly affect survivors of this disease in all aspects of their everyday life whether functioning at work, home or in the social sphere,” he said.

Additionally, cognitive, physical and mental problems could result in chronic pain conditions, further causing sleep disorders, which could ultimately affect the overall quality of life. What frightens the scientific community even more is that the long-term impact of such neurological effects has not yet been determined.

However, the virus’ potential long-term health effects do not stop at causing damage to the brain. Scientists are increasingly recognizing the cardiovascular side effects of the virus, with reports of markers of cardiac injury even in young people.

According to Poland, cases of COVID-19 have resulted in inflammation of the heart (myocarditis), decreased heart-muscle function (cardiomyopathy), irregular heart rhythms (arrhythmias) and dilation of coronary and other blood vessels due to vascular inflammation as well as blood clots.

For patients with a prior history of cardiovascular disorders and increased risk factors, such as hypertension and diabetes, chances of heart complications significantly rise when infected with COVID-19.

The British Heart Foundation confirms these findings, noting that this strain of the virus has been found to increase the risk of blood clotting or thrombosis, leading to cardiovascular problems and, in some cases, organ failure.

The term “COVID toe” has also been coined in reference to painful red or purple swollen patches on the feet, usually the toes of infected patients, a condition known as Chilblains and typically associated with exposure to cold weather.

Some experts have linked COVID toe to blood clots and other neurological issues caused by the virus.

Examining the plethora of symptoms and conditions triggered by the virus, Poland believes experts must not yet discuss the long-term health effects of COVID-19 on patients as research is still in its infancy.

“What we can say is that early indicators of pulmonary fibrosis and scarring are irreversible. We have seen myocarditis and cardiomyopathy, some of which can improve, but we don’t know if they will completely improve,” he said.

Poland also referred to a group of patients he calls the “long-haulers” who have developed “almost a chronic fatigue-like symptom” accompanied by an assortment of symptoms as result of infection with the virus. For these patients, the virus’ impact is long-lasting.

Evidence of kidney and liver damage has also been reported in cases around the world, with no clear indication of the long-term consequences.

Similarly, the impact of COVID-19 on pregnant women and their unborn children is yet to be defined with certainty.

With science yet to answer so many questions, Poland’s prognostication is no more reassuring than the available findings on virus. “My guess,” he said, “is that young, healthy people will recover, and older people will have a more difficult time getting back to baseline, if at all.”

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Twitter: @jumana_khamis


Hindu-Muslim divisions sway voting in Indian district scarred by deadly riots

Updated 6 sec ago
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Hindu-Muslim divisions sway voting in Indian district scarred by deadly riots

  • Villages are largely self-segregated by religion in and around Muzaffarnagar in the most populous Uttar Pradesh state
  • Violent clashes broke out in 2013 after two Hindus stabbed Muslim youth to death, accusing him of harassing their sister

MUZAFFARNAGAR: Hindu-Muslim enmity made way for peace in an Indian district that saw deadly riots a decade ago but religious divisions still influence residents who voted on Friday in general elections in which Hindu nationalism is a key theme.

Villages are largely self-segregated by religion in and around Muzaffarnagar district, in the most populous northern state of Uttar Pradesh, but people say there is no longer tension between the majority Hindu and minority Muslim communities.

Violent clashes broke out here in 2013 after two Hindus stabbed a Muslim youth to death, accusing him of sexually harassing their sister. They were later beaten to death by a Muslim mob, which sparked riots that killed about 65 people, mostly Muslims, and displaced thousands.

Violence has not returned to the district known as the country's sugarcane-belt, but political divisions remain as Hindus typically vote for Prime Minister Narendra Modi's Bharatiya Janata Party (BJP) and Muslims for the opposition.

Modi's government has "controlled Muslims", said Ramesh Chand, a Hindu biscuit baker in Kairana city near Muzaffarnagar.

Critics accuse the nationalist BJP of targeting India's 200 million minority Muslims to please their hardline Hindu base - charges they deny.

Modi is widely expected to win a third term on the back of strong growth, welfare and his personal popularity despite some concern about unemployment, price rises and rural distress.

Chand said Modi had improved security in the region. "We can live in peace, whether or not we have jobs ... We can sleep with our doors open."

There were opposing views too.

In Jaula village, sugarcane farmer Mohammed Irfan, 50, said Modi's "high-handedness against Muslims" as well as unemployment and inflation were major reasons for him voting for the opposition Samajwadi Party.

Uttar Pradesh elects 80 lawmakers to the 543-member lower house of parliament, the most among all states, and a strong showing here is critical to the nationwide outcome.

Support for Modi was visible in Kutba Kutbi village, the epicentre of the 2013 riots.

Although there is "brotherhood" between the two communities now, nearly all Muslim families left the village after the riots, said Vinay Kumar Baliyan, 43, a farmer who said he supports Modi for promoting economic growth and raising India's stature globally.

But Irfan said Muslims are expected to vote in larger numbers this time as Eid celebrations this month brought many migrant workers and students home.


After Pakistan alert, WHO likely to issue wider warning on contaminated J&J cough syrup

Updated 19 April 2024
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After Pakistan alert, WHO likely to issue wider warning on contaminated J&J cough syrup

  • The UN health body said it puts out global medical product alerts to ‘encourage diligence’ by authorities
  • The WHO this week sent out alert on five batches of contaminated cough syrup ingredients found in Pakistan

LONDON: The World Health Organization is likely to issue a wider warning about contaminated Johnson and Johnson-made children’s cough syrup found in Nigeria last week, it said in an email.

Nigeria’s regulator recalled a batch of Benylin paediatric syrup last Wednesday, having found a high level of diethylene glycol in the product during routine testing.

The contaminant, alongside another closely related toxin, ethylene glycol, has been linked to the deaths of more than 300 children in Cameroon, Gambia, Indonesia and Uzbekistan since 2022, though there is no evidence that these incidents are linked with the latest recalls.

The UN health body said it puts out global medical product alerts to “encourage diligence” by national authorities and was likely to do so in this instance, “subject to confirmation of certain details from parties.”

The recalled batch of Benylin syrup was made by J&J in South Africa in May 2021, although Kenvue now owns the brand after a spin-off from J&J last year.

J&J has referred requests for comment to Kenvue. In an emailed statement on Friday, Kenvue said it had carried out tests on the batch recalled by Nigeria and had not detected either diethylene or ethylene glycol.

“We continue to work closely with health authorities and the WHO and are engaging with NAFDAC to understand their test results, including verifying the authenticity of the sampled product, the testing methodology used, and results reported by the agency,” the statement added.

Since Nigeria’s recall, five other African countries have also pulled the product from shelves — Kenya, Rwanda, Tanzania, Zimbabwe and South Africa, where the drug was made.

South Africa’s regulator has also recalled another batch of the syrup, which is used to treat coughs, hay fever and other allergic reactions in children.

Diethylene glycol is toxic to humans when consumed and can result in acute kidney failure, although there have been no reports of harm in the latest incident.

RAW MATERIALS

In the 2022 cases, the contamination in the syrups came from the raw materials used by manufacturers in India and Indonesia.

The WHO said it was collaborating with both the manufacturer and regulatory authority in South Africa to investigate the Benylin paediatric syrup, and had information on the source of the ingredients used. Kenvue has previously said it tested its ingredients before manufacture.

The agency said the possibility that the syrup was counterfeit was also “under consideration as part of investigations.”

Earlier this week the WHO sent out a separate alert on five batches of contaminated cough syrup ingredients found in Pakistan that appeared to have been falsely labelled as Dow Chemical products.

It was the first alert the WHO has sent on excipients — elements of a medicine other than the active pharmaceutical ingredient — rather than finished products, the agency confirmed on Friday.

The batches of propylene glycol were contaminated with ethylene glycol.

“It was critical for WHO to also alert manufacturers that may have been procuring this material to exercise more caution,” a WHO spokesperson said by email.

Propylene glycol is not an ingredient in Benylin paediatric syrup, a Kenvue spokesperson said on Friday.


Polish flag carrier LOT cancels Friday flights to Tel Aviv and Beirut, PAP reports

Updated 19 April 2024
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Polish flag carrier LOT cancels Friday flights to Tel Aviv and Beirut, PAP reports

  • Decisions about future flights would be made on an ongoing basis

WARSAW: Polish national airline LOT canceled flights on Friday to Tel Aviv and Beirut due to the unstable situation in the region, a spokesperson was quoted as saying by state news agency PAP.
“Today’s flight 151/152 to Israel from Warsaw and to Beirut 143/144 have been canceled,” Krzysztof Moczulski told PAP. He said decisions about future flights would be made on an ongoing basis.


French police arrest man who threatened to blow himself up at Iran’s Paris consulate

Updated 19 April 2024
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French police arrest man who threatened to blow himself up at Iran’s Paris consulate

  • Police verifying man’s identity and trying to determine whether he had weapons

PARIS: A man who had threatened to blow himself up at Iran’s consulate in Paris was arrested by police, a police source said.

French police earlier cordoned off the Iranian consulate, Reuters reporters saw, and did not immediately confirm finding any weapons.

A police source told Reuters the man was seen at about 11 am (0900 GMT) entering the consulate, carrying what appeared to be a grenade and explosive vest.

A Paris police official told The Associated Press that officers were verifying the man’s identity and trying to determine whether he had weapons.

Police earlier said they were at the scene and asked the public to avoid the area but provided no further details.

Service was interrupted on a nearby metro line for security reasons, the RATP metro company said.

A police cordon remained in place on Friday afternoon, but traffic was resuming in the area.

A person at the Iranian embassy who responded to a call from Reuters declined to provide any information on the situation.

It was unclear whether the incident had any link to the escalating tensions between Iran and Israel.

Earlier on Friday, explosions echoed over the Iranian city of Isfahan in what sources described as an Israeli attack, but Tehran played down the incident and indicated it had no plans for retaliation — a response that appeared gauged toward averting region-wide war.

The incident also comes as Paris is gearing up to host the summer Olympics.

* With Reuters and AP


Blinken says US ‘not involved in any offensive operation’

Updated 19 April 2024
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Blinken says US ‘not involved in any offensive operation’

  • ‘All I can say is for our part and for all the members of the G7 our focus is on de-escalation’

CAPRI, Italy: US Secretary of State Antony Blinken on Friday refused to comment on reports of an attack by Israel on Iran, beyond saying Washington was “not involved in any offensive operation.”

Speaking to journalists after a meeting with G7 counterparts in Italy, he declined to answer repeated questions about explosions in Iran, and reports that Israel had carried out retaliatory strikes.

“I’m not going to speak to these reported events... All I can say is for our part and for all the members of the G7 our focus is on de-escalation,” Blinken told a press conference on the island of Capri.

“The US has not been involved in any offensive operation,” he said.

Speaking to reporters earlier, G7 host Antonio Tajani, the foreign minister of Italy, said Washington had been informed in advance of the strikes, without giving details.

“The United States were informed at the last moment,” he said, adding that “it was just information” passed on — without saying who by.

The reports dominated the G7 Friday, with Tajani forced to change the agenda, but little public information emerged.

In its final statement, the Group of Seven ministers said: “In light of reports of strikes on April 19th, we urge all parties to work to prevent further escalation. The G7 will continue to work to this end.”

Israel had warned it would hit back after Iran fired hundreds of missiles and drones at Israel almost a week ago, in retaliation for a deadly strike — which Tehran blamed on its foe — that levelled Iran’s consular annex at its embassy in Syria.