The new onset of metabolic syndromes with a multiorgan involvement is seen as Post Acute Sequelae of Covid-19 (PASC) and is an emerging global health crisis, said Prof Dr A S Narain Naidu, scientist, director-general of Mission Covid, US based Global Nutrition Healthcare Council, who has been researching on Long Covid.
While Covid may have gone, the lingering effects of the pandemic are still seen in the form of Long Covid cases reported in several countries. Researchers across the world are working on the remnants of the pandemic still affecting the quality of life for many, and Dr Naidu’s team has been working on developing precision biomarkers and interventions to combat Long Covid.
Dr Naidu was delivering the keynote address on ‘Long Covid and its Human Metabolic Reprogram/Dysregulation (HMR/D) with Neurocognitive implications’ at the Mind Matters 2023 summit organized by Happiest Health on December 9. Governments across the globe came up with strategies to combat Covid infections, but the need of the hour is to take account of various aspects of Long Covid which is real, he said.
Long Covid and its effects
Covid was an infection that lasted in a person for 28 days. After it is gone, the metabolic reprogram or HMR/D that it has inflicted to our body can continue for generations throughout our lives, Dr Naidu said, shedding light on the Human Metabolic Reprogram/Dysregulation (HMR/D), a new-phenomenon associated with Long Covid. He terms this as ‘virus-free clinical condition, a ‘new onset’ chronic metabolic syndrome.’
Speaking about the ways with which SARS-CoV2 has changed the human metabolism, Dr Naidu said that the virus knows how to interfere with our immune system. “The virus enters in a sequential order and gets integrated into the host DNA. In the initial phase of the viral infection, the binding mechanism of SARS-Cov2 to ACE-2 receptors on host cells reduces blood pressure, lung function and lowers oxygen availability, which causes hypoxia (low oxygen content in the blood),” he said.
ACE-2 is a human protein receptor that plays a crucial role in binding of the SARS-CoV-2 virus on the host cell. Hypoxia affects oxidative phosphorylation in mitochondria and alters host energy metabolism. “This hypoxia-induced clinical condition is triggered by an iron-regulated ‘HMR/D. HMR/D affects the body’s energy requirements for immune defense, aggravates inflammatory responses and causes tissue damage,” he said.
Elaborating on the HMR/D, Dr Naidu said that human metabolism has been reprogrammed at about 4793 sites and the number may increase. “Evolution is an ongoing continuous process. Nature has its own mechanisms to program and reprogram life,” he said, hinting that the pandemic was another catalyst in accelerating human metabolic reprogramming.
How SARS-CoV2 hijacked humans?
Dr Naidu explains that several routes of viral transmission in the human body have been identified. – Aerosol or droplet inhalation is the most common mode of viral spread. “While the focus was on wearing masks, the virus has also entered through the eyes,” he said.
Dr Naidu lists out the following new, persistent, or recurring symptoms associated with different organs, leading to multi organ dysfunction:
Neuro-cognitive: Brain fog, headache, post-traumatic stress disorder, sleep disorders, insomnia, anxiety, depression
Respiratory: Pulmonary fibrosis, cough, shortness of breath, hypoxia (low oxygen content in the blood)
Cardiovascular: Irregular heart rhythm (arrythmia), palpitations, inflammation of the heart muscles (myocarditis), heart failure, chest pain, and tightness
Gastrointestinal: Diarrhea, irritable bowel syndrome (IBS), nausea, acid reflux, loss of appetite, abdominal pain
Reproductive: Testis injury, inflammation of the testicles (orchitis), infertility, no sperm in the semen (azoospermia), menstrual/pregnancy issues
Skeleto-muscular: Fatigue, myalgia, joint pain, weight loss, loss of muscle mass (sarcopenia), Guillain-Barre syndrome (an autoimmune disorder that affects the nerves)
Sensory/ENT: Loss of smell (anosmia), loss of taste (ageusia), ringing in ear (tinnitus), ear ache, sore throat
Endocrine: ‘New onset’ diabetes, subacute thyroiditis (immune reaction of the thyroid gland following an upper respiratory infection), hypopituitarism (when pituitary gland doesn’t make enough hormones)
Hematological: Blood clots, deep vein thrombosis (blood clots in deeper veins in the body, usually in the legs), pulmonary embolism (blood clot in the lungs)
Hepato-Biliary: Acute liver injury, altered liver function
Excretory/renal: Acute kidney injury (AKI), high level of protein in the urine (proteinuria), glomerulopathy (disease affecting the glomeruli of the kidney cells, leading kidney malfunction)
Integumentary/skin: Hair loss, dermatitis, tingling fingertips
The pandemic has also led to several puzzling questions which need to be researched further to understand the effects of the SARS-CoV2 more in depth, he said.
Dr Naidu explains with examples. “We observed that despite the huge spread across the globe, the virus didn’t affect individuals with Thalassemia. Over 52 % of the total infected persons were asymptomatic. There were several miscarriages, sudden loss of pregnancy. The infection was not seen among the newborns,” Dr Naidu said.
He stressed on the need to come up with strategies to combat Long Covid by first acknowledging the sufferings of those who are enduring the aftermath of COVID-19, ensuring treatment protocols and maintaining a registry that can accurately capture the Long Covid burden globally.
Takeaways
While Covid may have gone, the reflections of the pandemic are still seen in the form of Long Covid, with multiorgan dysfunction through Post-Acute Sequelae of Covid-19 (PASC). Dr Narain Naidu, microbiologist and scientist who started the Mission Covid, in the US has been working on developing precision biomarkers and interventions to combat Long Covid. Some of the Long Covid symptoms that have been affecting the quality of life for many Covid survivors include fatigue, headache, brain fog, hair loss, dyspnea or short of breath, stomach pain, and irritable bowel syndrome, as well as both male and female reproductive/fertility issues.
