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Heart Problems in Long COVID #WorldHeartDay #UseHeart

By on 36

Today is 29th September, World Heart Day, I am writing about the cardiac issues of Long COVID.

COVID 19 is like a bad nightmare. Rather like a mass nightmare. It’s like a series of problems, not just one. I talked about how long does Long COVID lasts and potential kidney disorders in a previous post.

With more data being available about the nature of COVID, it’s not surprising that the tail end risk of an asymptomatic COVID 19 infection is also significant. Since the COVID 19 pandemic started and data was collected about acute, chronic symptoms of this, doctors all over the world are even more sure that prevention is still your best friend.

So who can have long COVID?

  • The risk of long COVID is two times higher in women compared to men.
  • Increasing age (50 -69 years most common).
  • The presence of more than 5 symptoms in the acute infection is associated with an increased risk of developing long COVID.
  • Associated Comorbidities increase the risk of Long COVID.
  • Asymptomatic and mildly symptomatic people also may develop long COVID.

What are the Symptoms of Long COVID?

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In people with “Long COVID,” one or more symptoms may be present even after 12 weeks.

  • Extreme fatigue,headache, joint pain, myalgia and weakness, insomnia, pins and needles
  • Breathlessness, cough, hoarseness,vocal fatigue,chest pain, palpitations.
  • Diarrhea, rash or hair loss,
  • Neurocognitive problems like memory issues, concentration problems, and worsened quality of life.
  • Impaired balance, gait.

5 Most common Long COVID symptoms are

Fatigue, headache, dyspnea, hoarse voice, and myalgia.

Long COVID is now classified into 3 different categories depending on the most troublesome and persistent symptoms.They are:

  • Post COVID cardio-respiratory syndrome
  • Post-COVID fatigue syndrome
  • Post COVID neuro-psychiatric syndrome.


Common Cardiac symptoms in Patients with suspected long COVID are:

  • Labile heart rate and blood pressure responses
  • Myocarditis
  • Pericarditis
  • Myocardial fibrosis,
  • Myocardial infarction,
  • Cardiac failure,
  • Arrhythmias,
  • Sudden cardiac death.
  • Coronary artery aneurysm, aortic aneurysm, accelerated atherosclerosis, venous and arterial thromboembolic disease, including life-threatening pulmonary embolism, can also occur.The problems may appear singly or together.


The tests required will depend on symptoms and signs but can include:

  • Serial clinical monitoring of Blood pressure and pulse
  • Electrocardiogram
  • Echocardiogram
  • Cardiac MRI
  • HRCT Chest for suspected respiratory pathology
  • Pulmonary function test

Wear a mask, get vaccinated, and stay healthy.

FIGHTING COVID 19:8 Steps
FIGHTING COVID 19:8 Steps
India is fighting COVID 19 with all its resources.As a citizen these 8 steps will help you stay safe
By Dr.Amrita Basu(MBBS,MS)
View all stories

Writing this for My Friend Alexa with Blogchatter

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056514/
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/articles/technicalarticleupdatedestimatesoftheprevalenceofpostacutesymptomsamongpeoplewithcoronaviruscovid19intheuk/26april2020to1august2021?s=03

COVISELF:Rapid Antigen Test for Home

By on 5

With ICMR approved Home testing kit Coviself , testing for COVID 19 will become easier. That’s our hope. This kit isdesigned and produced by Mylab a Pune based company. The kit will help you test yourself and your loved ones without needing to visit a hospital or testing center.

With the vaccine, medicines, and testing we can fight this COVID 19 and win.

What exactly is the test.

Test for COVID19 protein antigen in nasal swab samples of symptomatic and asymptotic people.

Who can do the test?

Any adult who is able to follow instructions provided.

Do you need a doctor?

No. You can self-test if you are an adult. For kids greater than two years, parents can perform the test

Do you need a prescription to buy the self-testing kit?

This is not yet clear.But the guidelines have warned against misuse.

How to know whether the test is positive?

Two lines like in a preg color test

One C and one T. If both present a positive. No need for RTPCR. It’s highly specific for COVID19

If C present only-test negative. You will need to repeat after a day or get an RT PCR done. For symptomatic patients, please contact your physician.

If nothing present or only t present and no c then invalid, then test needs to be repeated.

Important tips when you do the test

Wait for 10 to 20 minutes for the test to show actual results. A strong positive is obvious within fifteen minutes.

Check the manufacturing and expiry date of the kit. Please don’t use it after the expiry date.

Don’t refrigerate the kit.

Dispose of the kit after use in the bag provided wash hands and sanitize the surface.

Perform the test in a room with the AC and fan off windows open, and well ventilated.

Download the Mylab Coviself App for Google play or Apple store.

What to do if positive?

Wear a mask

Self-isolate

Contact your healthcare provider/physician online

Get your family tested

Maintain all precautions.

Any risks with this test?

No possible risks are known or anticipated.

Mild discomfort while taking the Nadal swab or inadequate sample could be an issue.

Proper disposal of test kits after use is crucial.

Mylab had designed the nasal swab stick to avoid discomfort.

In case of pain or any other issue, avoid the test and consult a physician

What does the Coviself Kit contain

  1. One sterile nasal swab
  2. One pre-filled extraction tube
  3. One instruction manual
  4. One test card
  5. One biohazard bag

Exact 16 steps to perform the Coviself test

  1. Download the Mylab Coviself app from Google Play or App Store.
  2. Register by scanning with your QR code on the Test kit.
  3. Register yourself on the app.(ICMR guidelines)
  4. Wash your hands with soap and water and pat dry. Take out the kit components and have them arranged for easy access.
  5. Take out nasal swab stick. Insert inside one nasal cavity gently 2 to 4 cm. Stop in case of pain.
  6. Twirl inside five times.
  7. Take out and insert in another nostril. Repeat step 6.
  8. This is the sample. Carefully insert this nasal swab stick inside the pre-filled extraction tube. Pinching the bottom of it, swirl the nasal swab inside ten times.
  9. Break off the top of the swab stick from the breakpoint. Discard inside biohazard bag.
  10. Cover the top of the extraction tube with the screw-on nozzle cap provided. Tighten it.
  11. Turn it over so that you can
  12. Pour 2 drops in the test palate wells provided.
  13. Wait 10- 20 minutes.
  14. Please take a picture and upload it to the app. Confirm test result.
  15. Discard all test kit content inside biohazard bag and dispose of it according to local government guidelines for biohazard guidelines. Do not throw it here and there.
  16. Get the English PDF here
CoviSelf-Kit-ContentDownload

In Hindi content manual

How expensive will it be?

250 INR approximately.

Precautions need to be taken while doing the test. It’s better to self-test.For performing on kids and the elderly, please wear masks and gloves. Not to be used for less than two years old.

How far should you insert the nasal swab stick?

2 to 4 cm.

The population of India is a strength and also the most significant hurdle behind large-scale health campaigns.We speak different languages, our access to Healthcare is limited by where we stay in this country. A home testing kit will be a big boost in our fight against COVID.

How Coviself can help India fight COVID19

Suppose this and similar reliable kits are available in the market. In that case, older adults and kids can easily be tested at home. Quick large-scale screening is possible for offices and shops before reopening.You can quickly screen travelers.

Last words

Do it gently.

Dispose of all properly in biohazard bags.

You need to get the app on your phone.

Register and upload the pictures

Reference:

https://coviself.com/ifu/

Different COVID 19 Vaccines,mRNA: What’s Hot, What’s Not

By on 8

I was vaccinated with Covishield as part of India’s effort to vaccinate health care workers. The Covishield was the only option then, and my hubby and I both took it.

Table of contents

What’s Covishield?

Covishield of Oxford-AstraZeneca is manufactured by Serum Institute of India in Pune.It was one of the first vaccines to be approved by the DGCI.

 It’s an adenovirus vaccine that has a harmless virus as the vector to carry spike protein. The body then produces antibodies against the spike protein. The premise being if and when the COVID 19 virus infects someone immunized with Covishield, the body will recognize the Spike protein and kill the virus.

The problem – immunity develops to the Spike protein but sometimes in vaccines like this, host immunity also develops to the adenoviral vector.

That is where Sputnik V scores.

What about the Sputnik V vaccine?

It uses two different virus vector for its two doses

I attended a webinar on Sputnik V and was interested to know more about it. Now Sputnik is approved for use in India. Plus, unlike the Pfizer vaccine, it does not need extraordinary temperature for storage and transport. It’s made in Russia. In collaboration with DrReddys in India, Sputnik did the bridge trial in the Indian population.

On May 1st the first doses of this vaccine will reach India.There’s an agreement for 85 crore doses per year of the Sputnik V being manufactured in India.Russia’s RDIF Sovereign wealth fund has tied up with multiple Indian????????companies to make this possible .

The DGCI approved for restricted emergency use the foreign produced vaccines which have received approval in USFDA,UK MDA ,EMA ,PMDA Japan.

What about the COVAXIN?

COVAXIN is India’s COVID-19 vaccine. It is developed by Bharat Biotech in collaboration with the Indian Council of Medical Research (ICMR) – National Institute of Virology. 

It is a whole virion inactivated Vero-cell-derived vaccine. It is a technology that is tried and tested. The dead virus cannot infect, but the protein can signal the body to learn from it and mount an immune response. It is a two-dose vaccine, too, and is stable at 2-8 degrees celsius.

Covaxin is our very own Made in India vaccine, which, as ICMR has said and Dr.Antony Fauci agrees, can neutralize all mutant variables of the COVID 19 virus. Since it is the complete antigen, the antibodies are produced to the entire structure. Multi mutants can be effectively killed by it. These make COVAXIN very well suited for the Indian population.

  • Made in India
  • Easy distribution and storage
  • Effective against all mutations
  • Economical

It has 81% efficacy. It’s effective against most of the mutant variants of COVID 19.

Today I thought I will tell you a bit about the mRNA vaccine, which is what the USA is getting. It is now also a favorite query point for many.

What is in the Pfizer-BioNTech COVID 19 Vaccine?

It is not a live vaccine. Its a messenger RNA vaccine is having both natural substance and synthetic components. The mRNA, once inside your cells, instruct it to make the viral Spike protein. Your body then creates its immunity against that particular protein. It also helps your body memorize the sequence of events so that if and when the actual viral infect, the body can mount its immunity against it.

Pfizer and Moderna have made history with the technological advancement of the mRNA vaccine. This is the first time such vaccines are approved for human use.

The problem with it is multifactorial.

Point to be remembered the mRNA does not have the information to create all the viral proteins or incite immunity against the whole virus, but a specific part. This means the mRNA will not cause an actual infection. It also means the immunity is technically only partial.

The mRNA is unstable. It needs a lipid nanoparticle for safe passage into cells. For stability, Pfizer vaccines need minus 94 degrees Celsius temperature. That’ a big hurdle for most countries. The technology is also patented and expensive as of now. India, along with several countries requested the companies to temporarily remove IP Intellectual property rights for the mRNA technology so that more vaccines can be produced in other countries quickly. That’s not yet approved.

The good news is USA is considering the gift of their Astra Zeneca Covishield vaccine once it passes the FDA regulations. Interestingly it is not yet approved for emergency use in America.

Now the problem with Moderna and Pfizer mRNA vaccine is their requirements for storage at sub-zero temperatures. That is the type of cold chain which is difficult in countries like India.

Why did the Indian Govt not approve Pfizer for emergency use earlier?

They were apparently not willing to do a bridging trial on the Indian population(Both AstraZeneca and Sputnik did this) and retracted the request . It’s always about money and previous commitments.

Nevertheless, now they have emergency use approval, but they still need to do a bridge trial.

The World has a diverse population. What works for the Western World could work differently in Indians. The point is to know science and statistics. Not people with agendas.

What is the best solution? Giving people a choice in those places in India where such a cold storage facility is possible. Remember, a mass vaccination campaign is different from a targeted vaccination campaign. The easier it is to produce the vaccine, store it, transport it, and immunize the citizens, the better it is health-wise and economy-wise.

Ignore negativity and opinions with no ground reality checks India fought polio successfully, but it took time.

COVID 19 will take time, but we will fight this and win the battle too.Know your choices.

How long does the COVID vaccine protection last?

No data is available yet about how long the protection will last for any of the vaccines.

Will someone get the infection even if vaccinated?

The full immunization starts 4 to 6 weeks after the second dose of the vaccine. Even then, a small percentage may have breakthrough infections. Data about that is still being collected.

We know that fully vaccinated people seem to have less chance of severe complications from the disease.

That is true for chickenpox and many other viral vaccines too.

So right now, getting the vaccine you have in hand is worth two in the bush!

How long should you wait to get vaccinated after a COVID 19 infection?

After testing Negative, at least 4 to 6 weeks is an excellent period to wait before the immunization.

Should pregnant women get vaccines?

Currently, India has opened vaccination for all above the age of 18. You should get vaccinated if not otherwise contraindicated. For specifics, you should consult your doctor.

Worried about which vaccine to take?

Stop worrying. Take the one available to you, your friends and family have taken, your doctor has taken.

If you are worrying about where to take the vaccine?

Govt or private your choice.

How to register for the vaccine online in India?

You can register through the CoWin portal from 28th April.

Using your phone number you can register upto 4 people. Each person will need their valid photo identification. Vaccination will start from 1st May in the 18-45 age group. You can choose a center nearest to you.

You can also register through the Arogya Setu app through the CoWin Tab on the Home page. Valid Id proof needed.

Through the Aarogya Setu app
CoWin

Once you receive both doses of vaccines you will get your COVID vaccination completed certificate.Dont share the certificate anywhere on social media.Its not a good idea.

If you can pay for the vaccine, do so.

If you are worried about whether to take it- take it 

If you are concerned about whether it will work, you have a better chance of fighting. It’s like a helmet, not an extra life.

What about those people who still don’t care.

Stop caring about them. Do your part.

What about the neighborhood uncle who tested positive, and you were just chatting with him the day before?

Get tested.Wear a mask and self-isolate till the test come back negative Stay positive.

References ,Resources and reading

https://www.biorxiv.org/content/10.1101/2021.01.26.426986v2

https://www.pfizer.com/news/hot-topics/the_facts_about_pfizer_and_biontech_s_covid_19_vaccine#_edn4

https://www.bharatbiotech.com/images/press/covaxin-phase3-efficacy-results.pdf

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

https://www.forbes.com/sites/williamhaseltine/2020/12/02/why-most-countries-wont-benefit-from-moderna-and-pfizers-covid-19-vaccines/

https://www.livemint.com/news/india/foreign-vax-makers-yet-to-chart-india-course-11618770043411.html

https://theintercept.com/2021/04/29/covid-vaccine-factory-production-ip_

Writing this for the BlogchatterAto Z .This is R .

About the #Sputnik V

By on 5

Sputnik V is starting its trial in India soon. I attended a webinar about the vaccine trial.The following were the talking points-

It is one of the three vaccines currently with the efficacy of over 90%.

The use of two vectors is a unique technology of the Gamaleya centre, making Sputnik V different from other vaccines.

Sputnik V uses two vectors in their vaccines. This boosts immune response and provides long-lasting immunity with an added element of safety.

The interim results of the phase 3 Gam-COVID-Vac trial show that the vaccine is 91·6% efficacious against COVID-19 (from day 21 after the first dose, the day of receiving second dose – From the analysis of data on 19,866 volunteers.

Sputnik V is the world’s first registered vaccine based on a well-studied human adenoviral vector-based platform. Sputnik V is now registered in 24 countries.

But what is the Sputnik V

It’s Russia’s contribution to fighting the COVID 19 .

Sputnik V is an Adenoviral based vaccine. Its targeted SARS COV-2 Sputnik V uses a weakened virus to deliver small parts of the pathogen (COVID19) to stimulate an immune response in the person getting the vaccine.

How does the Sputnik V work?

It is a vector vaccine where the adenovirus acts as the vector. The adenovirus gene is removed from the virus vector. The COVID 19 gene is inserted. When it enters the host’s immune system, the host cells start the synthesis of new Coronavirus envelope proteins—Thats how the immune system is primed to fight a future potential enemy.

The Sputnik V’s interesting part is that the first dose and second dose of the vaccine has two different adenoviral vectors with a gene coding the S protein of Coronavirus. When this vector gets inside a human cell, this genetic material of COVID 19 makes the cell synthesize S protein. This S protein is responsible for the immune response to begin. The use of two vectors is an exciting technology of the Russian vaccine.

When is the second dose of vaccine needed?

It’s needed after twenty-one days.

What is adenovirus?

Adenovirus is a type of viruses causing human acute viral respiratory infection. It can affect the eyes, urinary and nervous system too. But in the vaccine since the adenoviral genetic material; is removed, it cannot cause disease.

Results from the Lancet article briefly:

The article in lancet has reported Sputnik V being 91.6 % efficacious.

Robust humoral and good cellular immune response in all age group.

This vaccine-like the Covishield and Covaxin are suitable for storage and transportation in India. It requires storage at 2-8 degrees celsius.

Going forward we would like to know about the clinical trials of COVID 19 Vaccine combo of Sputnik V and the Oxford Astra Zeneca

The world needs safe, effective vaccines which are affordable. The more we know , the more informed the consent for vaccination will be. We await results of the duration of protection and other data as India continues its vaccine drive.

World’s first clinical trials of Covid-19 vaccine combination of Sputnik V and the Oxford–AstraZeneca begin soon. According to this Reuters report, Dr. Reddy’s laboratory in India conducts a small human trial of this vaccine supported by the Russian Direct investment fund. India may approve this vaccine in the following weeks.

Update:

As of today the 12th of April 2021 the Sputnik V has been cleared by Indian authorities .

Reference:
Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomized controlled phase 3 trial in Russia
Denis Y Logunov, DSc *
Inna V Dolzhikova, PhD *
Dmitry V Shcheblyakov, PhD
Amir I Tukhvatulin, PhD
Olga V Zubkova, PhD
Alina S Dzharullaeva, MSc
et al. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00234-8/fulltext

My experience with COVID Vaccine

Getting the #covidvaccine 

By on 18

It all started on 23rd January a day after my birthday. I got several messages requesting me to attend Malda Medical College, for my vaccine shot on the 25th of January. 

I checked rechecked and sat thinking.

I couldn’t believe,it was finally vaccine time.

Exactly one year before I had started writing about Corona virus and now the vaccine has arrived. 

I also got a call from the DM office telling me about the scheduled vaccination.I managed to crack some terrible vaccine jokes to my husband, friends ,my mom and friends.

Friends already vaccinated called to share their experiences. 

I am a preventive medicine fan.I have taken most recommended and elective vaccines I needed.So this was much awaited .

Morning of twenty fifth January 2021 arrived bright and early.

Housework,online school,homework,clinic work- done.

Self pep talk -done.

I took my PAN card(that was given as identification proof in the form I filled up),took the Aadhar card just in case.

It was time to get the vaccine shot.

My sister in law came to play with the little one ,while hubby went along.The vaccine picture has to be taken right?

The process was very well organized and implemented with zero hassle.They checked my name and PAN card in three different places,offering sanitizers at every stop.I was given a small token ,a few questions asked and then it happened.

Vaccine shot taken.My expression will tell you what was going on in my mind,rather than any words!The vaccine definitely needed a photo moment.My husband doesn’t believe in staged photos and the mask is a keeper!

COVID Vaccine shot :First dose

After thirty minutes of sitting in the observation room we left the hospital feeling light hearted.I felt fine .

5 Rules to follow even after your #CovidVaccination
Keep following rules even after #covidvaccine

Dr.Abhijit Misra (that’s my husband) ,got the vaccine next on 27th January.

Dr.Abhijit Misra:Getting the #covidvaccine

What kind of vaccine side effects are possible?

  • Milf fever
  • Headache/heaviness of head
  • Dizziness
  • Injection site pain,swelling
  • Red rash
COVID VACCINE EXPERIENCE Documenting my experience after getting the first dose of Covishield #LargestVaccinedrive

I received the Covishield Vaccine.

What is the Covishield vaccine?

Its a recombinant, replication-deficient chimpanzee adenovirus vector encoding the SARS-CoV-2 Spike (S) glycoprotein vaccine.It is Produced in genetically modified human embryonic kidney cells.

Sharing this to let you know .Will update my experiences on the blog when I get the second dose.Stay strong because the Indian Government cares ❤. 

Update April 2021

The vaccine is great. Hubby and I got both doses in January -February. Doing fine.
My mom got it last month. Doing fine.
In-laws took it: All well.
My friends who are doctors have taken it.
The Indian vaccine drive is being done very nicely.


Concern: studies about duration of protection

When I attended a conference about Sputnik V I learned this .

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