In Gujarat, Doctors Hint At High Viral Load, New Symptoms Am
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As the daily surge of Covid-19 cases continues at an alarming pace 2,815 infections and 13 fatalities recorded on April 3, the medical fraternity in Gujarat has warned of symptoms like abdominal pain without cough and fever, the typical indicators of the disease, among patients. A higher viral load has been also noted among the patients recently as compared to the surge seen last year post-Diwali.

On April 2, Surat Municipal Commissioner Banchha Nidhi Pan issued an advisory stating “the new strain of coronavirus is highly contagious” and because of its characteristic of high infectivity “the virus can quickly enter the lungs and cause pneumonia”. The advisory noted that the symptoms were “different” this time: absence of cough and fever and yet people were testing positive for the disease.

Infectious disease specialist Dr Atul Patel told: “The second surge is seeing symptoms such as abdominal pain and diarrhoea more than that was seen earlier. This might be because the virus attaches to ACE-2 receptor and the receptor is present in the gastrointestinal tract. At present, a cycle threshold value of less than 15 was being recorded. Cycle threshold value is an indicator of viral load greater the replication cycles during the RT-PCR test, the lower the viral load.

Dr Maulik Sheth, the vice-president of Ahmedabad Medical Association, said the surge in cases is due to a high viral load. He said, "We are right now seeing a lot of family clusters, especially since the last 15-20 days, which was not the case during the last surge." While there is low mortality at present, Dr Sheth said, it was too premature to comment on anything and that some clarity may emerge only in the coming weeks.

~ Treatment Protocol

Hydrochloroquine, which was ubiquitous in the Covid-19 treatment protocol even as of September last year, has now been phased out. Steroids and Remdesivir continue to be the primary go-to drugs. Plasma therapy, too, has been discontinued unless a case history indicates immunoglobulin deficiency.

Dexamethasone has been associated with dysglycemia (makes blood sugar levels abnormal) and increases the risk of fungal infections as well. Dr Patel said, in steroids, dexamethasone could be replaced with Barcitinib. "Because of shorter duration of therapy and no effect on sugar, it may be better," he said.

Source:
https://indianexpress.com/article/cities/ahmedabad/in-gujarat-doctors-hint-at-high-viral-load-new-symptoms-among-patients-7257848-7257848/
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