Linked: People with loss of smell had behavioural, functional, and structural brain changes.
| Photo Credit: Getty Images

A large body of studies has found how even mild COVID-19 impacts the brain of people. One the most common ailments seen among people who had COVID-19 was the loss of smell, otherwise called as anosmia. In most cases, people recover their sense of smell after a few weeks to months. Many studies have found that months after recovery from COVID-19, some people continued to experience neurological and cognitive effects. While persistent cognitive symptoms have been linked to brain alterations, patients recovering from mild COVID-19 without cognitive symptoms presented with cortical thickness alterations and changes in white matter integrity.

A small study from Chile recruited 73 adults with a mild to moderate COVID-19 without signs of respiratory failure and 27 people without any history of COVID-19. The 73 participants who had COVID-19 and recruited for the study had an average of nine months after diagnosis. Participants with COVID-19 and the control group were subjected to cognitive screening, a decision-making task, and MRI evaluations. The team used loss of smell and need for hospitalisation as proxies for potential markers of neurologic involvement and disease severity, respectively. The study, published in the journal Scientific Reports, has found that people who suffered from loss of smell had behavioural, functional, and structural brain changes.

 “Given the significant global incidence of COVID-19, identifying factors that can distinguish individuals at risk of developing brain alterations is crucial for prioritizing follow-up care,” the authors write. Since the anosmia “correlated with brain measures, including decreased functional activity during the decision-making task, thinning of cortical thickness in parietal regions, and loss of white matter integrity”, the authors say that anosmia could be used as a criterion when identifying at-risk populations for follow-up.

Of the 73 participants with COVID-19, 22 (30.1%) individuals reported experiencing varying degrees of attention and memory issues, which persisted at the time of the cognitive test administered as part of the study. Relatively minor indications were headache in seven participants, fatigue in six people, and four with persistently impaired sense of smell lasting, on average, 1.3 months. Of these patients, a complete loss of smell (anosmia) was experienced by 68% (29 participants), while 32% (14 participants) experienced differing degrees of changes in their sense of smell (hyposmia/microsmia). Both these categories were clubbed together as ‘patients with anosmia’.

While no significant differences in cognitive performance between groups based on COVID-19 diagnosis, anosmia, or hospitalisation requirements,  “intriguing patterns” emerged in behavioural task performance. Participants with a loss of smell displayed a distinct decision-making strategy characterised by more impulsive behaviour and were more likely to make a choice that is different when the earlier result was negative when performing a behavioural task. But the participants who were hospitalised displayed less strategic thinking and unlike those who were not hospitalised repeatedly made the same wrong choice.

Loss of smell was positively associated with decreased functional activity during the decision-making task, thinning of cortical thickness, and loss of white matter integrity. “Hence, anosmia could be a factor to be considered when identifying at-risk populations for follow-up,” the authors write.

“Only six patients present indicators of persistent olfactory deficit; thus, our results are not due to actual deficit. Hence, anosmia could serve as both a potential marker of virus-induced damage to neuronal tissues and a marker for individuals susceptible to brain damage,” the authors note. 

More than four years since Covid-19 was declared a pandemic by the WHO (World Health Organization) in March 2020, fear of another mass outbreak looms large. The WHO, on August 14, declared the current upsurge of Mpox or Monkeypox in Central Africa as a global emergency requiring urgent action. The global concern for the virus grew as it spread to other African countries, and, within no time, the deadly strain of Mpox – Clade 1b – crossed the African continent to reach Sweden, Pakistan, and other countries.

The virus has killed more than 500 people so far, mainly in the Democratic Republic of Congo, where the disease has been spreading since last year. The country saw more than 96% of the world’s roughly 17,000 recorded cases of Mpox this year.

Though India has not reported any cases yet, the Central government is keeping a close eye on the situation. Our healthcare infrastructure faced severe challenges during the Covid-19 pandemic, which resulted in thousands of deaths. One wouldn’t wish to be caught unawares this time.

Is Mpox As Dangerous As Covid-19 Or Swine Flu?

Mpox is a zoonotic infection that causes flu-like symptoms and skin lesions. Fatal in some cases, the WHO first declared it a global emergency in 2022. 

Mpox virus can be categorised into two clades: Clade 1 and Clade 2. The first, which is found mainly in Central African countries, is more severe and has a high mortality rate. Clade 2 has milder symptoms and is found in western Africa. The latter caused a public health emergency in 2022, wherein some 300 cases — though mild — were reported from Sweden. This time, it’s the newer and more serious Clade 1b, identified in September last year, that has been driving the current outbreak.

Though experts worry that Mpox may be as dangerous as Covid-19 or the swine flu, there is a difference in the nature of transmission. Both Covid-19 and swine flu were highly infectious because they were airborne. In contrast, Mpox is transmitted through close skin-to-skin contact, talking or breathing close to an infected person, or using their soiled clothes or bedsheets. “Mpox is unlikely to become a pandemic like Covid-19 primarily due to its mode of spread. It requires very close and physical contact, unlike the airborne SARS-CoV-2. Also, symptoms like blisters on the skin are more visible indicators and therefore, it’s easier to identify the disease and isolate a person to contain the spread,” says Rakesh K. Mishra, former director of the Centre for Cellular and Molecular Biology.

India’s first Mpox case was recorded in Kerala in 2022, from a traveller from the UAE. Soon, the virus spread within the country, with cases emerging in Delhi even from individuals who had no recent international travel. India reported 27 confirmed cases and one death that year, according to WHO. The last case in the country was in March this year, in Kerala, and since then, no new cases have been recorded.

How To Stay Safe

In response to the WHO’s warning, both Central and state governments have sprung into action. There are monkeypox advisories in place and public health measures are being taken. Both the Indian Council of Medical Research (ICMR) and the National Centre for Disease Control (NCDC) are closely monitoring the situation and reviewing international trends.

In Tamil Nadu, the Directorate of Public Health and Preventive Medicine (DPH) has already issued alerts. Reports say that passengers arriving from the Democratic Republic of Congo and Central African countries are being tracked by airport health officers and port health personnel. Both Hyderabad and New Delhi — cities popular among African students pursuing higher education — have also been placed on high alert.

The Need For Vaccines

The first Mpox strain was isolated by ICMR researchers in 2022. Pharmaceutical companies and drug manufacturers are being called upon to develop vaccines and testing kits for the virus. Existing vaccines for smallpox and chickenpox might also offer protection in India. 

About other prevention strategies, Mishra says, “It is important to closely monitor the spread of the disease in different countries and be ready for screening by already available methods of DNA-based diagnostics. There is an effective vaccine already available but supply of that may not be easy to ensure.”  

“Simple practices like avoiding close physical contact with suspected/potentially infected person, maintaining distance from people with symptoms, and wearing a mask, should be effective in containing the spread of the infection,” Mishra adds. 

Developed nations, mostly those in Europe, already have vaccines available for those at greater risk of monkeypox. And given the high quality of healthcare there, containing the disease will be less challenging. It’s underdeveloped African countries, which have neither vaccines nor the resources to buy them, that remain at most risk and which need the most help. 

(Bharti Mishra Nath is Contributing Editor, NDTV)

Disclaimer: These are the personal opinions of the author

Sydney, Australia:

Covid-19 is still driving Australia’s above-average mortality rate, research showed on Monday, with experts predicting the disease’s impact will continue to be felt for years to come.

The Australian Actuaries Institute found that five per cent more people died than would be expected in 2023, amounting to 8,400 excess deaths.

Experts measured the number of people who had died as a direct or indirect result of Covid and found the excess mortality rate was still higher than pre-pandemic levels.

About 4,600 deaths were directly attributed to Covid-19, the ninth leading cause of death last year.

Non-Covid-19 excess deaths, meanwhile, were “particularly apparent” in Australians over 75 years old — with previous infections and interruptions in healthcare related to Covid increasing risks related to heart disease, stroke, diabetes and dementia.

Delays in routine or emergency care and undiagnosed Covid-19 were cited as possible reasons for the higher-than-usual death rate.

Still, the excess mortality rate was lower in 2023 than it was in 2022, according to experts.

“It’s encouraging that each successive Covid-19 wave has, so far, resulted in fewer deaths than the previous one,” Actuary Institute spokeswoman Karen Cutter said.

“However, we think that Covid-19 is likely to cause some excess mortality for several years to come, either as a direct cause of death or a contributing factor to other causes such as heart disease.”

She added the “new normal” level of mortality was likely higher than it would be had the pandemic not occurred.

The report also found Australia’s excess mortality was lower than the global average — with Ecuador, Mexico and Russia showing the highest rates of unexplained deaths.

New Zealand had the lowest excess mortality rate of the 40 countries for which data was available.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

Steroid use for COVID raises blood sugar levels. File
| Photo Credit: Sushil Kumar Verma

Diabetes is a chronic disease affecting hundreds of millions worldwide and has multiple risk factors. The more the risk factors present, the higher the likelihood of developing diabetes. Understanding these factors is essential for prevention. A new study published in The Lancet Diabetes and Endocrinology describes a link between COVID-19 and diabetes.

From databases of tens of millions of people in England registered with their general practitioners, researchers examined the risk of developing diabetes following COVID-19. They found a four-fold increase in risk during the first month post-infection. The risk remained elevated in two-thirds of these individuals in the second year.

Early indications came in 2020 when doctors across the world noted a surprisingly high occurrence of diabetes in previously healthy individuals following a diagnosis of COVID-19. Some required high doses of insulin. A paper published in the Journal of Family Medicine and Primary Care in October 2022 from Telangana reported similar findings.

However, observations based on small numbers of patients are not always definitive. For instance, steroid use for COVID-19 raises blood sugar levels on its own. Besides, in any population, diabetes exists undetected in a significant proportion of individuals. This might have been unearthed only because of the medical attention they received after contracting COVID. A reverse causality has also been implicated, with people with diabetes being at greater risk for severe COVID-19. It was also unclear whether the rise in blood sugars would settle down after the immediate stress of COVID passed. Thus, the link remained a matter of debate, necessitating larger studies over an extended period of time.

The new study also examined health records from before and after the vaccine rollout, enabling researchers to investigate the impact of vaccination on diabetes risk. With a follow-up period exceeding a year, they could assess the persistence of newly diagnosed diabetes. Since the study relied on well-maintained databases from before the pandemic, the findings are unlikely to be due to increased testing alone. The persistence of diabetes into the second year indicates that steroid use alone was not responsible.

Two key observations linked the severity of COVID-19 to an increased risk of diabetes. Firstly, the risk was significantly higher among hospitalised patients. Secondly, vaccinated individuals, who experienced less severe COVID-19, had a lower risk of developing diabetes.

When comparing vaccinated and unvaccinated populations, it is important to address demographic differences. For instance, unvaccinated people in England tended to be younger, healthier, and more likely to be of South Asian or Black ethnicity. Although South Asians have a higher baseline risk of diabetes, younger age lowers the overall risk in a population. To ensure accurate conclusions, the researchers adjusted for these factors, eliminating any inaccuracies from comparing unequal populations.

The increased diabetes risk following COVID-19 is believed to involve at least two mechanisms. The receptors used by the virus to attach and enter human cells are also found in the insulin-producing beta cells in the pancreas. Therefore it is possible the virus might have damaged these cells. Additionally, the widespread inflammation caused by COVID-19 leads to insulin resistance. Besides adding to the body of evidence connecting chronic diseases and viral infections, the study enhances our understanding of the various mechanisms involved in the development of diabetes. In summary, COVID-19 has increased the burden of chronic diseases among survivors in several ways, with diabetes being one of them.

(Rajeev Jayadevan is co-chairman of the National IMA COVID task Force)

Steroid use for COVID raises blood sugar levels. File
| Photo Credit: Sushil Kumar Verma

Diabetes is a chronic disease affecting hundreds of millions worldwide and has multiple risk factors. The more the risk factors present, the higher the likelihood of developing diabetes. Understanding these factors is essential for prevention. A new study published in The Lancet Diabetes and Endocrinology describes a link between COVID-19 and diabetes.

From databases of tens of millions of people in England registered with their general practitioners, researchers examined the risk of developing diabetes following COVID-19. They found a four-fold increase in risk during the first month post-infection. The risk remained elevated in two-thirds of these individuals in the second year.

Early indications came in 2020 when doctors across the world noted a surprisingly high occurrence of diabetes in previously healthy individuals following a diagnosis of COVID-19. Some required high doses of insulin. A paper published in the Journal of Family Medicine and Primary Care in October 2022 from Telangana reported similar findings.

However, observations based on small numbers of patients are not always definitive. For instance, steroid use for COVID-19 raises blood sugar levels on its own. Besides, in any population, diabetes exists undetected in a significant proportion of individuals. This might have been unearthed only because of the medical attention they received after contracting COVID. A reverse causality has also been implicated, with people with diabetes being at greater risk for severe COVID-19. It was also unclear whether the rise in blood sugars would settle down after the immediate stress of COVID passed. Thus, the link remained a matter of debate, necessitating larger studies over an extended period of time.

The new study also examined health records from before and after the vaccine rollout, enabling researchers to investigate the impact of vaccination on diabetes risk. With a follow-up period exceeding a year, they could assess the persistence of newly diagnosed diabetes. Since the study relied on well-maintained databases from before the pandemic, the findings are unlikely to be due to increased testing alone. The persistence of diabetes into the second year indicates that steroid use alone was not responsible.

Two key observations linked the severity of COVID-19 to an increased risk of diabetes. Firstly, the risk was significantly higher among hospitalised patients. Secondly, vaccinated individuals, who experienced less severe COVID-19, had a lower risk of developing diabetes.

When comparing vaccinated and unvaccinated populations, it is important to address demographic differences. For instance, unvaccinated people in England tended to be younger, healthier, and more likely to be of South Asian or Black ethnicity. Although South Asians have a higher baseline risk of diabetes, younger age lowers the overall risk in a population. To ensure accurate conclusions, the researchers adjusted for these factors, eliminating any inaccuracies from comparing unequal populations.

The increased diabetes risk following COVID-19 is believed to involve at least two mechanisms. The receptors used by the virus to attach and enter human cells are also found in the insulin-producing beta cells in the pancreas. Therefore it is possible the virus might have damaged these cells. Additionally, the widespread inflammation caused by COVID-19 leads to insulin resistance. Besides adding to the body of evidence connecting chronic diseases and viral infections, the study enhances our understanding of the various mechanisms involved in the development of diabetes. In summary, COVID-19 has increased the burden of chronic diseases among survivors in several ways, with diabetes being one of them.

(Rajeev Jayadevan is co-chairman of the National IMA COVID task Force)

Washington:

US President Joe Biden returned to the White House on Tuesday, after days of self-isolation at his Delaware House, with his doctors saying that his symptoms of COVID-19 have been resolved.

“I am feeling well,” Biden said when asked how is he feeling.

The president took a Binax rapid antigen test and is negative, Dr Kevin O’Connor, Physician to the White House said in a memorandum to the White House Press Secretary.

Biden’s “symptoms have resolved,” he said.

He did not respond to shouted questions about why he dropped out of the race and whether his deputy Vice President Kamala Harris could beat the Republican presidential nominee Donald Trump.

During his quarantine period, the 81-year-old President sent political shockwaves around the country on Sunday with a post on social media announcing that he was not accepting the Democrat nomination.

He added that he would “focus all his energies on his duties as president for the remainder of his term” and offered his full support and endorsement to his vice president, Kamala Harris, as his choice to replace him on the ticket.

The announcement came after mounting pressure about Biden’s age and ability to take on Republican rival Trump.

Biden tested positive for COVID-19 while campaigning in Las Vegas on Wednesday and has been isolating at his Delaware home since.

“The President’s symptoms have resolved. Over the course of his infection, he never manifested a fever, and his vital signs remained normal, including pulse oximetry. His lungs remained clear,” said O’Connor.

“BINAX rapid antigen testing is negative. He will continue to be monitored for any recurrence of illness. The President continues to perform all of his presidential duties. As always, I will continue to keep your office updated with any changes in his condition or treatment plan,’ he added.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

New Delhi:

The National Testing Agency (NTA) postponed at least 16 exams due to different reasons since its inception in 2018, the Ministry of Education informed the Lok Sabha on Monday.

The reasons for postponement included the COVID-19 pandemic, administrative reasons, logistical reasons, and technical issues.

The information was shared by Minister of State for Education Sukanta Majumdar in response to a written question in Lok Sabha asked by DMK MP Kanimozhi Karunanidhi.

“Since its inception in 2018, NTA has successfully conducted over 240 examinations involving over 5.4 crore students.

“Since most of the examinations conducted by NTA are held in multiple-subjects, multiple-shifts and span over a number of days, there have been instances due to unforeseen circumstances like COVID-19 pandemic, logistical and technical issues, administrative issues, legal orders etc, when examination dates initially notified in respect of specific subjects or shifts could not be adhered to,” the Minister said.

According to the data shared by the minister, four exams — JEE-Main (2020), NEET-UG (2020), JEE-Main (2021) and NEET-UG (2021) — were postponed due to COVID-19 pandemic.

CSIR UGC-NET (2020), UGC-NET (December 2020), UGC-NET (May 2021), and Indian Council of Agricultural Research (ICAR) AIEEA (2020) were postponed due to “COVID-19 pandemic and logistical challenges”.

Delhi University Entrance Test (DUET) 2020 for admission to UG, PG-MPhil, and PhD courses was postponed as the registration process was put on hold by DU due to the COVID-19 pandemic.

Common Management Admission Test (CMAT)-2021 was postponed due to the revision of the examination pattern by the AICTE.

All India Ayush Post Graduate Entrance Test (AIAPGET), 2021, and the Joint Integrated Programme in Management Admission Test (JIPMAT), 2021, were postponed due to the COVID-19 pandemic.

IGNOU PhD Entrance was postponed in 2022 due to administrative reasons.

Graduate Aptitude Test Biotechnology (GAT-B), 2023 was postponed as per consultation with regional centres for biotechnology.

In 2024, the National Common Entrance Test (NCET), 2024 was postponed due to technical issues, and CSIR-NET, 2024 due to logistic issues.

“NTA has started declaration of examination calendar of major examinations, much in advance for the facilitation of candidates. The examination calendar is planned taking into consideration, buffer days to accommodate for reschedules and postponements for reasons beyond the control of NTA,” the minister said. 

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

Milind Lakkad, EVP and Chief Human Resources Officer (CHRO) at Tata Consultancy Services. File
| Photo Credit: PTI

Tata Consultancy Services, India’s largest IT services exporter, has reached pre-pandemic levels on the percentage of employees working from offices, a top official has said.

Admitting that it took longer than expected, the Tata Group company’s chief of human resources Milind Lakkad said the levels have been achieved after 18 months of “hard” efforts. “We actually have come to the point where we believe we are coming back to almost the same levels as we were pre-pandemic times,” Mr. Lakkad told PTI.

Stating that “it is kind of a business as usual” for the company employing over 6 lakh people, he said TCS will not track this metric as much in the next couple of quarters.

The number of employees working from offices for five days a week is higher than the 70% it had previously announced, he said, without giving a figure.

It can be noted that the pandemic-induced lockdowns resulted in the entire IT industry’s staff delivering work from their homes, but companies, who look at working from offices as more virtuous because of the team building, mentoring, culture deepening aspects, have struggled to get them back to workplaces.

TCS reported a marginal decline in the number of women employees at 35.5% as of June this year, but Mr. Lakkad said this is not an aspect of concern for the company and added that it has a slew of policies and measures in place before the pandemic itself wherein it has been flexible as an organisation to take care of employees’ needs.

On hiring, involuntary attrition

Mr. Lakkad declined to specifically answer if it will close the fiscal year 2024-25 by hiring 40,000 freshers. Likewise, when asked if it will close the fiscal on a positive number on the net hiring front ‘last year saw a decline in staffage amid business volatilities, he declined to give a specific answer.

To a question on whether the incidence of involuntary attrition has gone up as the company becomes more rigorous in assessing its employees, he said such an eventuality is not a core part of its HR strategy.

When a resource is hired, the company feels it is its responsibility to ensure that the talent is productive, he said, adding that it is only when there are skill mismatches over a period of time or productivity issues even after attempts are mounted to improve, that it resorts to involuntary attrition.

Meanwhile, amid a raging national controversy following the integrity of professional examinations, Mr. Lakkad said the focus on governance and ethics would have to continue, adding that technology can offer solutions to avoid instances of people gaming the system by helping in assessments and background verifications.

On SBI’s disclosure that 80% of its fresher hires are qualified engineers, Mr. Lakkad said the country was producing a huge number of engineers yearly and TCS does not see any concerns from a talent availability standpoint.

With the TCS management calling expanding on utilisation as a key metric to grow its profit margins, Mr. Lakkad said there still exists the headroom of a few percentage points to grow the number but made it clear that it will not “take it to the brim” and continue to have sufficient bench strength.

New Delhi:

About one in 10 women who acquire COVID-19 infection during pregnancy are likely to suffer longer from long-term COVID symptoms like fatigue, gastrointestinal issues, and feeling drained in routine life, finds a study.

COVID acquired during pregnancy is known to be much more dangerous as it can lead to stillbirths and preterm births.

The study, published in the journal Obstetrics & Gynecology, included 1,500 participants who already had Covid during pregnancy and reported the symptoms after six months.

Of these 9.3 per cent of people reported experiencing long-term symptoms. These included fatigue, gastrointestinal issues, and feeling drained or exhausted by routine activities.

“This is an important study for the pregnancy and postpartum times are the most vulnerable and this study gives insights on the linkage between Covid and pregnancy,” said Dr David Goff, division director for the Division of Cardiovascular Sciences at the NIH’s National Heart, Lung, and Blood Institute, US.

The researchers also called on obstetricians “to be vigilant” because the symptoms of long-term COVID can overlap with the symptoms of pregnancy itself.

To ensure that the reported long Covid symptoms weren’t symptoms of pregnancy, a secondary study was done on people who reported symptoms more than 12 weeks after giving birth. The results confirmed the findings.

As the prevalence of long Covid in pregnant populations is high the researchers called on health practitioners to keep an eye out for its symptoms.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

Geneva:

Covid-19 is still killing around 1,700 people a week around the world, the World Health Organization said Thursday, as it urged at-risk populations to keep up with their vaccinations against the disease.

WHO director-general Tedros Adhanom Ghebreyesus sounded a warning on declining vaccine coverage.

Despite the continued death count, “data show that vaccine coverage has declined among health workers and people over 60, which are two of the most at-risk groups,” the UN health agency’s chief told a press conference.

“WHO recommends that people in the highest-risk groups receive a Covid-19 vaccine within 12 months of their last dose.”

More than seven million Covid deaths have been reported to the WHO, though the true count of the pandemic is thought to be far higher.

Covid-19 also shredded economies and crippled health systems.

Tedros declared an end to Covid-19 as an international public health emergency in May 2023, more than three years on from when the virus was first detected in Wuhan, China, in late 2019.

The WHO has urged governments to maintain virus surveillance and sequencing, and to ensure access to affordable and reliable tests, treatments and vaccines.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)