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Vipin M. Vashishtha

@vipintukur

May 4, 2021 • 9 tweets • 6 min read • Read on X

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Have we reached to the peak of 2nd #Covid wave in India? May be, yes! Its already 2.5 months in to it. Most badly affected countries peaked within 1.5-3 months of onset of a new surge. Is it too early to comment? 1/

More interesting would be to see which way our curve goes: the UK/Israel or the US way! While both UK/Israel took 1.5-2 months to flatten their curves w/ strict lockdowns & aggressive vaccination, US had a long plateau (>3.5 months) 2/

However, there is heterogeneity in caseloads: While states like MH, UP, CG, PB, DL are showing ⬇️ in case load, some southern & eastern states (KA, KL, AP, TN, WB, ) still reporting cases in high numbers! What is driving Covid in these states? 3/ indiatoday.in/coronavirus-ou…

Different variants (VOC) are circulating in diff states of India. While it is #B1617 is in MS & neighboring states, #B117 in PB, DL & northern states, Delhi & #B1618 in WB & eastern states outbreak.info/situation-repo… 4/

Now, a new variant having #N440K spike substitution is believed to be behind the sudden rise of cases in southern India, particularly in KA, KL, AL & Telangana. Some believe it is believed to be 15 times more lethal than the earlier ones 5/ biorxiv.org/content/10.110…

So, what lies in store for #India? The few key factors that may extend India's suffering for a prolonged period:
1-lack of strict #lockdowns: having halfway yo-yo lockdowns are not the answer!
2-sluggish #inoculation drive: still only 2% of the population received 2-doses! 6/

3-rampant circulation of #variants: not sure which one is the main driver!
4-limited #sequencing: only 1% of isolates sequenced!
5-modestly efficacious #vaccines: unlike the other 3 countries
6-lack of #effectiveness data on currently employed vaccines: so, driving blindly! 7/

What could be the saving grace? Hoping the rapid descent follows the explosive ascent! And the virus, mutating at a staggering pace, might be heading for an evolutionary cliff all on its own. Amen! 8/
bbc.com/future/article…

One interesting thing to note: All the three countries had 3 waves, the last surge the severest!

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More from @vipintukur

Vipin M. Vashishtha

@vipintukur

Jun 26

A meta-analysis from Egypt of 125 studies involving over 4 million COVID survivors shows that months to years after infection, fatigue was the most common symptom at 43%. Around 27% of people experience cognitive impairment after COVID infection. 1/

Further, 28% experienced memory issues, 24% sleep disorders, 20% headaches, 16% dizziness, 14% depression, and 13% anxiety, with significant variability depending on follow‑up time, disease severity, sex, and BMI. 2/

Neurological symptoms are common & persistent in COVID survivors. This study highlights significant burden these symptoms place on individuals, emphasizing the need for well-resourced multidisciplinary healthcare services to support post-COVID recovery. 3/3

Read 4 tweets

Vipin M. Vashishtha

@vipintukur

Jun 24

A new review on neuroimmune pathophysiology of #LongCOVID explores how SARS-CoV-2 can cause lasting neurological symptoms through a combination of direct infection, immune dysregulation, and persistent inflammation. 1/

Key mechanisms include viral antigen persistence, autoimmunity, blood–brain barrier disruption, neurotransmitter imbalances, and glial cell dysfunction. The authors link these processes to cognitive impairment, fatigue, dysautonomia, and other Long COVID symptoms. 2/

Despite the perception that COVID-19 is now a mild disease, there is overwhelming evidence indicating that SARS-CoV-2 infection is capable of producing widespread post-acute sequelae in a significant percentage of infections. 3/

Read 4 tweets

Vipin M. Vashishtha

@vipintukur

Jun 19

I think, therefore I age!

As people get older, a growing population of cells starts to consume more energy — perhaps because the cells accumulate damage that leads them to rev up processes such as inflammation. 1/

An emerging hypothesis suggests that the brain accommodates these energy-hogging ‘senescent cells’ by stripping resources from other biological processes, which ultimately results in outward signs of ageing, such as greying hair or a reduction in muscle mass. 2/

It’s one example of a growing understanding of how our brains control ageing and how psychological stress can accelerate the process at a molecular level. 3/

Read 5 tweets

Vipin M. Vashishtha

@vipintukur

Jun 17

A NEW study found that the SARS-CoV-2 nonstructural protein 15 (nsp15) helps the virus hide from the immune system in human lung and nasal cells. The nsp15 endoribonuclease is important in promoting virus replication and influencing disease severity. 1/

SARS2 variants lacking this activity exhibit impaired replication & cause milder disease, highlighting nsp15 as a key virulence factor. This underscores the importance of nsp15’s endoribonuclease activity in both promoting virus replication & influencing disease severity. 2/

The viral variants lacking nsp15 endoribonuclease activity elicited higher innate immune responses and exhibited reduced replication in human stem cell–derived lung alveolar type II epithelial cells, as well as in the lungs of infected hamsters. 3/

Read 5 tweets

Vipin M. Vashishtha

@vipintukur

Jun 16

Researchers developed a 23-amino acid peptide that mimics ACE2 and effectively binds the SARS-CoV-2 spike protein, preventing viral entry. 1/

The peptide demonstrated potent antiviral activity against both the original and Omicron strains, with a therapeutic index greater than 20, indicating strong potential for therapeutic use. 2/

Moreover, future viruses from this family of coronaviruses may likely use ACE2 as their host cell receptor, as recently demonstrated in the MERS Virus of bats and, therefore, the ACE2 decoy therapeutic may have future applications as well. 3/

Read 4 tweets

Vipin M. Vashishtha

@vipintukur

Jun 5

A NEW preprint found that submaximal exercise in people with #LongCOVID caused large microclots to fragment into smaller microclots and this then triggered increases in inflammatory and vascular injury markers. 1/

The breakdown of large microclots, rather than clearing them from circulation, was linked to reduced oxygen uptake and heightened inflammation. 2/

The data suggest that while the immune system tries to control inflammation caused by microclot fragmentation after physical exertion, its compensatory mechanisms are inadequate or failing. 3/

Read 6 tweets

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