Omicron variant can turn serious, experts say
Experts pointed out that Omicron, which is known to largely affect the upper respiratory tract and thus produce milder symptoms compared to the Delta or Delta plus variant can still cause severe disease, and in some instances, death
Mumbai: City doctors have started encountering cases of Omicron in the Intensive Care Units (ICUs) and HT has learnt of at least three cases, including the death of an unvaccinated senior citizen, wherein doctors corroborated the presence of Omicron variant through the S-gene target failure test.
Medical experts said that co-morbid conditions dictate how the viral infection manifests. Uncontrolled and unmonitored diseases, active cancer therapies such as radiation and chemotherapy, HIV, active steroid treatment and immunosuppressive treatments pose a greater risk of severe Covid-19. In addition, unvaccinated patients or patients who fail to mount their immune response despite vaccination also face a higher risk of getting a severe disease.
To be sure, the number of deaths reported daily by the Brihanmumbai Corporation (BMC) in the past seven days has hovered between six (January 13) and 12 (January 20). In absolute numbers, this is far less than the peak of the second wave, when the average daily deaths reported was 52 in the months of April and May 2021. Epidemiologists said that severe manifestation of the Covid-19 disease — irrespective of which wave, or variant — affects a section of the population that has co-morbidities, insufficient immunity, and/or is unvaccinated or partially vaccinated. However, experts pointed out that Omicron, which is known to largely affect the upper respiratory tract and thus produce milder symptoms compared to the Delta or Delta plus variant that caused damage to the lungs, can still cause severe disease, and in some instances, death.
“The Omicron variant can trigger complications depending on the co-morbid condition of the patient,” said Dr Sanjith Saseedharan, head of critical care at the SL Raheja Hospital in Mahim who has encountered two such cases including one death. In both cases, the patients underwent an RT-PCR test which used specific kits to look for the S-gene deletion —while genome sequencing is considered to be the gold standard for identifying variants of SARS-CoV-2 virus, the S-gene target failure is an indirect way to detect the Omicron variant.
In the first case, Saseedharan said, a 70-year-old unvaccinated man from Kandivli facing severe breathlessness visited the hospital in the last week of December with a Covid-19 positive report. Medical investigations revealed that he had developed viral myocarditis, an inflammation of the heart muscle triggered by the viral infection. The patient had an existing heart ailment — his heart’s pumping ability was barely 15% of a normal heart. This co-morbidity in addition to his age and unvaccinated status made him vulnerable, the doctor said.
“His condition deteriorated rapidly and we had to put him on a ventilator, but he eventually developed a severe pulmonary edema (fluid accumulation in the lungs) and succumbed three days later,” he said.
In another case, Saseedharan said, a 71-year-old fully vaccinated man with multiple co-morbidities including a history of stroke, poorly controlled diabetes, hypertension and asthma, spent 12 days in the hospital including six in the ICU. He developed a fever in the first week of January, and underwent an RT-PCR test, which was positive and indicated the Omicron variant. The man’s family members who also had Covid recovered within four days. “Viral infections can trigger asthma exacerbation. We gave him remdesivir, steroids and anticoagulants and he had to be put on non-invasive ventilator support,” he said adding that the patient recovered gradually.
Critical care specialist Dr Kedar Toraskar from Wockhardt Hospital said that a 60-year-old fully vaccinated man with a history of hypertension is currently in the ICU with Covid-19 pneumonia and on oxygen support. His test carried out at the hospital showed the S gene deletion.
“He has been in the ICU for five days due to severe breathing issues, but he is now recovering,” said Toraskar. “In a group of patients with severe risk factors, close monitoring is important when it comes to Covid-19. Most importantly, we must not ignore the disease by labelling it as mild,” said Toraskar.