Covid third wave has brought many new secondary infections

The low immunity caused by Covid-19 has triggered secondary infections, with city doctors seeing several cases of herpes, zoster and arthralgia in patients who have just recovered. Unlike the pre-pandemic era, when mostly the senior citizens got these illnesses, people under the age of 40 are getting affected now.

Dr Neeraj Tulara from Dr LH Hiranandani Hospital said that since the start of the pandemic, they have observed that Coronavirus infection has led to many autoimmune manifestations, and many dormant infections have surfaced in a post-Covid setting due to persistent low immunity.

Dr Vandana Punjabi, senior consultant, Dermatology, Nanavati Max Super Speciality Hospital, said several viral diseases like herpes zoster, molluscum contagiosum and warts rose significantly in August-September 2021, during the second wave. “Though the cases have reduced now, they account for nearly 20 per cent of the total dermatological complaints. Major cause of the trend is compromised immunity due to Covid-19 and the body’s inability to fight these viruses successfully,” she said.

Affecting under-40s

“In the pre-pandemic period, these infections were common among senior citizens, pregnant women or co-morbid people with compromised immunity. Since the second wave, the infections have increased among patients aged 40 years and below, with no major health indications,” she added. Dr Pritam Moon, consultant physician, Wockhardt Hospitals, said many Covid-19 patients have reported skin complications during the recovery phase and have been diagnosed with herpes zoster (HZ), called shingles. “Herpes in some patients, who have had a previous history of the condition, is getting triggered, owing to the low immunity from Covid-19,” he said.

Dr Tulara said, “Herpes zoster usually remains dormant in nerves and doesn’t create any issues when people have a good immunity. However, post-Covid, many people have come with different manifestations of herpes zoster like shingles, herpes around eyes, lips or nose, as the immunity weakens.”

Dr Tulara added that arthritis, which is mainly autoimmune or rheumatoid in nature, can also get precipitated post-Covid. “The prime reason is again the autoimmune affinity in the post-Covid setting. Quite a few people continue to have joint pains, autoimmune arthritis patients feel more pain, or sometimes even develop new onset autoimmune arthritis,” he said.

Exercise daily, stay healthy

Dr Safiuddin Nadwi, orthopaedic surgeon at Apollo Spectra Mumbai, said the treatment with monoclonal anti-TNF alpha antibodies may be linked with a higher risk of herpes or zoster. “Moreover, musculoskeletal symptoms are seen in some people after getting Covid-19, along with other symptoms such as cough, fever, or loss of smell and taste. Five out of 10 younger and older Covid-19 patients visit us. It is also dependent on the severity of the disease and the course of treatment given to the patient along with modification of lifestyle. So, try to exercise daily to reduce the stress level due to the pandemic,” he said.

A prolonged recovery

A 40-year-old professor was started on anti-viral and other medication after she was diagnosed with genital herpes. The Ghatkopar resident had recovered from Covid-19 in the first week of January. “I suddenly had discomfort, itchiness with burning sensation while passing urine.

At first, I thought it was a urinary tract infection. I had to see a doctor when symptoms did not subside. The recovery from Covid-19 was uneventful, and now it seems to be a prolonged journey of complete recovery,” she said.