‘Omicron has severe effects on unvaccinated or immuno-compromised patients’

New Delhi: India is witnessing a sudden surge of Covid-19, although fortunately, most of the patients have been showing mild effects of Omicron. Most of the experts have claimed that more results and studies are needed to be conducted to understand the new variant. Although vaccinations do not prevent the infection, it reduces the severity of the virus and its variants. Anybody with comorbidities, diabetes, heart problems or an immunocompromised system will have a severe effect of Covid-19.
Omicron was first discovered in South Africa on 25 November, 2021, when some laboratory technicians at the Lancet Labs in Pretoria, South Africa, discovered unusual features in coronavirus samples. What they discovered was remarkable as a gene was missing from the usual genomic profile of the virus so the PCR testing were failing to detect one of the intended targets of the virus, indicating that something had changed about it. A similar occurrence happened a few days later at the Lancet’s Molecular Pathology Department in Johannesburg. The discovery, according to Dr Allison Glass, a pathologist at Lancet, coincided with a spike of positive Covid-19 cases in portions of South Africa. The discovery raised concerns, however, the origination is still unknown to the scientists.
A leading pulmonologist in South Arica, who works at Midstream Mediclinic in Tshwane, Dr E.M. Taban, said, “Omicron variant has presented with mild clinical symptoms amongst young people, vaccinated patients with multiple co-morbidity and unvaccinated with no chronic conditions. I have seen a few severe cases in the unvaccinated individual that require intensive care admission, but when compared to the previous variants such as delta, they have fewer inflammatory markers. Current, mortality in South Africa is not directly as a result of omicron, but rather due to unvaccinated individuals with underlying severe chronic conditions and co-infection with another virus.”
While discussing whether Omicron affects the lungs of asymptomatic patients, he went on to add, “I have not seen one yet but difficult to say because most of these patients are isolated at home. I have done a CT scan of the lungs for patients at our hospital with upper respiratory symptoms and underlying asthma (24 patients unpublished study) and none of the patients developed lung involvement or opacities despite complaining of shortness of breath and chest pain. Only patients who developed mild lung problems are unvaccinated with an uncontrolled chronic condition or on immunosuppressive treatment.”
As per the research paper, dated, 16 December 2021, in The New England Journal of Medicine, Molnupiravir, which is now approved in India, in unvaccinated adult outpatients with mild-to-moderate Covid-19, reduced rates of hospitalization or all-cause mortality by 30%. However, it has not been approved for children below 18 and pregnant women. Similarly, Paxlovid, which has not yet been approved in India, is administered with ritonavir reduced rates of hospitalisation or all-cause death by almost 90% among unvaccinated high-risk adult outpatients.
“We have sufficient evidence to believe that Omicron is not as severe as other variants of Covid-19, as the cases are mild. However, people who are unvaccinated or immunocompromised have the severe effects of Omicron,” Prof G.C. Khilnani, Chairman of Pulmonology, Critical Care and Sleep Medicine, PSRI Hospital, told this paper. He also believes that there is a chance that Omicron has already surpassed Delta in India, however, many since many samples are not being sequenced so the main cause of the Covid-19 spike is difficult to determine. Prof Khilnani suggested that oral medications, Molnupiravir and Paxlovid, can be given in home and both reduce severity and hospitalization.
The severe symptoms witnessed in patients with Omicron are sore throat, body ache, headache, tight chest and sometimes cough, few gastrointestinal symptoms such as diarrhoea and abdominal pain. As per the report published by the South African Medical Research Council, the mortality of the patients fell in a week and the official deaths have declined in South Africa. The excess deaths were reported in the first three weeks. The WHO officials have said that though Omicron may produce less severe symptoms but should not be categorised as ‘mild.’ Janet Diaz, who leads WHO clinical management, stated that as most of studies have been on younger people, impact of Omicron on elderly is one of the unsolved questions.