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 Table of Contents  
Year : 2023  |  Volume : 4  |  Issue : 1  |  Page : 93-94

Author reply: Post-COVID syndrome is a call for more research on all ‘post-viral illness syndromes’

1 Human Capital Lighthouse Consulting Private Ltd., New Delhi, India
2 Foundation for People Centric Health Systems, New Delhi, India
3 Department of Health Policy, Epidemiology, Preventive Medicine and Pediatrics, Foundation for People Centric Health Systems, New Delhi, India

Date of Submission26-Jan-2023
Date of Acceptance25-Feb-2023
Date of Web Publication26-Apr-2023

Correspondence Address:
Dr. Chandrakant Lahariya
Foundation for People Centric Health Systems, B-2/105, Safdarjung Enclave, New Delhi - 110 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JME.JME_11_23

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How to cite this article:
Upadhyay A, Pathak VK, Lahariya C. Author reply: Post-COVID syndrome is a call for more research on all ‘post-viral illness syndromes’. J Med Evid 2023;4:93-4

How to cite this URL:
Upadhyay A, Pathak VK, Lahariya C. Author reply: Post-COVID syndrome is a call for more research on all ‘post-viral illness syndromes’. J Med Evid [serial online] 2023 [cited 2023 Jun 7];4:93-4. Available from: http://www.journaljme.org/text.asp?2023/4/1/93/374709

We thank the authors of correspondence for reading our article with interest.[1] It has now become increasingly clear that post-COVID syndrome consists of nearly 200 symptoms, and at times, the diagnosis is by exclusion.[2] Regarding the headache as a Post-COVID Condition (PCC) symptom, it has been documented as the first presenting symptom in many studies, for which the patient seek healthcare.[3],[4],[5] However, there is a need for more context and setting-specific data, including from low- and middle-income countries on PCCs. The article has[1] called for developing skills at all levels of healthcare starting from primary health care level to ask and evaluate the patient for PCC who are presenting with symptoms such as headache. Furthermore, for intractable headaches, a referral consultation to a specialist, i.e., a neurology consultation should be considered by physician.[6] The primary healthcare reforms such as health and wellness centres of India should be optimally used for such exploration and strengthening of services.[7],[8]

Regarding the training of healthcare staff on timely identification and management of PCC, there is no doubt that a two-way communication system for the success of timely and quality management of PCCs will go a long way. In the current healthcare system in most low- and middle-income countries, we have achieved a lot through the execution of a bottom-to-top approach, in fact, many national programmes have successfully adopted the principles for a stronger referral system with wider community engagement.[7],[9]

There are clearly a few more issues emerging. One that while we hear a lot about long- and post-COVID, it is logical to hypothesise that post-acute-illness syndrome may not be something which is exclusive to severe acute respiratory syndrome coronavirus 2 but a wider reflection of characteristics linked to all viral illnesses. We have known for a long that other viral illnesses such as chikungunya, etc., also result in joint pain and chronic fatigue.[10] It is likely that post-viral illness syndrome is very common with other viral illnesses,[11] and it is just that it has been recognised after COVID as a large number of clinical cases had been reported in a short period. The other likely factor and hypothesis are that post- and long-COVID have more likely been reported by those individuals who had pre-existing autoimmune disease, which was unrecognised till then. These individuals also developed more serious diseases than the rest of the people. Clearly, it calls for extensive research on post-viral syndrome and related health conditions.

These hypotheses need to be explored and examined. We really hope that our article will initiate the academic and policy debate on post-COVID as well as post acute illness syndrome as India and many countries across the world enter the endemic stage for COVID-19.[12],[13]

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Conflicts of interest

There are no conflicts of interest.

  References Top

Chauhan P, Pathak VK, Kumar D, Upadhyay A, Chatterjee A, Lahariya C. Post and long-COVID conditions: Epidemiology, clinical symptoms and the prevention and treatment. J Med Evid 2022;3:149-54.  Back to cited text no. 1
  [Full text]  
Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: Major findings, mechanisms and recommendations. Nat Rev Microbiol 2023;21:133-46.  Back to cited text no. 2
Sørensen AI, Spiliopoulos L, Bager P, Nielsen NM, Hansen JV, Koch A, et al. A nationwide questionnaire study of post-acute symptoms and health problems after SARS-CoV-2 infection in Denmark. Nat Commun 2022;13:4213.  Back to cited text no. 3
Kikkenborg Berg S, Palm P, Nygaard U, Bundgaard H, Petersen MN, Rosenkilde S, et al. Long COVID symptoms in SARS-CoV-2-positive children aged 0-14 years and matched controls in Denmark (LongCOVIDKidsDK): A national, cross-sectional study. Lancet Child Adolesc Health 2022;6:614-23.  Back to cited text no. 4
Morrow AK, Malone LA, Kokorelis C, Petracek LS, Eastin EF, Lobner KL, et al. Long-term COVID 19 sequelae in adolescents: The overlap with orthostatic intolerance and ME/CFS. Curr Pediatr Rep 2022;10:31-44.  Back to cited text no. 5
Brightling CE, Evans RA. Long COVID: Which symptoms can be attributed to SARS-CoV-2 infection? Lancet 2022;400:411-3.  Back to cited text no. 6
Lahariya C. Health and wellness centers to strengthen primary health care in India: Concept, progress and ways forward. Indian J Pediatr 2020;87:916-29.  Back to cited text no. 7
Lahariya C. 'Ayushman Bharat' program and universal health coverage in India. Indian Pediatr 2018;55:495-506.  Back to cited text no. 8
Lahariya C, Roy B, Shukla A, Chatterjee M, De Graeve H, Jhalani M, et al. Community action for health in India: Evolution, lessons learnt and ways forward to achieve universal health coverage. WHO South East Asia J Public Health 2020;9:82-91.  Back to cited text no. 9
Lahariya C, Pradhan SK. Emergence of chikungunya virus in Indian subcontinent after 32 years: A review. J Vector Borne Dis 2006;43:151-60.  Back to cited text no. 10
Lahariya C. The COVID-19 wave in China: What, Why and What next for the pandemic? EFI Bulletin 2022;4:93-6. Doi: https://doi.org/10.56450/EFIB.2022.v3i04.004.  Back to cited text no. 11
Lahariya C. COVID-19 Has, Arguably, Become Endemic in India. The Hindu; All Editions; 11 August, 2022. Available from: https://www.thehindu.com/opinion/lead/covid-19-arguably-has-become-endemic-in-india/article65755040.ece. [Last accessed on 2022 Dec 30].  Back to cited text no. 12
Lahariya C. Why a Fresh National Wave is Unlikely in India. The Indian Express; 30 December 2022. Available from: https://indianexpress.com/article/opinion/columns/why-a-fresh-national-covid-wave-is-unlikely-in-india-8350799/. [Last accessed on 2022 Dec 31].  Back to cited text no. 13


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