Continued Impact of Covid-19 in India: Long Covid Insights

Despite the passage of over five years since the first wave, Covid-19 continues to significantly influence India's health landscape. A recent study in the Journal of Medical Virology (October 2025) underscores the urgency of addressing persistent blood abnormalities in long Covid patients.

Key Findings of the Study

• Led by researchers from France and South Africa.
• Long Covid patients exhibit lasting changes in the complement system, a group of 20 proteins crucial for natural immunity.
• Elevated markers of complement activation indicate chronic immune activation and microclots, central to long Covid’s persistence.
• Implications for India are profound, with estimated unreported cases between 580 to 980 million.

Relevance to India

• The Indian Council of Medical Research’s fourth national serosurvey indicated a 67.6% seroprevalence by mid-2021.
• Estimated that 5-10% of infected individuals develop long Covid, potentially affecting 50-100 million Indians with symptoms like fatigue and cardiovascular issues.

Clinical Implications and Observations

• Highlighted by Dr. Manisha Arora, the study's focus on immune dysregulation offers clarity beyond psychosomatic diagnoses.
• Blood-related abnormalities post-Covid include increased thrombosis, pulmonary embolism, and deep vein thrombosis.
• UK Biobank study noted double the risk of major cardiovascular events in Covid patients over 1,000 days.
• Indian cardiologists note confounding factors like lifestyle and stress impacting cardiovascular health alongside Covid.

Challenges in Diagnosis and Treatment

• In India, long Covid is often underdiagnosed or misattributed to stress or anxiety.
• Dr. Deepesh G Aggarwal observes small clots and stressed blood vessels in long Covid patients, mirroring global findings.
• Standardized testing is lacking, with healthcare providers relying on symptom evaluation.

Economic and Health System Impact

• Estimated 10-20 million Indians experiencing moderate long Covid impacts, affecting productivity and exercise tolerance.
• Unlike Western nations, India's health system integrated long Covid care into general medical care, risking subtle cases being missed.
• India's existing burden of non-communicable diseases complicates the management of long Covid.

Conclusion and Future Directions

• Despite unanswered questions, the discourse shifts from the reality of long Covid to strategies for testing, monitoring, and treatment.
• Recognition of long Covid as a biological condition is crucial for shaping policy, health budgets, and insurance coverage.