Latest news with #COVID-related
Gulf Insider
a day ago
- Health
- Gulf Insider
Most COVID Lung Abnormalities Heal Over Time, New Guidelines Confirm
Up to half of hospitalized COVID-19 patients show lung abnormalities on chest CT scans long after the acute infection is over. Many fear these changes mean lasting damage or worsening lung disease. However, new guidelines on treating long COVID confirm that lung abnormalities usually stabilize or even improve over time. 'The lungs are an organ, like skin, that are in constant contact with the environment. Because of that, they have a significant amount of stem cells in reserve and cells ready for healing,' Dr. Panagis Galiatsatos, a pulmonary and critical care medicine physician and an associate professor at Johns Hopkins Medicine, told The Epoch Times. Researchers found that in patients with lung damage following a COVID-19 infection, around 90 percent who continued to show lung abnormalities at the time of hospital discharge began to see improvements one to three years after infection. After a COVID-19 infection, roughly six in 100 people are estimated to develop persistent symptoms that can last for months to years—a condition known as long COVID. Common complaints include fatigue, joint and muscle aches, breathlessness, headaches, and difficulty concentrating, often called 'brain fog.' Symptoms typically improve over time—usually within four to nine months. Lung recovery tends to follow a similar trajectory. After infection, the lungs can show changes that resemble scarring—such as inflammation, collapsed air sacs, or temporary thickening of lung tissue—but these often heal on their own, Dr. Joseph Varon, president and chief medical officer of Independent Medical Alliance, who is not one of the authors of the treatment guideline, told The Epoch Times. Based on Varon's clinical experience, most patients with mild-to-moderate COVID-related lung issues show improvement on scans and of symptoms within three to six months. However, he noted that some people, especially older adults or those who had severe illness, can have lingering lung changes or symptoms for a year or more. In COVID-19, the early lung damage is mostly due to inflammation, not permanent destruction, he said. Once the infection clears and inflammation goes down, the lungs can start to heal, absorbing fluid and repairing tissue, a process that can take several months. 'The body has the capacity to heal,' Dr. Pierre Kory, founder of Leading Edge Clinic, which treats long COVID patients, told The Epoch Times. COVID is typically an acute illness that heals over time rather than a chronic inflammatory condition—though in some cases, lingering lung inflammation or fibrosis can persist, he said. Many post-COVID lung changes seen in scans are not signs of permanent damage. They often reflect the lung's natural healing process after inflammation, similar to what's seen in other viral pneumonias or recovery from acute respiratory distress syndrome. Over time, these abnormalities often fade as the tissue repairs itself. Unlike chronic conditions such as interstitial lung disease, which involve ongoing triggers and progressive scarring, post-COVID changes are typically non-progressive. However, older patients who had been on mechanical ventilation or had severe or critical initial infection were more likely to have persistent lung changes, possibly due to the extent of initial lung injury. Chest CT scans often reveal lung changes long after COVID-19 infection that may look severe on imaging. These include ground glass opacities, which are hazy areas suggesting inflammation, or fibrous strands, thin bands of tissue left over from healing. However, many of these findings are residual effects from the infection, not signs of irreversible damage. 'Radiologic findings often lag behind clinical recovery and must be interpreted within a broader clinical framework,' said Varon, 'I have seen patients that have 'white lungs' for months and are doing well.' The disconnect between imaging and the actual patient condition may lead to confusion, unnecessary follow-up, or even overtreatment of long COVID. 'Some patients report persistent symptoms despite near-normal imaging,' Varon said, likely due to lingering viral effects or nervous system issues rather than actual lung damage. 'The key takeaway is that both lung damage and symptoms often improve—but not always in synchrony, and not always completely,' he said. That's why an individualized, symptom-based follow-up approach remains essential in managing long COVID patients. The new guidelines specifically address the tendency to over-interpret nonspecific findings as signs of progressive lung disease. The new consensus advises using CT only when clinically indicated, such as in patients with persistent or worsening respiratory symptoms. Mislabeling can also lead to costly treatments, repeated imaging, and even affect life insurance or disability claims. 'These medications can cost up to $60,000 per year—and patients may not really need them,' Varon said. The new guidelines suggest providers request follow-up chest CT only in patients whose respiratory symptoms persist or worsen three months after infection, with those symptoms lasting at least two months and with no other identifiable cause. They also recommend low-dose protocols for follow-up imaging to reduce radiation exposure. CT was invaluable early in the pandemic, especially when RT-PCR testing was unreliable, Varon said, but its continued use in asymptomatic or mildly symptomatic long COVID patients is often unnecessary. The guidelines also urge radiologists to avoid using terms such as 'fibrosis' or 'interstitial lung disease,' which often imply progressive or permanent scarring, when describing nonspecific residual findings. The bigger concern, Kory said, is the tendency to over-label nonspecific findings, like ground-glass opacities or mild fibrotic changes, as definitive signs of fibrotic interstitial lung disease. 'I see this in my practice every single day,' he said. 'These interpretations can trigger unnecessary anxiety, inappropriate referrals, and misguided treatment plans.' Kory takes a symptom-focused approach, monitoring patients clinically and repeating imaging only if conditions worsen. 'My experience in general is that yes, most things in medicine are overused, including imaging,' he said.
The Hindu
6 days ago
- Health
- The Hindu
India's pandemic toll remains elusive
The Civil Registration System (CRS) data has brought into sharp relief the magnitude of excess mortality that India witnessed during the COVID-19 pandemic years. Excess mortality refers to the difference between the total number of deaths during a pandemic or any other natural disaster compared to the number of deaths that would have been expected under normal conditions. According to the CRS, India recorded 76.4 lakh deaths in 2019. This figure rose to 81.11 lakh in 2020 and further surged to 1.02 crore in 2021 — an implicit acknowledgement of the fact that the true mortality impact of COVID-19 far exceeds the official toll of 5.33 lakh. Data from the Medical Certification of Cause of Death (MCCD) for 2021, released alongside the CRS and Sample Registration System reports, adds further weight to this claim. COVID-19 was identified as the second leading cause of death, with 5.74 lakh certified fatalities attributed to the virus — already exceeding the official figure. However, this estimate was drawn from less than a quarter (23.4%) of registered deaths in 2021. Taken together, the rise in all-cause mortality and the limited scope of medical certification offer a compelling case that India's true pandemic death toll may be far closer to the World Health Organization's estimate of 47 lakh deaths — a model that the Government of India had earlier rejected, citing concerns over its methodological robustness. A systemic deficiency CRS data/all-cause mortality data is indispensable, especially given the widespread undercounting of COVID-related deaths. This metric captures not only confirmed cases but also fatalities arising from misdiagnoses, misclassification, and pandemic-induced systemic disruptions. Nonetheless, the utility of the all-cause mortality data in gauging the true impact of COVID-19 is limited in the Indian setting, as the recording of deaths is far from universal. The National Family Health Survey-5 states that nearly 29% of deaths between 2016 and 2020 went unregistered. The omission of civil registration from the list of essential services during the 2020 lockdown further obscured the mortality landscape. As a consequence, even comprehensive datasets such as CRS may fall short in reflecting the full impact of the pandemic. Editorial | A belated admission: On the undercount of India's COVID-19 pandemic deaths Beyond numerical discrepancies lies a deeper issue — the structural inadequacy of death certification and classification. During the pandemic years, we visited crematoriums and burial grounds in a locality in Kerala. We observed a marked rise in the number of daily cremations compared to previous years — an increase that was evident not only in facilities designated for handling COVID-19 deaths, but also in those without such designation. This raises pertinent questions regarding the misclassification of COVID-19 deaths and under-ascertainment of causes. A significant driver of this opacity is the absence of medical certification. In 2020, 45% of deaths occurred without any form of medical attention — 10% points higher than in pre-pandemic years. Within our study cohort, only 22.8% of the deceased had any formal medical documentation indicating the cause of death. Nationally, only 23.4% of deaths are medically certified as per the recent MCCD data. This systemic deficiency compromises mortality surveillance as well as public health planning. Indirect deaths A further dimension of the pandemic's mortality burden relates to indirect deaths — a category of deaths that, while not directly caused by SARS-CoV-2 infection, can be reasonably attributed to the wider repercussions of the pandemic. These fatalities, often absent from COVID-19 official statistics, occurred due to systemic disruptions: delays in seeking care due to fear of infection, scarcity of hospital beds and essential medicines, post-infection complications, economic distress, and logistical barriers to healthcare access during prolonged lockdowns. During our field study, we found that a considerable share of deaths was indirectly linked to these cascading effects of the pandemic. Many people suffered physical and psychological deterioration post-infection, some experienced an exacerbation of chronic conditions, and others refrained from seeking timely medical attention. When extrapolated to the broader national context, particularly in regions where healthcare systems are fragile and supply chains were acutely disrupted, the implications would be sobering. To gauge the true mortality impact of the pandemic, it is insufficient therefore to rely solely on officially recorded COVID-19 deaths or all-cause mortality data. Also read | 'Excess deaths in 2020 and 2021 not equal to deaths by COVID-19, increase attributable to several reasons' Our study in Kerala found that 34% of deaths were indirectly attributable to the pandemic, and 9% may have been misclassified. If such patterns exist in a State with a relatively strong public health systems (although the death registration in the prescribed time was around 61% in 2021), the scale of undercounting could be even more pronounced in States such as Gujarat and Madhya Pradesh where discrepancies between excess deaths and official figures are significantly wider. These findings make a compelling case for a systematic inquiry into the full extent of mortality during the pandemic. Policymakers should consider conducting a large-scale study, which could be also accomplished by including questions on decedents in the next Census. More importantly, they must serve as a wake-up call to urgently reform India's mortality surveillance architecture. Shilka Abraham, Master of Public Health graduate, School of Health Systems Studies, Tata Institute of Social Sciences; Soumitra Ghosh, Associate Professor and Chairperson, Centre for Health Policy, Planning and Management, School of Health Systems Studies, Tata Institute of Social Sciences
Express Tribune
03-08-2025
- Entertainment
- Express Tribune
Adam Lambert defends Cynthia Erivo as Jesus in Jesus Christ Superstar Hollywood Bowl production
Adam Lambert is voicing strong support for Cynthia Erivo's casting as Jesus in the Hollywood Bowl's three-night production of Jesus Christ Superstar, saying the musical was always meant to provoke and challenge audiences. In a recent interview with Billboard, Lambert—who plays Judas in the production—said he is 'excited' to present a version of Christ led by a 'female, Black' performer. 'Cynthia's brilliant,' he said. 'Her voice, presence, and simultaneous power and vulnerability absolutely blow my mind, and working with her has been a dream.' Casting a queer, Black woman in the role of Christ has drawn some pushback, but Lambert sees it as an opportunity to rethink traditional portrayals. 'I'm excited by the challenge of presenting the audience with a production led by a female, Black Jesus and encourage the audience to expand their minds a bit,' he told Billboard. 'Originally utilizing rock and roll, Jesus Christ Superstar is supposed to provoke and challenge—that's the point. And shouldn't the teachings of Jesus transcend gender?' Erivo also addressed the criticism in a separate Billboard interview in June, responding with humor: 'Why not? You can't please everyone. It is legitimately a three-day performance at the Hollywood Bowl where I get to sing my face off. So hopefully they will come and realize, 'Oh, it's a musical, the gayest place on Earth.'' The production also features Milo Manheim, Raúl Esparza, and Phillipa Soo. John Stamos joined the cast at the last minute, replacing Josh Gad, who had to withdraw due to a COVID-related complication. Directed and choreographed by Tony Award winner Sergio Trujillo, the show is conducted and music-directed by Tony and Grammy winner Stephen Oremus. The event, running August 1–3, reflects a growing movement in modern theater to reimagine classic works through more inclusive casting and storytelling.
Indian Express
01-08-2025
- Business
- Indian Express
Bengaluru Metro: Yellow Line connecting Electronic City ready for commercial operations
The Commissioner of Metro Railway Safety (CMRS) Friday gave the safety clearance to Bengaluru Metro's 18.82-km-long Yellow Line, clearing the way for commercial operations on the stretch. This development comes nearly eight years after the civil works for the Yellow Line were awarded in 2017. The Yellow Line connects RV Road with Bommasandra via Electronic City. A Bengaluru Metro Rail Corporation (BMRCL) spokesperson told The Indian Express, 'We have received the safety clearance report from CMRS with certain general observations. We will now inform both the state government and the central government, seeking permission to operationalise the line for revenue services.' The official added, 'Currently, we have three trainsets, and three coaches of the fourth train set have been dispatched from Titagarh. The remaining coaches will be dispatched for Bengaluru either today (Friday) or tomorrow and should reach the Hebbagodi depot by August second week.' The fourth train set will also have to undergo signalling and other tests for a couple of weeks before commissioning it for revenue services. BMRCL is eyeing a high-profile inauguration event in August, with officials preparing to invite Prime Minister Narendra Modi to flag off the line. A private firm has reportedly been engaged to produce a documentary film showcasing the new corridor, including drone footage of the stations and route, for the inaugural program. The event is tentatively scheduled for the first or second week of August. BMRCL has also drawn up three possible operational plans. The first involves opening the entire 16-station stretch with three trains at a frequency of 24 minutes. The second plan proposes partial operation between RV Road and Bommasandra. The third option is to run services between Bommasandra and the Central Silk Board stations. The Yellow Line has suffered significant delays, primarily due to disruptions in the supply of metro coaches. CRRC, the Chinese firm originally contracted to supply the rolling stock, failed to meet the 75 per cent local manufacturing requirement mandated by the 'Make in India' policy. The issue was exacerbated by the India-China border standoff in June 2020, complications with foreign direct investment (FDI) norms, and COVID-related disruptions. To resolve the impasse, CRRC partnered with Bengal-based Titagarh Rail Systems to manufacture and deliver the coaches domestically. However, visa delays for Chinese engineers and the late arrival of propulsion systems from Japan further slowed down testing and commissioning of the corridor.
United News of India
01-08-2025
- Business
- United News of India
SC sets aside NCLAT ruling, allows IL&FS appeal in insolvency case
New Delhi, Aug 1 (UNI) The Supreme Court today allowed the appeal filed by IL&FS Financial Services Ltd. (IFIN) and overturned the March 25, 2025, judgment of the National Company Law Appellate Tribunal (NCLAT), which had upheld the National Company Law Tribunal's (NCLT) dismissal of IFIN's insolvency plea as time-barred. The case involved a loan default by Adhunik Meghalaya Steels Pvt. Ltd., and the key issue was whether entries in the company's 2019–20 balance sheet could be treated as an acknowledgment of debt. IFIN argued that this acknowledgment extended the limitation period under Section 18 of the Limitation Act, 1963, allowing them to initiate insolvency proceedings under the Insolvency and Bankruptcy Code (IBC). The Supreme Court agreed with IFIN, holding that the balance sheet entries indicated that the debt was still unpaid even though IFIN's name was not directly mentioned. The Court said that acknowledgment of liability does not need to name the creditor, as long as it shows the existence of a debt. The Bench also addressed confusion over its earlier COVID-related orders on extension of limitation. It clarified that the correct clause to apply was Para 5(I) of its suo motu judgment in In Re: Cognisance for Extension of Limitation. As a result, the period between March 15, 2020, and February 28, 2022, would not be counted in calculating the deadline. Thus, IFIN's application filed on January 15, 2024, was held to be well within the extended limitation period. The Court referred to and reaffirmed earlier rulings, including Asset Reconstruction Co. v. Bishal Jaiswal (2021) and Vidyasagar Prasad v. UCO Bank (2024), stating that balance sheet entries should be interpreted in a broad, contextual manner to determine acknowledgment of debt. Setting aside the findings of both the NCLT and NCLAT, the Supreme Court sent the matter back to the NCLT for a fresh decision on the merits. Senior Advocate Ritin Rai, along with a legal team from Cyril Amarchand Mangaldas, represented IFIN. UNI SNG AAB
