Younten Tshedup

More than 99 percent of the total Covid-19 cases in the country have recovered so far. Most of these cases, according to doctors, experienced little or no signs of severe illness.

However, a few experienced severe symptoms from the infection including three deaths as of yesterday. With no specific treatment outlined for Covid-19 infection, how do people recover?

According to Dr Guru P Dhakal, a gastroenterologist with the national referral hospital, for Covid-19 the individual’s immune system takes care of the infection. “However, it is also this immune system that kills an infected individual.”

Dr Dhakal said that during the first week after a person is exposed to the infection, he or she experiences flu-like symptoms specifically because of the virus. “They have fever, cough, runny nose and in some people loss of smell and taste. Most of these symptoms disappear as the person recovers with the help of the body’s immune system over a week.”

He added: “After one week, the body’s immune system starts reacting with the virus or viral particles that remain in the body. It is at this time when an event called cytokine storm occurs. This process is the one that kills a patient and not the virus itself.”

During a cytokine storm, various inflammatory cytokines (proteins) are produced at a much higher rate than normal. This overproduction of cytokines causes positive feedback on other immune cells to occur, which allows for more immune cells to be recruited to the site of injury that can lead to organ damage.

Cytokines are small proteins that are crucial in controlling the growth and activity of other immune system cells and blood cells. When released, they signal the immune system to do its job — trigger immune response.

Dr Dhakal, who have been actively managing Covid-19 patients since March last year, said that for Covid-19 patients whose oxygen demand is increasing and who fails to maintain more than 93 percent oxygen saturation, they are provided with steroids to suppress the immunity so that they don’t develop cytokine storm. “This is one life-saving drug we are currently using besides some antiviral drugs and monoclonal antibodies for Covid-19 patients.”

However, he added that not all positive patients require these drugs. Symptomatic treatment or therapies addressing a particular pain or illness is practised in most cases.


Covid is serious 

Although the majority of the infected individuals including children in the past outbreaks have not displayed any severe disease from the infection, Dr Dhakal said that the emerging variants have the potential to cause severe diseases.

“Yes, most of our cases have recovered without having suffered severe disease. But this does not mean Covid is like any other flu,” said the gastroenterologist.  “People should take Covid very seriously because you never know who would develop a cytokine storm.”

He said that a major difference between Covid-19 and common flu is that flu did not cause cytokine storm. “Your immunity doesn’t overreact to a flu virus or viral particles, but Covid has this character.”

Dr Dhakal said that the receptor cells that the SARS-CoV-2 virus attacks were found in multiple organs in the human body. “This is why Covid-19 not only affects the respiratory tract but also can damage various other organs.”

He added: “It is important for people to know that despite the high recovery rate, many of our Covid patients had markers for severe disease. They could have become very sick but luckily, they didn’t. This is why we cannot take Covid for granted.”

Edited by Tshering Palden