DNA Explainer: How second wave of COVID-19 pandemic has been more dangerous than first

The deadly second wave of the COVID-19 pandemic that struck India in the month of April-May was quite different from the first wave that struck in 2020 in terms of infectiousness, severity and symptoms. Though some symptoms were similar in both waves, such as dry cough, fever and breathing difficulty, some new and more alarming symptoms emerged during the second wave.

Symptoms in the first wave were more flu-like but in the second wave, things completely changed.

From eye infection, hearing problems, loose motion to more fatal secondary infection and fungal infection like mucormycosis or black fungus, white fungus, green fungus, was seen creating havoc. In some cases, gastrointestinal tract problems were also seen in patients suffering from coronavirus infection.

Now experts are trying to understand why the second wave has been more dangerous than the first so that it could help to identify the potential areas of diagnostics to target with future control strategies.

In a correspondence published on Wednesday in The Lancet Respiratory Medicine on the implications of the second wave in India, experts have written that the second wave had severe consequences in the form of spiralling cases, reduced supplies of essential treatments, and increased deaths, particularly in the young population.

Today we try to analyse some of these points as to how the second wave proved more deadly than the first wave as per The Indian Express.

Higher severity in the second wave

The study revealed an overall higher disease severity at admission during the second wave. 

The study also revealed higher mortality rates, especially in younger patients.

Severe cases accounted for 39.4% of the patients in the second wave, compared to 32.7% in the first. 

Patients with comorbidities like diabetes, hypertension and chronic kidney disease, too, was higher in the second wave 59.7% compared to 54.8% in the first wave.

Higher severity of disease was observed at the time of admission, which necessitated a greater requirement for oxygen.

Young affected more

Young adults suffered higher mortality during the second wave of the pandemic than during the first wave.

More younger people were affected and faced earlier manifestations of hypoxia.

According to an ICMR report, the average age of cases was 50 years in the first wave and 49 in the second. 

The second wave had more asymptomatic patients, but the mortality rate between the two waves is not different.

Prolonged COVID syndrome

The second wave saw protracted long COVID, features of which were mainly fatigue, brain fog and neuromuscular complications.

Experts say they continue to see lung and heart complications in people who have recovered from COVID-19 in the second wave.

The need for post-COVID vigilance is up to 100 days in the second wave, whereas in the first wave it was predominantly two weeks.

Patients have post-COVID syndrome even with mild to moderate infections including fatigue, anxiety and occasional breathlessness.

Especially those who were in the ICU suffer profound weakness and can need long-term oxygen care at home due to lung damage.

Bacterial and fungal infections

There have been unusual bacterial, viral and fungal infections during the second wave of the pandemic.

During the second wave, there has been a spurt of mucormycosis or black fungus, independent of diabetes and steroid therapy.

Doctors are witnessing anecdotal cases of arterial thrombosis leading to infarction of the legs and amputation. 

Bleeding is also seen in some COVID patients as people are put on anticoagulation medicines after discharge.