Kev soj ntsuam ua rau muaj kev kub ntxhov tam sim no hauv Is Nrias teb tshwm sim los ntawm COVID-19 tuaj yeem raug ntaus nqi los ntawm ntau yam xws li kev ua neej nyob tsis tu ncua ntawm cov pej xeem, kev tsis txaus siab nyob rau hauv vim qhov kev nkag siab ntawm tus kab mob kis thoob qhov txhia chaw, predisposition ntawm cov pej xeem Indian rau co-morbidities xws li ntshav qab zib. uas ua rau muaj qhov tsis zoo, tsis txaus ntawm cov vitamin D uas ua rau muaj cov tsos mob ntawm COVID-19 hnyav thiab tsis tau npaj rau kev kho mob uas raug ntes tsis paub. Kab lus tam sim no tham txog cov cwj pwm no thiab seb lawv tau coj mus rau qhov teeb meem niaj hnub no li cas.
Tag nrho lub ntiaj teb no yog grappling nrog lub Covid-19 Tus kab mob kis thoob qhov txhia chaw uas tau ua rau ntau lab tus tib neeg poob thiab cuam tshuam kev lag luam hauv ntiaj teb nrog rau kev ua neej nyob ib puag ncig mus txog qhov ua tau. Qhov xwm txheej tam sim no yog qhov phem tshaj qhov xwm txheej Tsov Rog Ntiaj Teb Zaum II uas cov teb chaws tau ntsib yuav luag xya xyoo caum dhau los thiab yog ib qho kev ceeb toom tsis txaus ntseeg ntawm tus mob khaub thuas Spanish uas tshwm sim yuav luag ib puas xyoo dhau los hauv 1918-19. Txawm li cas los xij, ntau npaum li peb tau liam tus kab mob rau qhov kev puas tsuaj uas tsis tau pom dua ua ke nrog rau kev tsis muaj peev xwm ntawm ntau lub tseemfwv los daws qhov xwm txheej ntawm lub luag haujlwm, peb yuav tsum paub tias qhov xwm txheej tam sim no tau ntsib los ntawm lub ntiaj teb thiab tshwj xeeb hauv Is Nrias teb, yog vim li cas. rau tib neeg tus cwj pwm tus qauv thiab peb li tib neeg hom yuav tsum muaj rau qhov xwm txheej tau ntsib niaj hnub no rau ntau qhov laj thawj hauv qab no.
Thawj thiab qhov tseem ceeb tshaj plaws yog kev ua neej nyob tsis muaj zog (tsis muaj kev ua si ntawm lub cev) 1, Ua ke nrog kev noj zaub mov tsis zoo uas ua rau peb lub cev tiv thaiv kab mob tsis zoo rau cov kab mob sib txawv ntawm cov kab mob xws li kab mob xws li SARS CoV-2. Muaj ntau ntau cov pov thawj txuas nrog kev noj zaub mov kom zoo rau lub cev noj qab haus huv nrog lub cev tiv thaiv kab mob muaj peev xwm tiv thaiv kab mob. Hais txog Covid-19, tau muaj kev qhia tshwj xeeb los tswj cov qib ntawm cov vitamins sib txawv hauv lub cev, tshwj xeeb tshaj yog vitamin D. Vitamin D insufficiency yog txuam nrog kev mob hnyav zuj zus los ntawm COVID-19.2-10. Raws li kev soj ntsuam ntawm qhov xwm txheej uas tau ntsib los ntawm Is Nrias teb tam sim no, feem ntau ntawm cov kab mob uas tau tshaj tawm yog cov neeg muaj txiaj ntsig ntau dua uas feem ntau nyob hauv tsev nyiam kev ua neej nyob hauv ib puag ncig cua txias dua li cov neeg ua haujlwm. kev ua si lub cev nyob rau hauv ib puag ncig ntuj nyob rau hauv lub xub ntiag ntawm tshav ntuj (pab nyob rau hauv vitamin D synthesis). Tsis tas li ntawd, pawg neeg no tsis noj zaub mov tsis zoo vim tsis muaj nyiaj ntau zog thiab yog li tsis muaj kev cuam tshuam nrog kev ua neej nyob xws li ntshav qab zib.10-12, kab mob plawv, daim siab rog thiab lwm yam. Cov kab mob sib kis no ua lub luag haujlwm tseem ceeb hauv kev ua rau cov tsos mob tshwm sim los ntawm COVID-19. Qhov no tsis tau txhais hais tias cov neeg muaj nyiaj tsawg tsis tau txais COVID-19. Lawv yeej ua tau thiab muaj ntau tus neeg muaj tus kabmob, txawm li cas los xij, lawv yuav yog asymptomatic lossis tsim cov tsos mob me uas yuav tsis xav tau mus pw hauv tsev kho mob.
Qhov thib ob hais txog kev sib raug zoo thiab kev coj tus cwj pwm ntawm Indian kab lis kev cai13,14 thiab qhov tseem ceeb cuam tshuam rau kev ntsuas kev ua raws cai thaum nws los txog rau zej zog thiab cov txiaj ntsig kev noj qab haus huv rau pej xeem. Qhov txo qis ntawm cov neeg mob ntawm COVID-19 nyob rau lub sijhawm ob peb lub hlis ua rau muaj kev xav thiab kev nkag siab tias qhov phem tshaj ntawm kev sib kis tau dhau mus. Qhov no ua rau tib neeg tsis txaus siab ua rau tsis muaj qhov tseem ceeb rau kev ua raws li cov lus qhia ntawm kev hnav lub qhov ncauj qhov ntswg hauv cov chaw pej xeem, tswj kev nyob sib nrug deb, siv cov tshuaj ntxuav tes thiab tsis tawm qhov tsis tsim nyog, uas tau ua rau muaj kev kis tus kab mob ntau ntxiv ua rau muaj kev hloov pauv thiab xav tias muaj ntau yam sib txawv. cov ntaub ntawv uas tau kis ntau dua. Qhov no tau ua rau muaj tus kab mob ntau dua, txawm hais tias muaj cov neeg tuag zoo sib xws lossis qis dua. Nws tsim nyog hais txog ntawm no tias nws yog qhov xwm txheej ntawm tus kab mob hloov pauv nws tus kheej, tshwj xeeb tshaj yog cov kab mob RNA, thaum lawv rov ua dua. Qhov kev rov ua dua no tsuas yog thaum tus kab mob nkag mus rau hauv tus tswv tsev, qhov no tib neeg, thiab rov ua dua ua rau muaj kab mob ntau dua thiab kis mus rau lwm tus. Sab nraum tib neeg lub cev, tus kab mob no "tuag" thiab tsis muaj peev xwm rov ua dua thiab yog li tsis muaj kev hloov pauv. Yog tias peb tau txais kev qhuab qhia ntau dua rau kev coj noj coj ua hauv zej zog, hnav lub qhov ncauj qhov ntswg, siv cov tshuaj tua kab mob thiab nyob hauv tsev, tus kab mob yuav tsis muaj sijhawm los kis rau tib neeg thiab yog li tsis tuaj yeem hloov pauv, yog li ua rau muaj kev sib kis ntau dua. . Qhov tshwj xeeb hais txog ntawm no yog ob tus mutant thiab triple mutant ntawm SARS-CoV2 uas kis tau ntau dua thiab kis tau sai dua piv rau thawj SARS-Cov2 uas tau pib kis rau tib neeg thaum Lub Kaum Ib Hlis / Kaum Ob Hlis 2019. Qhov ob15 thiab peb tus neeg mutant tam sim no tsim kev puas tsuaj hauv Is Nrias teb uas lub tebchaws tau ntsib yuav luag qhov nruab nrab ntawm 300,000 tus kab mob hauv ib hnub rau ob lub lis piam dhau los. Ntxiv mus, qhov no ntuj xaiv los ntawm tus kab mob no yog ib qho tshwm sim lom uas yuav tsum tau tshwm sim raws li txhua yam tsiaj nyob sim hloov / hloov (qhov no mutates) rau nws txoj sia nyob zoo dua. Los ntawm kev rhuav tshem cov kab mob sib kis, tiam ntawm kev hloov pauv ntawm tus kab mob tshiab yuav raug tiv thaiv, uas tshwm sim vim muaj tus kab mob sib kis (rau qhov txiaj ntsig ntawm tus kab mob ciaj sia), txawm tias ua rau muaj kab mob rau tib neeg. hom.
Nyob rau hauv nruab nrab ntawm qhov xwm txheej tsis zoo no, cov nyiaj hauv ob sab phlu yog tias yuav luag 85% ntawm cov neeg uas tau kis los ntawm COVID-19 yog asymptomatic lossis tsim cov tsos mob uas tsis ua rau qhov hnyav dua. Cov neeg no tau txais kev kho mob nrog kev cais tawm tus kheej thiab los ntawm kev kho mob hauv tsev. Ntawm qhov seem 15%, 10% tsim cov tsos mob hnyav uas xav tau kev kho mob thaum 5% ntxiv yog cov uas xav tau kev kho mob tseem ceeb. Nws yog cov 15% ntawm cov pejxeem uas yuav tsum tau mus pw hauv tsev kho mob qee yam lossis lwm yam, yog li ua rau muaj kev cuam tshuam rau kev noj qab haus huv tshwj xeeb hauv lub tebchaws xws li Is Nrias teb nrog cov pej xeem coob. Qhov no 15% ntawm cov neeg uas xav tau kev kho mob ceev feem ntau suav nrog cov neeg laus uas tsis muaj zog tiv thaiv kab mob lossis cov neeg uas muaj kab mob sib kis xws li ntshav qab zib, mob hawb pob, kab mob plawv, kab mob rog rog, kub siab thiab lwm yam uas ua rau lub cev tsis muaj zog. thiab txhim kho cov tsos mob hnyav ntawm COVID-19. Nws kuj tau raug pom (kev soj ntsuam tsis tau tshaj tawm) tias feem coob ntawm 15% cov neeg no muaj vitamin D tsis txaus hauv lawv lub cev. Qhov no qhia tau hais tias los ntawm kev tswj hwm lub cev tsis muaj zog, nrog rau cov vitamins txaus, tshwj xeeb tshaj yog cov vitamin D thiab tsis muaj cov kab mob sib kis, tus naj npawb ntawm cov neeg tuaj xyuas thiab xav tau kev saib xyuas hauv tsev kho mob yuav txo qis heev uas ua rau muaj kev cuam tshuam rau kev noj qab haus huv. Indian kev noj qab haus huv system14,15 raug ntes tsis paub raws li cov thawj coj saib xyuas kev noj qab haus huv laus nrog rau cov neeg tsim cai lij choj thiab cov thawj coj yeej tsis tau xav txog qhov xwm txheej zoo li no uas ntau txhiab tus neeg xav tau oxygen thiab txaj pw hauv tsev kho mob ib zaug, yog li ua rau muaj kev nyuaj siab rau cov peev txheej muaj. Kev muaj tus kab mob sib kis tau ua rau qhov xwm txheej tsis zoo vim cov neeg no tau tsim cov tsos mob hnyav dua COVID-19 thiab xav tau kev kho mob uas tsuas yog muab rau hauv tsev kho mob nrog qhov xav tau ntawm cov pa oxygen thiab lub tshuab ua pa uas tsim nyog. Nov yog qee yam tsim nyog los xav txog kev mus tom ntej txhawm rau tiv thaiv tus kab mob COVID-19 thiab thaum kawg txo qis thiab tshem tawm.
Kev tsim cov tshuaj tiv thaiv COVID-19 los ntawm ntau lub tuam txhab thiab kev txhaj tshuaj loj ntawm tib neeg tawm tsam tus kab mob SARS-CoV2 tseem yuav ua lub luag haujlwm tseem ceeb hauv kev txhim kho kev tiv thaiv kab mob. Ib qho tseem ceeb uas yuav tsum tau hais ntawm no yog qhov kev txhaj tshuaj tiv thaiv yuav tsis tiv thaiv peb ntawm kev kis kab mob tab sis tsuas yog yuav pab txo qis qhov mob hnyav yog tias peb kis tus kab mob no (tom qab txhaj tshuaj tiv thaiv). Yog li, peb yuav tsum ua raws li cov lus qhia uas yuav tsum tsis txhob kis tus kab mob (hnav lub qhov ncauj qhov ntswg hauv cov chaw pej xeem, tswj kev sib nrug deb, siv cov tshuaj ntxuav tes thiab tsis txhob tawm qhov tsis tsim nyog), txawm tias peb tau txhaj tshuaj tiv thaiv, txog thaum tus kab mob no ploj mus.
Qhov xwm txheej no ntawm kev sib cav sib ceg ntawm tus kab mob thiab tib neeg, ua rau peb nco txog txoj kev xav ntawm Charles Darwin uas tau tham txog keeb kwm ntawm cov tsiaj los ntawm kev xaiv ntuj thiab muaj sia nyob ntawm qhov haum. Txawm hais tias tus kab mob no yuav yeej kev sib tw tam sim no, tsis muaj qhov tsis ntseeg tias peb, raws li tib neeg hom, yuav tshwm sim yeej thaum kawg, los ntawm kev tsim txoj hauv kev thiab txhais tau tias los tawm tsam tus kab mob (xws li txhaj tshuaj tiv thaiv thiab / lossis los ntawm peb lub cev tsim kev tiv thaiv mechanisms. los tawm tsam thiab tua tus kab mob), ua rau lub ntiaj teb rov qab mus rau qhov xwm txheej zoo siab uas peb nyob, ua ntej qhov tshwm sim ntawm COVID-19.
***
References
- Lim MA, Pranata R. Kev phom sij ntawm kev ua neej nyob tsis tu ncua nyob rau hauv cov neeg mob ntshav qab zib thiab rog thaum lub sij hawm tus kab mob COVID-19. Clinical Medicine Insights: Endocrinology thiab Ntshav Qab Zib. Lub Ib Hlis 2020. doi:10.1177/1179551420964487
- Soni R., 2020. Vitamin D Insufficiency (VDI) Leads to Severe COVID-19 Symptoms. Kev Tshawb Fawb Tebchaws Europe Tshaj Tawm 02 Lub Rau Hli 2020. Muaj nyob online ntawm https://www.scientificeuropean.co.uk/covid-19/vitamin-d-insufficiency-vdi-leads-to-severe-covid-19-symptoms/
- Pereira M, Damascena AD, Azevedo LMG, Oliveira TA thiab Santana JM. Vitamin D deficiency ua rau COVID-19 hnyav dua: kev tshuaj xyuas thiab ntsuas ntsuas ntsuas, Kev Ntsuam Xyuas Tseem Ceeb hauv Kev Tshawb Fawb Txog Khoom Noj thiab Khoom Noj, 2020 DOI: https://doi.org/10.1080/10408398.2020.1841090
- Rubin, R. Kev txheeb xyuas seb puas muaj vitamin D tsis txaus ua rau muaj kev pheej hmoo ntawm COVID-19. JAMA. 2021; 325(4): 329-330. DOI: https://doi.org/10.1001/jama.2020.24127
- Lub Koom Haum ntawm Vitamin D Deficiency thiab Kev Kho Mob nrog COVID-19 tshwm sim. Meltzer DO, Best TJ, Zhang H, Vokes T, Arora V thiab Solway J. medRxiv 2020.05.08.20095893; doi: https://doi.org/10.1101/2020.05.08.20095893
- Weir EK, Thenappan T, Bhargava M, Chen Y. Puas yog vitamin D tsis txaus ua rau muaj qhov hnyav ntawm COVID-19?. Clin Med (Lond). 2020;20(4):e107-e108. doi: https://doi.org/10.7861/clinmed.2020-0301
- Carpagnano, GE, Di Lecce, V., Quaranta, VN et al. Tsis muaj vitamin D raws li kev kwv yees ntawm qhov tsis zoo hauv cov neeg mob uas ua pa tsis ua pa vim yog COVID-19. J Endocrinol Ua Lag Luam 44, 765–771 (2021). https://doi.org/10.1007/s40618-020-01370-x.
- Chakhtoura M, Napoli N, El Hajj Fuleihan G. Tawm tswv yim: dab neeg thiab qhov tseeb ntawm vitamin D thaum muaj tus kab mob COVID-19. Metabolism 2020; 109: 154276. DOI: https://doi.org/10.1016/j.metabol.2020.154276
- G, R.; Gupta, A. Vitamin D Deficiency nyob rau hauv Is Nrias teb: Prevalence, Causalities thiab Interventions. Nutrients 2014, 6, 729-775. https://doi.org/10.3390/nu6020729.
- Katz J, Yue S thiab Xue W. Muaj kev pheej hmoo rau COVID-19 hauv cov neeg mob uas tsis muaj vitamin D. Khoom noj khoom haus, Volume 84, 2021, 111106, ISSN 0899-9007. DOI: https://doi.org/10.1016/j.nut.2020.111106.
- Jayawardena, R., Ranasinghe, P., Byrne, NM et al. Prevalence thiab tiam sis ntawm cov kab mob ntshav qab zib nyob rau hauv South Asia: kev tshuaj xyuas thiab kev tshuaj ntsuam meta. BMC Public Health 12, 380 (2012). https://doi.org/10.1186/1471-2458-12-380.
- Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. Peb Hlis 2007; 125(3): 217-30. PIB: 17496352. https://pubmed.ncbi.nlm.nih.gov/17496352/
- Bavel, JJV, Baicker, K., Boggio, PS et al. Siv kev tshawb fawb txog kev sib raug zoo thiab kev coj tus cwj pwm los pab txhawb rau COVID-19 kev sib kis thoob qhov txhia chaw. Nat Hum Behav 4, 460–471 (2020). https://doi.org/10.1038/s41562-020-0884-z
- Tus kab mob kis thoob qhov txhia chaw thiab kev sib tw ntawm kev hloov tus cwj pwm Muaj nyob online ntawm https://www.thehindu.com/opinion/op-ed/the-pandemic-and-the-challenge-of-behaviour-change/article31596370.ece
- Anjana, RM, Pradeepa, R., Deepa, M. et al. Prevalence ntawm ntshav qab zib thiab prediabetes (ua tsis taus noj qab haus huv thiab / los yog impaired qabzib kam rau ua) nyob rau hauv nroog thiab nyob deb nroog Is Nrias teb: Phase I tau los ntawm Indian Council of Medical Research-INdia Diabetes (ICMR-INDIAB) txoj kev tshawb no. Diabetologia 54, 3022–3027 (2011). DOI: https://doi.org/10.1007/s00125-011-2291-5
- Kumar V, Singh J, Hasnain SE thiab Sundar D. Muaj peev xwm txuas ntawm kev sib kis ntau dua ntawm B.1.617 thiab B.1.1.7 variants ntawm SARS-CoV-2 thiab nce kev ruaj ntseg ntawm nws cov protein ntau thiab hACE2 affinity. bioExiv 2021.04.29.441933. DOI: https://doi.org/10.1101/2021.04.29.441933
- Niti Ayog 2020. Mitigation & Management of COVID-19. Muaj nyob online ntawm https://niti.gov.in/sites/default/files/2020-11/Report-on-Mitigation-and-Management-of-COVID19.pdf
- Gauttam P., Patel N., et al 2021. Public Health Policy of India and COVID-19: Diagnosis and Prognosis of the Combating Response. Sustainability 2021, 13(6), 3415; DOI: https://doi.org/10.3390/su13063415
***
Very comprehensive and well articulated article covering different aspects of the reasons of the surge of Covid 19 in India. Congratulations Rajeev Soni!
Excellent article that presents a comprehensive perspective on ‘what went wrong’. It’s a battle of survival between the virus and humans. To win, we need to use the right strategies to restrict the growth of the virus through mutations. This requires humans to change their social behaviour significantly by quickly adopting and adapting to the new normal of cautious interactions and healthy living. This seems tough in the Indian context. But, our other option is to suffer!
excellent article. Very well analysed and articulated.
Very well written: So concise, with relevant references, coherent, centered around the thesis, and leaving one with some ray of hope!!
Great to see Vitamin D can help combat the spread of Covid epidemic!!
A very concise diagnosis of the problem and actually it gives a new perspective. India seems will over come the vaccine thru 1. Vaccination : a very slow process , currently we are at 18 lac per day , constrained by production capacity for one. 2. Hospitalization 3. Home quarantined / isolation 4. Public taking precautions and also starting early consultation and medication.
What I would like to know : how Pakistan , Bdesh , Nepal are coping with the virus. Or is it the deadly / virulent nature of Indian mutant, which is causing the issues in India. These countries also face the same health and cultural issues.
Why Brazil, Italy and USA had a near collapse of the medical infrastructure due to sudden surge ? Was it due similar health and cultural issues as faced by India ?
Will Developed countries continue to support India , once they have secured their Borders from Indian Mutant ?
Very well written article. Meticulous analysis on the current situation. Imp information on life style & Vitamin D role to fightback against covid. No doubt
Human being will survive the race against virus.
Congratulations Dr. Soni.