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Published on: Apr 25, 2021
2 minute read
By: Dr Rajan Choudhary

COVID 19 Mutations: An Update

COVID 19 Mutations: an update

India is currently experiencing a very high rate of infections across the country, resulting in record hospitalisations, ICU admissions and now a severe shortage of oxygen. How did this happen? As with all things, it is likely multifactorial, and blame cannot be associated with one single issue. Socioeconomic issues preventing effective lockdown, stretched healthcare resources, poor communication and maintenance of social distancing and mask use. And of course, viral variants, something we will be discussing below.

GENETIC MUTATIONS

Mutations are integrated deeply into the backbone of genetics. When DNA replicates, its two strands split apart and are used as blueprints to create two new strands, each containing half the original DNA. Mutation’s sneak into the replication phase, and can change the proteins the DNA encodes. If these mutations are compatible with life, they survive and may be passed down the generations. If the mutations provide an evolutionary benefit that improves the survival of the organism and allows it to outcompete other organisms, its descendants will survive, and the mutation will flourish.

Complex organisms such as plants and animals have inherent DNA repair mechanisms that reduce the rate of mutations. This is because most mutations are incompatible with life, as they destroy critical proteins required for the most basic functions of cell function and life. Cancer is evidence of what happens when these repair mechanisms fail. Viruses do not have such protection; when the high mutation rate is combined with the high replication rate, viral variants are inevitable.

COVID MUTATIONS

Scientists have been tracking mutations of the SARS-CoV-2 virus closely. Countries across the world are basing the re-opening and recovery of their societies on reducing infection rates and preventing re-infections through vaccination programmes. If the virus mutates, it can result in increased infectivity, mortality, and potentially the ability to escape from natural immunity offered by antibodies.

Indian genome scientists first detected the “double variant” of the novel coronavirus in October 2020, and in the UK in Feb 2021. It has been on the rise, and B.1.617 accounts for almost 70% of genomes submitted by India to the global database GISAID. It has a total of 13 mutations, which in turn lead to the change in multiple amino acids. B.1.617 has multiple mutations and describing it as a “double mutant” virus is therefore inaccurate.

L452R

B1617 s more contagious because of a mutation in the spike protein known as L452R.This mutation has been studied as it has also been found in variants identified in California (including apes in San Diego Zoo). It is thought this improves the binding to the ACE2 receptors in the lung and may also have some ability to escape from neutralising antibodies.

E484Q

The second mutation is E484Q, which also affects the spike protein to make it less susceptible to pre-existing antibodies, though there is limited evidence for this. Looking at convalescent plasma donated by people it appears to have weaker neutralisation of B.1.617 in some people, though this isn’t a consistent finding.

Mutations at position 484 have also been found in other global variants, though these E484K mutations lead to different functions. One study looking at the UK B.1.1.7 variant looked at how this E484K mutation affected viral interactions in vaccinated patients. Patients who have been vaccinated produce antibodies with a wide range of actions targeting multiple sections of the spike protein. When these patient serums were exposed to the B.1.1.7 mutation, it was found to have decreased neutralisation. This raised the risk of reduced vaccine efficacy and threatened the vaccine programme. Currently, public health officials are confident our vaccine programmes cover the emerging variants.

CONCERNS

Whilst B.1.617 is concerning, it currently accounts for about 20% of cases in Maharashtra, and likely a low percentage of total infections in the country. There is not yet enough evidence to classify it as a “variant of concern”, and further research is required. Though it has increased potential for spreading, currently the UK variant B.1.1.7 may be on the rise, and more concerning. It has over 50% increased transmissibility and 60% lethality and contributed to the UK’s most recent wave of infections. Genomic studies have shown it is now the dominant form of the virus in the Indian state of Punjab.

What is most concerning, however, is the risk of more variants emerging. As the infection spreads unimpeded through the population, viral replication remains at an all-time high, which in turn increases the risk of mutations. Current mutations are covered by vaccines, future mutations may not be. This is why we need to lower infection rates as soon as possible.

Social distancing, use of masks, vaccinations, lockdowns, and quarantine when expressing symptoms. We have to follow public health advice, to prevent our infection rates from spiralling further out of control

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Health Problems Linked to Excessive Caffeine Intake: When Too Much Becomes Harmful

Caffeine is one of the most widely consumed stimulants in the world. Found in coffee, tea, energy drinks and many soft drinks, it is often used to improve alertness and combat fatigue. While moderate caffeine consumption can be safe for most people, understanding the health problems linked to excessive caffeine intake is important, especially as daily consumption levels continue to rise in India.

Urban lifestyles, long working hours and increased reliance on energy drinks have made caffeine overconsumption a growing public health concern.

How Caffeine Works in the Body

Caffeine stimulates the central nervous system by blocking adenosine, a chemical responsible for promoting sleep and relaxation.

This results in:

increased alertness
faster heart rate
heightened mental activity

However, overstimulation places stress on multiple body systems.

What Is Considered Excessive Caffeine Intake?

According to WHO and global health guidelines:

up to 400 mg per day is considered safe for most healthy adults

Excessive intake occurs when:

multiple caffeinated beverages are consumed daily
energy drinks are used frequently
caffeine is consumed late in the day

Many people unknowingly exceed safe limits.

Nervous System Overstimulation

Excess caffeine overstimulates the brain.

Common symptoms include:

restlessness
nervousness
tremors
irritability

Chronic overstimulation can worsen stress and reduce emotional stability.

Anxiety and Panic Symptoms

Caffeine increases adrenaline release.

This can:

trigger anxiety attacks
worsen panic disorder
increase feelings of unease

ICMR mental health studies note caffeine as a common trigger for anxiety symptoms in sensitive individuals.

Sleep Disruption and Insomnia

Sleep is one of the first systems affected.

Excessive caffeine:

delays sleep onset
reduces deep sleep
shortens total sleep duration

Even caffeine consumed 6–8 hours before bedtime can impair sleep quality.

Impact on Heart Health

High caffeine intake affects the cardiovascular system.

Possible effects include:

increased heart rate
palpitations
irregular heart rhythm

People with underlying heart conditions are particularly vulnerable.

Blood Pressure Elevation

Caffeine temporarily raises blood pressure.

Chronic excessive intake may:

worsen hypertension
increase cardiovascular risk

NFHS-5 data highlights rising hypertension prevalence in India, making caffeine moderation important.

Digestive System Problems

Caffeine stimulates stomach acid production.

This can cause:

acidity
heartburn
gastritis
bloating

People with sensitive digestion may experience symptoms even at lower doses.

Dependency and Withdrawal Symptoms

Regular high intake leads to caffeine dependence.

Withdrawal symptoms include:

headaches
fatigue
irritability
difficulty concentrating

Dependence reinforces overconsumption cycles.

Effect on Bone Health

Excessive caffeine:

increases calcium loss through urine
may affect bone density over time

This is particularly concerning for older adults and women.

Dehydration and Electrolyte Imbalance

Caffeine has a mild diuretic effect.

High intake without adequate hydration may lead to:

dehydration
muscle cramps
fatigue

Hot climates increase this risk.

Impact on Blood Sugar and Metabolism

Caffeine affects glucose metabolism.

Excessive intake:

worsens insulin sensitivity
increases stress hormone release

This may increase diabetes risk when combined with poor lifestyle habits.

Energy Drinks and Hidden Risks

Energy drinks often contain:

very high caffeine levels
added sugar
stimulants

Lancet reports associate energy drink overuse with heart rhythm disturbances and metabolic stress.

High-Risk Groups

Certain individuals should be especially cautious:

people with anxiety disorders
those with heart disease
pregnant women
individuals with sleep disorders

Safe limits may be lower for these groups.

Signs You May Be Consuming Too Much Caffeine

Warning signs include:

frequent palpitations
chronic insomnia
persistent anxiety
digestive discomfort
reliance on caffeine to function

These signals indicate the need for reduction.

How to Reduce Caffeine Intake Safely

Effective strategies include:

gradual reduction rather than abrupt stopping
switching to decaffeinated options
avoiding caffeine after mid-afternoon
improving sleep and nutrition

Small steps prevent withdrawal symptoms.

Healthier Alternatives for Energy

Better ways to improve energy include:

adequate sleep
balanced meals
hydration
regular physical activity

These support sustained energy without overstimulation.

Role of Preventive Health Awareness

Preventive healthcare focuses on:

identifying lifestyle triggers
reducing dependency habits

NITI Aayog highlights lifestyle modification as key to non-communicable disease prevention.

Long-Term Health Consequences of Ignoring Excess Intake

Chronic caffeine overuse increases risk of:

sleep disorders
anxiety and mood issues
heart rhythm problems
digestive disorders

These conditions often develop gradually.

Conclusion

The health problems linked to excessive caffeine intake extend beyond temporary jitters or sleep loss. Chronic overconsumption strains the nervous system, disrupts sleep, affects heart rhythm, worsens anxiety and impacts digestion and metabolism. While caffeine can be enjoyed safely in moderation, recognising personal limits and maintaining balance is essential for long-term health. Listening to early warning signs and adopting healthier energy habits can prevent serious health consequences.

References

World Health Organization (WHO) – Caffeine Intake and Health Guidelines
Indian Council of Medical Research (ICMR) – Nutrition and Mental Health Studies
National Family Health Survey (NFHS-5) – Hypertension and Lifestyle Risk Data
Lancet – Energy Drinks, Caffeine and Cardiovascular Effects
NITI Aayog – Preventive Health and Lifestyle Modification Reports
Statista – Caffeine Consumption Trends in India

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