- 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
Vitamin D Deficiency Symptoms: Signs Your Body May Be Lacking Vitamin D
Vitamin D is an essential nutrient that plays a vital role in maintaining strong bones, supporting the immune system and regulating several important functions in the body. Despite its importance, vitamin D deficiency is one of the most common nutritional deficiencies worldwide.
In India, vitamin D deficiency has become increasingly prevalent due to lifestyle factors such as limited sunlight exposure, indoor working environments and dietary habits. According to the Indian Council of Medical Research (ICMR), a significant percentage of the population may have insufficient vitamin D levels.
Recognizing the symptoms of vitamin D deficiency early is important because prolonged deficiency can lead to serious health complications affecting bones, muscles and overall wellbeing.
What Is Vitamin D and Why Is It Important?
Vitamin D is often called the “sunshine vitamin” because the body produces it when the skin is exposed to sunlight. It plays a key role in calcium absorption, which is essential for maintaining healthy bones and teeth.
In addition to bone health, vitamin D supports several important functions including:
immune system regulation
muscle function
inflammation control
hormonal balance
Low levels of vitamin D can disrupt these functions and contribute to various health problems.
Common Symptoms of Vitamin D Deficiency
Vitamin D deficiency can manifest through several symptoms, many of which are often overlooked or mistaken for other health issues.
Persistent Fatigue
Constant tiredness or low energy levels may be one of the earliest signs of vitamin D deficiency. Even after adequate rest, individuals with low vitamin D levels may continue to feel exhausted.
Vitamin D plays a role in cellular energy production, and insufficient levels may contribute to chronic fatigue.
Bone and Back Pain
One of the most well-known effects of vitamin D deficiency is bone discomfort. Vitamin D helps the body absorb calcium, which is essential for maintaining bone strength.
Low vitamin D levels may cause:
bone pain
lower back pain
increased risk of fractures
Persistent bone discomfort should be evaluated by a healthcare professional.
Muscle Weakness
Vitamin D is important for muscle health and function. Deficiency can lead to muscle weakness, cramps or general muscle fatigue.
Older adults with vitamin D deficiency may also experience reduced mobility and increased risk of falls.
Frequent Illness or Infections
Vitamin D plays a key role in supporting the immune system. Individuals with low vitamin D levels may experience frequent colds, infections or slower recovery from illness.
Research suggests that adequate vitamin D levels help strengthen immune defenses against respiratory infections.
Mood Changes and Depression
Vitamin D may influence brain function and mood regulation. Some studies have found a connection between low vitamin D levels and mood disorders such as depression or anxiety.
People experiencing persistent mood changes should consider evaluating vitamin levels as part of a broader health assessment.
Hair Loss
Severe vitamin D deficiency may contribute to hair thinning or hair loss. While hair loss can have multiple causes, nutritional deficiencies including vitamin D deficiency may play a role.
Slow Wound Healing
Vitamin D contributes to the body’s inflammatory response and tissue repair processes. Individuals with deficiency may notice slower wound healing or delayed recovery from injuries.
Who Is at Risk of Vitamin D Deficiency?
Several factors can increase the risk of vitamin D deficiency.
Limited Sun Exposure
People who spend most of their time indoors or use strong sun protection regularly may not receive enough sunlight to produce sufficient vitamin D.
Urban lifestyles and indoor work environments contribute to this problem.
Older Adults
As people age, the skin becomes less efficient at producing vitamin D from sunlight. Older adults may therefore require additional dietary intake or supplements.
Individuals with Darker Skin
Melanin reduces the skin’s ability to produce vitamin D from sunlight. Individuals with darker skin tones may require longer sun exposure to produce adequate levels.
Poor Dietary Intake
Few foods naturally contain vitamin D. Diets lacking fortified foods, dairy products or fatty fish may contribute to deficiency.
Medical Conditions
Certain medical conditions such as kidney disease, liver disease or digestive disorders can affect vitamin D absorption and metabolism.
How Is Vitamin D Deficiency Diagnosed?
Vitamin D deficiency is diagnosed through a simple blood test that measures the level of 25-hydroxyvitamin D in the bloodstream.
Doctors may recommend testing for individuals who experience symptoms of deficiency or belong to high-risk groups.
Early diagnosis allows healthcare providers to recommend appropriate treatment and lifestyle adjustments.
How to Improve Vitamin D Levels
Sunlight Exposure
Regular sunlight exposure is one of the most effective ways to increase vitamin D levels. Experts generally recommend 10 to 30 minutes of sunlight exposure several times per week, depending on skin type and location.
Dietary Sources of Vitamin D
Although limited, certain foods contain vitamin D, including:
fatty fish such as salmon and mackerel
egg yolks
fortified milk and cereals
mushrooms
Including these foods in the diet can help maintain healthy vitamin D levels.
Vitamin D Supplements
In cases of significant deficiency, doctors may recommend vitamin D supplements. The dosage depends on the individual’s vitamin levels, age and health status.
It is important to take supplements under medical supervision to avoid excessive intake.
Preventing Vitamin D Deficiency
Maintaining adequate vitamin D levels requires a balanced combination of sunlight exposure, proper nutrition and regular health monitoring.
Routine health checkups and vitamin testing can help identify deficiencies early and prevent complications.
Adopting a healthy lifestyle with balanced nutrition and outdoor activity can significantly improve vitamin D status and overall health.
Conclusion
Vitamin D deficiency is a common but often overlooked health concern. Symptoms such as fatigue, bone pain, muscle weakness and frequent infections may indicate low vitamin D levels.
Early detection and proper management are essential to prevent long-term health complications. By ensuring adequate sunlight exposure, maintaining a balanced diet and undergoing regular health checkups, individuals can support healthy vitamin D levels and improve overall wellbeing.
Recognizing the warning signs of vitamin D deficiency and seeking timely medical advice can help protect long-term health and maintain optimal body function.
References
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Indian Council of Medical Research (ICMR) – Nutritional Deficiency Reports
-
World Health Organization (WHO) – Micronutrient Deficiency Guidelines
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National Institute of Nutrition (NIN) India – Vitamin D Research Reports
-
Lancet Public Health – Nutritional Health Studies
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National Institutes of Health (NIH) – Vitamin D Fact Sheets for Health Professionals
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