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Published on: Jul 14, 2021
1 minute read
By: Raj Dwivedi

Telemedicine, COVID-19 And Liver Diseases

For liver diseases, there have been successful experiences with the use of different modalities of telemedicine [i.e. asynchronous telemedicine (analysis of patient's data by a single physician or multidisciplinary team), synchronous real-time patient management and tele-education]
Our Telemedicine program showed successful results as the sustained virologic responses achieved by those patients treated in primary care settings under the expert guidance.
Currently, this type of care is considered a vital tool for the goal of global elimination of HCV infection.In addition to HCV management, telemedicine offers opportunities for a better management of patients with chronic liver diseases by increasing their access to tertiary care, thus improving efficiency of healthcare delivery at reasonable cost .
We forsee expansion of telemedicine into other areas of hepatology is desirable and hold potential for improving management of pre- and post-liver transplant patients, patients with hepatocellular carcinoma (HCC) and patients with both compensated and decompensated cirrhosis.
It is important to note that in liver transplant setting existing data suggest that use of telemedicine may expedite evaluation and listing of patients referred to liver transplant centers and could improve outcomes (hospital readmissions, and quality of life) after liver transplantation.
In the case of HCC, telemedicine aslo offers the possibility of multidisciplinary evaluation in virtual tumor boards leading to tailored and more effective treatments . Finally, in cirrhosis, telemedicine may enhance self-care and facilitate HCC surveillance eventually preventing readmissions in recently hospitalized patients.
With the onset of COVID-19 pandemic everyone has forced the implementation of telemedicine actions for many liver patients.
Major international societies have released recommendations encouraging the use of remote care to manage patients with all liver diseases, particularly liver transplant patients.
However, the crisis will seriously impact cirrhosis care with social distancing and isolation causing major delays in elective procedures and routine care with potential overwhelm of medical centers managing postponed and potentially decompensated patients in the upcoming months.
Developing robust telemedicine programs and revamping remote care initiatives in hepatology will be critical during COVID times. The next challenge will be how to integrate telemedicine into routine clinical care beyond the COVID-19 pandemic.

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How Cold Weather Affects Health: Understanding Winter’s Impact on the Body

Seasonal changes influence human health more than most people realise. Cold weather, in particular, places unique stress on the body and can worsen existing health conditions while increasing susceptibility to new illnesses. Understanding how cold weather affects health is essential for preventing seasonal complications and maintaining wellbeing during winter months.

In India, winter-related health issues vary by region but commonly include respiratory infections, cardiovascular strain and joint discomfort. According to the Indian Council of Medical Research (ICMR) and World Health Organization (WHO), cold exposure is associated with increased morbidity, especially among older adults and people with chronic conditions.

Why Cold Weather Impacts the Body

The human body works constantly to maintain core temperature. In cold environments:

blood vessels constrict to conserve heat
energy expenditure increases
immune responses may weaken
organs work harder to maintain balance

These adaptations, while protective, also create health vulnerabilities.

Increased Risk of Infections

Weakened Immune Response

Cold weather can suppress immune function, making it harder for the body to fight infections.

Factors contributing to winter infections include:

reduced vitamin D due to less sunlight
dry air affecting mucosal defenses
closer indoor contact

Common winter infections include colds, flu and respiratory illnesses.

Respiratory Health Problems

Cold air irritates the respiratory tract.

This can lead to:

worsening asthma symptoms
bronchitis flare-ups
increased cough and breathlessness

WHO reports higher hospital admissions for respiratory illnesses during colder months.

Impact on Heart Health

Cold temperatures affect cardiovascular function.

Blood Vessel Constriction

Cold causes blood vessels to narrow, increasing:

blood pressure
heart workload

This raises the risk of:

heart attacks
strokes

People with existing heart disease are particularly vulnerable.

Joint and Muscle Pain

Cold weather affects musculoskeletal health.

Common complaints include:

joint stiffness
muscle aches
worsening arthritis pain

Lower temperatures reduce joint lubrication and increase sensitivity to pain.

Metabolic and Weight Changes

Winter often leads to:

reduced physical activity
increased calorie intake
metabolic slowdown

These changes contribute to weight gain and worsen metabolic conditions such as diabetes.

Skin and Hydration Issues

Cold air holds less moisture.

This leads to:

dry skin
cracked lips
worsening eczema

Dehydration is also common as thirst perception reduces in cold weather.

Mental Health Effects

Seasonal changes can influence mental wellbeing.

Cold weather is associated with:

low mood
reduced motivation
seasonal affective symptoms

Limited sunlight affects circadian rhythm and serotonin levels.

Cold Weather and Older Adults

Elderly individuals face higher risks due to:

reduced temperature regulation
weaker immunity
existing chronic conditions

Winter-related complications are a significant cause of hospitalisation in older populations.

Why Chronic Diseases Worsen in Winter

Conditions such as:

hypertension
arthritis
asthma
diabetes

often worsen due to reduced activity, stress on organs and infection risk.

Preventive Strategies for Winter Health

Maintain Body Warmth

Layered clothing and warm environments reduce cold stress.

Support Immunity

Adequate nutrition, vitamin intake and sleep strengthen immune defences.

Stay Physically Active

Indoor exercises and regular movement prevent stiffness and metabolic decline.

Manage Chronic Conditions

Regular monitoring and medication adherence are critical during winter.

Hydration and Skin Care

Drinking fluids and using moisturisers prevent dehydration and skin damage.

Role of Preventive Healthcare

Preventive healthcare helps:

identify seasonal risk factors
adjust treatment plans
prevent winter complications

NITI Aayog highlights seasonal preparedness as an important public health strategy.

When to Seek Medical Help

Medical attention is necessary if:

infections persist or worsen
chest pain or breathlessness occurs
joint pain limits mobility
mental health symptoms interfere with daily life

Early care prevents serious outcomes.

Long-Term Impact of Ignoring Winter Health Risks

Ignoring cold weather effects may lead to:

severe infections
cardiovascular events
chronic pain progression
reduced quality of life

Seasonal awareness plays a critical role in long-term health.

Conclusion

Understanding how cold weather affects health allows individuals to take timely preventive measures. Winter increases the risk of infections, heart strain, respiratory problems, joint pain and mental health challenges. With proper warmth, nutrition, activity and preventive healthcare, most cold-related health issues are manageable and preventable. Seasonal care is not optional—it is essential for protecting health and wellbeing throughout the colder months.

References

ICMR – Seasonal Health and Infectious Disease Reports
National Family Health Survey (NFHS-5) – Seasonal Morbidity Data
NITI Aayog – Preventive Healthcare and Seasonal Preparedness Strategy
WHO – Cold Weather and Health Impact Guideline
Lancet – Seasonal Variation in Cardiovascular and Respiratory Diseases
Statista – Winter Health Trends and Illness Data
Indian Journal of Public Health – Climate and Health Studies

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