NEW DELHI • The coronavirus variant driving India's devastating second wave is the most infectious to emerge so far. Doctors now want to know if it is also more severe.
Hearing impairment, severe gastric upsets and blood clots leading to gangrene, symptoms not typically seen in Covid-19 patients, have been linked by doctors in India to the so-called Delta variant.
In England and Scotland, early evidence suggests the strain - which is also now dominant there - carries a higher risk of hospitalisation.
Delta, also known as B16172, has spread to more than 60 countries over the past six months and triggered travel curbs from Australia to the United States.
Higher rates of transmission and a reduction in the effectiveness of vaccines have made understanding the strain's effects more critical.
"We need more scientific research to analyse if these newer clinical presentations are linked to B1617 or not," said Dr Abdul Ghafur, an infectious disease physician at the Apollo Hospital in Chennai, southern India's largest city. He said he is seeing more Covid-19 patients with diarrhoea now than in the initial wave of the pandemic.
"Last year, we thought we had learnt about our new enemy, but it changed," Dr Ghafur said. "This virus has become so, so unpredictable."
Some patients develop microthrombi, or small blood clots, so severe that they led affected tissue to die and develop gangrene, said Dr Ganesh Manudhane, a cardiologist in Mumbai who has treated eight patients for thrombotic complications at the Seven Hills Hospital during the past two months. Two required amputations of fingers or a foot.
"I saw three to four cases the whole of last year, and now it's one patient a week," Dr Manudhane said, adding that he was baffled by the blood clots he was seeing in patients across age groups with no history of coagulation-related problems.
Doctors are also finding instances of clots forming in blood vessels that supply the intestines, causing patients to experience stomach pain - their only symptom, local media have reported.
Some Covid-19 patients are also seeking medical care for hearing loss, swelling around the neck and severe tonsillitis, said Dr Hetal Marfatia, an ear, nose and throat surgeon at Mumbai's King Edward Memorial Hospital.
The most alarming aspect of the current outbreak in India is the rapidity with which the virus is spreading, including to children, said Dr Chetan Mundada, a paediatrician with the Yashoda group of hospitals in Hyderabad.
Dr Ghafur said he was also seeing entire families with Covid-19 symptoms, unlike last year when individuals dominated, reflecting an increase in household transmission caused by the Delta variant.
Cases of mucormycosis - a rare opportunistic fungal infection - have also been surging in India. It had infected more than 8,800 Covid-19 patients and survivors as at May 22, forcing local healthcare authorities to call it an epidemic.
On a more positive note, India's daily cases dropped below 100,000 for the first time in two months.
"India reports less than 100,000 daily new cases after 63 days, with 86,498 new cases reported in the last 24 hours, which is the lowest in 66 days," said the federal Health Ministry yesterday.
India's death toll surpassed the 350,000 mark, reaching 351,309 yesterday.
With emerging evidence that Delta and at least one other variant may be adept at evading vaccine-induced antibodies, pharmaceutical companies are under pressure to tweak existing shots or develop new ones.
"New vaccines have to be prepared with new variants in mind," said Dr Ghafur. "We can't get ahead of the virus, but we can at least keep up with it."