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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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High Blood Pressure: Everything You Need to Know

High blood pressure, also known as hypertension, is a common health condition affecting millions of people worldwide. Despite its prevalence, many are unaware they have it because it often presents no symptoms. This silent condition can lead to serious health problems if left untreated.

In this blog, we'll walk you through everything you need to know about high blood pressure — from causes and symptoms to prevention and treatment.

What is High Blood Pressure?

Blood pressure is the force of blood pushing against the walls of your arteries. It's measured using two numbers:

Systolic pressure (top number): Pressure when your heart beats.
Diastolic pressure (bottom number): Pressure when your heart is at rest.

Normal blood pressure is usually around 120/80 mmHg. If your readings are consistently 140/90 mmHg or higher, you may have high blood pressure.

Why is High Blood Pressure Dangerous?

High blood pressure forces your heart to work harder than normal, which can damage your arteries and vital organs over time. If not managed properly, it can lead to:

Heart disease
Stroke
Kidney failure
Vision loss
Cognitive decline

The worst part? You might not feel anything until these serious problems develop.

What Causes High Blood Pressure?

There isn't always one specific cause. However, several factors can increase your risk:

Unhealthy Diet: High salt, fat, and processed foods raise your blood pressure.
Lack of Physical Activity: A sedentary lifestyle weakens your heart.
Obesity: More weight means more pressure on your blood vessels.
Smoking and Alcohol: These habits damage your arteries.
Stress: Chronic stress can raise blood pressure over time.
Genetics: Family history plays a role in your risk.

Sometimes, medical conditions like thyroid disorders, kidney disease, or certain medications can also cause high blood pressure.

Symptoms of High Blood Pressure

High blood pressure is often called the "silent killer" because it rarely causes obvious symptoms. However, in some cases, people may experience:

Headaches
Dizziness
Nosebleeds
Blurred vision
Shortness of breath

If you feel any of these symptoms regularly, it’s best to get your blood pressure checked.

How is High Blood Pressure Diagnosed?

Diagnosing high blood pressure is simple. A healthcare professional uses a device called a sphygmomanometer to measure your blood pressure. You might be asked to monitor your levels over several days or weeks to confirm the diagnosis.

At SecondMedic, you can also schedule a virtual or home visit for convenient health check-ups.

How is High Blood Pressure Treated?

Treatment for high blood pressure usually involves a combination of lifestyle changes and, in some cases, medication. Here’s how you can manage it:

1. Lifestyle Changes

Healthy Eating: Follow the DASH diet — rich in fruits, vegetables, whole grains, and low-fat dairy.
Exercise Regularly: Aim for at least 30 minutes of moderate activity most days.
Limit Salt: Less salt means lower pressure.
Reduce Alcohol: Keep it in moderation.
Quit Smoking: It improves heart and lung health.
Manage Stress: Meditation, deep breathing, and yoga help reduce pressure.

2. Medications

If lifestyle changes aren’t enough, your doctor may prescribe:

Diuretics
ACE inhibitors
Beta-blockers
Calcium channel blockers

Always take medications as directed by your healthcare provider.

Tips for Preventing High Blood Pressure

Even if your blood pressure is normal now, taking preventive steps can help keep it that way:

Get regular check-ups.
Maintain a healthy weight.
Stay active.
Eat fresh, low-sodium meals.
Avoid excessive caffeine.
Track your blood pressure at home.

By being proactive, you can significantly lower your chances of developing high blood pressure in the future.

Managing Stress and Mental Health

Mental health has a powerful impact on physical health. Stress, anxiety, and depression can all contribute to high blood pressure. Here are a few relaxation techniques that can help:

Practice mindfulness and meditation.
Take short walks during work breaks.
Listen to calming music.
Stay connected with friends and family.
Talk to a counselor or therapist if needed.

Your heart and your mind are deeply connected — take care of both.

When to See a Doctor

If your blood pressure is consistently high, or if you’re experiencing symptoms like dizziness or chest pain, consult a doctor immediately. Regular monitoring and early intervention can save your life.

SecondMedic offers expert consultation services online and offline, making it easy for you to take charge of your heart health from the comfort of your home.

Conclusion: Take Control of Your Health Today

High blood pressure doesn’t have to control your life — with the right steps, you can manage and even prevent it. Start small, make simple changes, and seek medical help when needed. Regular monitoring, healthy habits, and awareness are your best tools in this journey.

If you or a loved one is dealing with high blood pressure, book a consultation with SecondMedic today to get expert guidance and personalized care. Let’s take the first step toward better health together.