Pune: A recent spurt in the number of people affected by the herpes group of viruses may be the result of weakened immunity caused by Covid-19 infection, doctors in the city have said.
This reduced immunity may be part of what has been described as ‘long Covid‘, doctors said, referring to the lingering of symptoms well after Covid infection. Ophthalmologists, dermatologists and infectious diseases experts TOI spoke to said many people who had Covid continue to have problems, 19 months after the pandemic was declared over.
Such patients, many of them left with weakened immune systems, have faced repeated bouts of viral and bacterial illnesses. And one such category of pathogens that has seemingly taken advantage of this weakened state is the herpes group of viruses, which has triggered rashes, blurred vision and recurrence of diseases such as chickenpox.
The four primary herpes viruses capable of causing severe symptoms are the Varicella zoster virus, Epstein-Barr virus, the Herpes Simplex Virus (HSV) and the one that caused Herpes Zoster Ophthalmicus (HZO) infection, or shingles. This family of viruses can remain dormant in the body only to reemerge when immunity levels dip.
The number of herpes cases has had a sudden increase, doctors said. “Before Covid, herpes was more common in those above 60 years of age, mainly due to age-related immunity decline. Now, I’m seeing about 4-5 cases daily and many of these patients are in the 30-40 age group,” said Dr Varsha Rangari, a senior dermatologist with the Aditya Birla Memorial Hospital in the city. She added that herpes attacks are also being seen in many women, particularly in the genital area. “These cases have increased suddenly,” she said.
Dr Sapna Kamalani, a dermatologist with Jupiter Hospital said incidence of Herpes Zoster infection has definitely increased in the last few months. “Although the correlation of this spike with Covid infection is yet to be ascertained, we can certainly say that weakened immunity has had a role here. So if there is evidence of an increase in incidence post-Covid, logically, it could be due to a drop in immunity post-Covid rather than the Covid virus itself,” she said.
At Noble Hospital, infectious diseases expert Dr Ameet Dravid said: “Weakened immunity, which is one of the symptoms of long Covid, can flare up herpes viruses. Herpes is a broad family of viruses which is often present in our body and stays dormant until immunity is weakened enough for them to become active again. HSV, for instance, can cause oral or genital ulcers; varicella-zoster virus can cause chickenpox, herpes zoster, and can affect vision in rare instances.”
Dr Dravid added that symptoms of long Covid, such as fatigue, breathlessness, loss of appetite, and depression, can in some cases be attributed to reactivation of the Epstein-Barr virus.
“So, this broad family of viruses has been troubling patients after Covid infection. If one sees symptoms of long Covid, or recurrent oral and genital ulcers, it’s necessary to consult a doctor. Treatment includes medicines like Acyclovir for Herpes Simplex and Varicella Zoster virus. For viruses like Epstein-Barr, where treatment is not available, symptomatic treatment is given. We saw numbers of such patients rise drastically immediately after the Covid pandemic. The incidence has since reduced, but is still higher than pre-Covid levels,” Dr Dravid said.
Dr Ratna Masi, senior physician with Jehangir Wellness Center, said: “We are getting a lot of queries from patients for a vaccine against herpes zoster, especially from those who’ve had the infection once. This virus remains dormant in the body and reactivates once immunity drops. The pain is unbearable, and there is no treatment for it. Before Covid, we hardly had cases of herpes this severe. Now, we’re seeing more of them. A few days ago, we had a patient come in with a headache. His MRI report was normal but later, we found out he had a rash. He unfortunately succumbed due to herpes encephalitis.”
Ophthalmologists TOI spoke to said they have been seeing a number of people coming in with herpes-linked problems.
Dr Anil Dudhbhate, a city-based ophthalmologist, said: “We never saw such numbers before Covid. I’m getting at least 2-3 patients every month, coming in with painful papules over the eyelid and parts of the face, even near the scalp. This is a classic symptom of typical herpes zoster ophthalmicus. Most of these patients had a Covid infection during its pandemic stage, either mild or moderate.”
