Char Dham Yatra- surge in sudden cardiac deaths linked to Covid infection?
Sunday, 29 May 2022 | Ajay Semalty | DEHRADUN
In Uttarakhand upto May 27, at least 83 pilgrims had died while undertaking this year’s Char Dham Yatra, which started earlier this month, owing to health-related reasons, mostly cardiac arrest. The Yatra which started after a two-year break is going on in full swing with record number of pilgrims reaching the shrines. The sudden cardiac death of pilgrims has been reported in past years also. In 2019 around 38 lakh pilgrims undertook the Yatra and over 90 of them died. And, 112 and 102 pilgrims died during the Yatra in 2017 and 2018 respectively. But this time the death toll is multi fold in the first month itself.
The world has just come out of the jaws of Covid-19 but the survivors are carrying the impact of the damage caused by the infection. It should be noted that although Covid-19 is primarily a respiratory or lung disease, the heart can also suffer. Covid patients who suffer a cardiac arrest either in or out of hospital are far more likely to die than patients who are not infected with the novel coronavirus. In particular, women have the highest risk of dying- they are nine times more likely to die after suffering a cardiac arrest in hospital, according to research published in the European Heart Journal. Various studies have reported and highlighted the link between sudden cardiac death and Covid-19. Global data indicate the correlation between increased death due to cardiac arrest and the Covid pandemic. Data from the Houston Fire Department shows a 45 per cent jump in sudden cardiac deaths during the pandemic. In New York city, the incidence of out-of-hospital cardiac arrest (OHCA) attended by EMS (March 1-April 25, 2020) increased three-fold, compared with the same period a year earlier (Heart and Stroke Statistics – 2022 Update by The American Heart Association).
Data from Italy suggests a significant positive association between the spread of Covid-19 and an increased number of OHCA. There is a 58 per cent rise in OHCA as compared to the previous year. Hospital data from China revealed that 27.8 per cent of admitted Covid patients had a myocardial injury. All of this evidence points towards some association of increased mortality and sudden cardiac death with Covid-19 infection. The risk of sudden cardiac death becomes more prominent at the high altitude of Char Dham where the chilly weather, lack of oxygen and tiredness make the scenario more complex. The lungs which have been affected adversely by the single and multiple infections are incapable to handle the harsh conditions of weather in Char Dham. In normal circumstances and even for healthy persons a certain level of acclimatisation (adjustment of the body to weather conditions) is also needed before visiting the high-altitude places. But pilgrims coming from the places of extreme temperatures regions are reaching to freezing Char Dham without any acclimatisation and hence the body is unable to face the change of weather. The government has provided health facilities in Char Dham Yatra but even those people who are declared unfit are going for the Yatra and inviting trouble. The pilgrims must take care of their health with respect to acclimatisation by staying a day or two in the lower Himalayas while the unfit people should avoid the pilgrimage.
Though there is no scientifically proven link between cardiac deaths and Covid infections the global data indicate a link. This must be critically and scientifically studied. Moreover, the government should record the metadata very carefully and analyse the same for planning the policy for future Yatra.
(The author is listed among World’s Top 2 % scientists of Pharmacy and Pharmacology by Stanford University in 2020 and 2021, and an assistant professor at HNB Garhwal University. Views expressed are personal)
