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The puzzle of the long-term effects after coronavirus disease seems to have to be solved for a long time by the medical community, which is now faced with new terms such as “long-term” illness from covid-19 (long-term covid-19).
As doctor-curator of the 2nd NSS and head of the COVID department at the hospital “Alexandra” states in APE-MPE Eleni Koromboki, the term “prolonged” COVID-19 illness refers to the persistence of symptoms or the appearance of new symptoms after an acute SARS-CoV-2 infection. “Long-term symptoms are very diverse, can occur even after mild illness (and not just after ICU treatment), and seem to affect all body systems. That is why the clinical approach of COVID-19 patients it requires a holistic approach. “
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And the ideal form of this holistic approach, as Ms. Koromboki points out, is the creation of post-covid clinics, like the ones that are gradually being structured and have begun to operate in all organized health systems, offering comprehensive care to patients. affected by the new coronavirus. “With the aim not only to alleviate” prolonged illness, but to restore psychosomatic health and well-being. “The head of the Covid department of” Alexandra “emphasizes that patients with persistent symptoms need regular monitoring by a team interdisciplinary of health professionals Laboratory tests and treatment approach should be individualized, based on the symptoms and clinical findings of each patient.
What specialties are required for rehabilitation.
“Eg According to the British Thoracic Society, patients with severe respiratory symptoms need a reexamination with an X-ray or chest X-ray after 12 weeks, while those with persistent symptoms should be referred to a pulmonologist and specialist.” Given the multisystematic nature of the disease, says Ms Koromboki, different medical specialties (infectious diseases, physiologists, pulmonologists, cardiologists, psychiatrists, neurologists, physiatrists, rheumatologists, hematologists, endocrinologists, etc.) in rehabilitation (psychologists, physiotherapists, neuropsychologists, occupational therapists, speech therapists, dietitians, etc.) must interact in an interdisciplinary way for this holistic approach.
Up to 80% suffer persistent symptoms after discharge from hospital
According to the doctor, about 10% of patients who test positive for the SARS-CoV-2 virus continue to feel that they have not fully recovered even 3 weeks or even months after the acute illness, as evidenced by a population study in the United States. Kingdom, in which patients were asked to record their prolonged symptoms in an app on their mobile phone. “A recent study from the United States found that 35% of patients report persistent symptoms for more than three weeks. In studies of hospitalized patients, the percentage of persistent symptoms after hospital discharge appears to be higher, ranging from 50- 80% “.
Post-traumatic stress delays recovery
But why is recovery delayed in some patients, while others return faster? Ms. Koromboki replied that among the possible causes of delayed recovery, prolonged viremia (presence of the virus in the blood) due to the inability of the body to produce antibodies, relapse or reinfection, inflammatory or immune response, as well as factors psychological problems such as post-traumatic stress disorder. Long-term complications of respiratory, musculoskeletal, and neuropsychiatric symptoms have been reported after and after illness and other coronaviruses (SARS and MERS) and may be analogous to the underlying mechanisms.
With chronic fatigue, one in two recovered
The most common persistent symptoms after COVID-19 infection can come from different body systems. “Chronic fatigue is the most frequently reported symptom in a percentage of around 50%, which significantly affects the quality of life and mental health of people infected with the new coronavirus. Post-traumatic stress disorder and depression, anxiety disorders, and sleep disorders are commonly reported at about 30%. In the respiratory system, shortness of breath and cough are reported in about 40%, while imaging disorders (evidence of fibrosis in the lungs) can be found even three months after the acute phase of the disease.
Approximately 20% of patients report symptoms of the cardiovascular system such as chest pain, palpitations, tachycardia, orthostatic hypotension, while a small percentage may later develop more serious complications such as myocarditis and thrombosis. Memory and concentration disorders are common in approximately 30% of patients, and headaches and dizziness are reported. Immunity and taste, often symptoms in the acute phase of the disease, can persist up to 10% for more than three weeks.
Possible trigger or exacerbation of autoimmunity
“Persistent myalgias and arthralgias occur in 30% of cases. Alopecia, nail disorders, skin rash, osteoporosis, the appearance or difficulty of controlling diabetes and vitamin D deficiency, which in the long run can lead to osteoporosis, they are also among the rarest long-term complications. “From laboratory test to findings and imaging of the respiratory system, there may be a persistent increase in inflammatory markers, an increased chance of thrombosis and a possible trigger or exacerbation of autoimmune diseases. “
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