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Long covid: how is a diagnosis made? Is there a cure?

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Long covid: how is a diagnosis made?  Is there a cure?

As we have seen several times, lowering the guard on covid is always very risky, also because the number of those who, after the disease, continue to have disorders that compromise the quality of life is growing. They are the victims of long covid, a complex and still little known syndrome, the subject of numerous studies that try to identify its causes and find a therapy. Journalist and writer Agnese Codignola dedicated her latest book to the most recent results of the research, and to the history of this disease, long denied by the scientific community: Il Lungo Covid (Utet).

1. Why is Long Covid associated with other mysterious diseases? Very similar syndromes have also been described in past centuries, as a legacy left by the great pandemics and epidemics. The similarities are first of all in the type of symptoms, in their frequency and in the course over time. Disorders such as extreme fatigue, difficulty concentrating (or brain fog), widespread pain, labored breathing, tachycardia or depression, are in fact found in various conditions following a viral infection and also in numerous autoimmune diseases. With the latter, then, the long covid has various points of contact: for example, it affects women more than men, especially between 40 and 55 years. It also has a fluctuating trend, that is, it alternates moments of relative quiescence with others in which the symptoms become acute.

2. Among the syndromes of the past, are there any caused by coronavirus? Most likely yes. According to recent studies, the called pandemic la Russa, which plagued Europe and North America between the late 1800s and early 1900s, was determined by one of the four coronaviruses that cause colds today: the one called OC43. That pandemic left behind a post viral syndrome that lasted for years and that had many features in common with long covid such as, for example, olfactory distortions, fatigue and difficulty concentrating.

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3. Why is it so difficult to identify these diseases? Knowledge is increasing. For example, specific antibodies are being discovered which form early in the disease and which could be associated with the later development of long covid. However, there is still no procedure that allows a precise diagnosis to be made, because there are no tests that give an unequivocal answer. Everything is then complicated by the fact that the disease presents itself in a very different way and everyone has the your constellation of disturbances. As for the causes, there are currently many hypotheses. In general it is believed to be an autoimmune reaction (in which antibodies formed by the patient are directed against his own tissues), possibly triggered by viral particles that remain in the body even when the swab is now negative. Alternatively, the immunological upheaval could be caused by an encounter with an entirely new virus.

4. How is the diagnosis made? And what therapies are there today? The diagnosis can only be made with a detailed reconstruction of the patient’s history, even prior to the Sars-CoV2 infection. There are in fact some conditions (such as diabetes, asthma or obesity) that seem to predispose to long covid. Precisely because of the great heterogeneity of the symptoms, there is no single procedure: the doctor must evaluate the prevailing disorders, and direct towards the most suitable tests. Furthermore, he must listen carefully to what the patient reports, for example when he talks about depression or brain fog. The same goes for treatments: there is not just one, but we try to help the patient with drugs, rehabilitation (respiratory, physical and olfactory) and, when necessary, with psychotherapy and relaxation techniques. Many studies are underway to find more effective and specific treatments.

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