WHEN we seem to be out of it, tiredness, pains around the body and shortness of breath remind us that the suffering has not yet gone away. And the Long Covid, a post-viral syndrome with debilitating multi-organ symptoms that, even after weeks, do not go away, even after the negativity of the tampon. Much more than a simple convalescence, so much so that in recent days, even the director of WHO Europe, Hans Kluge, declared: “For the health authorities, Long Covid 19 must immediately become a priority”. Taking up this invitation, the Istituto Superiore di Sanità, which has already published information on the subject accessible to all on the institutional website, has recently set up a working group to understand more and develop a document in which they participate. even general practitioners.
What is Long Covid
The president of the Italian Society of General Medicine and Primary Care (Simg), Claudio Cricelli, took stock of Long Covid and how to deal with the symptoms. Especially those who have been severely affected by the coronavirus infection are affected by the sindrome post-Covid-19 characterized by all the consequences that even for months the coronavirus infection brings to patients who have contracted it, in particular in those who have developed the disease in a moderate or severe way, with pneumonia. The consequences reported in the literature, and in the field, are systemic: pulmonary, cardiological, renal, hepatic, neurological. Organ damage caused by an excessive inflammatory response triggered by the virus, but also an autoimmune reaction induced by the virus itself, could be responsible for the symptoms of Long Covid.
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What are the symptoms and how long they last
Having Covid after-effects is by no means a rare occurrence. “It happens very frequently that patients who have had Covid-19 complain of symptoms such as tiredness, headache, breathlessness, fatigue, anosmia, muscle weakness”, explains Cricelli who adds: “There are those who carry a crawling low-grade fever, the so-called ‘brain fog’, gastrointestinal disturbances such as diarrhea or skin manifestations and hair loss. These are dysfunctions that occur even after contracting other infectious diseases or the same flu “. How long they last? “It depends on the cases, but often it even reaches 2-3 months after the negativization of the tampon”, replies the president of Simg. Women appear to be twice as likely to develop the Long Covid, compared to men, but only up to around 60, when the risk level becomes similar. In addition to being a woman, older age and a higher body mass index also appear to be risk factors.
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Check-up post Covid
After overcoming the infection, it seems inappropriate to complain of fatigue or breathing difficulties, yet those suffering from Long Covid often describe themselves as a ‘vegetable’ because they feel completely without strength, in short, not cured. So what to do to feel good again? Some outpatient centers or private structures are offering real ‘post Covid check ups’ which include specific tests for the lungs (for example, the walking test and chest CT scan) and above all, as a preliminary, laboratory tests. They are useful? “They are useless because you check the machine if you know what the possible failure is”, warns Cricelli. “Most viral diseases often have symptoms of this type and Covid is no exception, but we still have to study the causes of this malaise in depth. As for blood tests, inflammatory markers such as PCR or Ves rather than CT scan of the lungs are normally done because they are subjects who have fallen ill with Covid and who continue to be treated as they cannot be considered completely cured. “.
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How the symptoms are treated
Since the symptoms can last a long time and can also be very disabling, what can the doctor prescribe? “We do not know if we can cure Long Covid or not because we do not have specific treatments”, explains Cricelli. “It is useless to trim supplements to combat fatigue: you have to wait for it to pass, do a watchful wait and in the meantime help yourself with rest and good nutrition”. The individual symptoms, however, can be treated or better kept at bay with common painkillers or drugs related to individual ailments: “We can treat headaches by prescribing anti-migraine drugs, cough with syrups and bone pain with an anti-pain reliever. We cannot do more until we understand if the cause of Long Covid is damage to the immune system or the persistence of the virus with a low viral load “. There are also less common symptoms such as reversible hair loss in 2 months and post-covid diabetes, a syndrome that has been recognized by the use of corticosteroids in patients where they have been used for moderate / severe symptoms.
Rehabilitation therapies
In case of chronic dyspnea, especially as an outcome of interstitial pneumonia, a specification may be useful respiratory rehabilitation therapy to recover damaged tissue from multiple foci of pneumonia. Patients should do respiratory gymnastics, and then gradually return to everyday life. Among the most frequent symptoms that recover after a longer time are the loss of smell and taste. According to a study by the Center for Smell and Taste at the Carl Gustav Carus University Hospital in Dresden, even in these cases, rehabilitation therapy could help, a sort of ‘olfactory training’ that is carried out through repeated treatments of 20 ‘-30’ with essences such as rose, eucalyptus, clove, lemon, for 12 weeks. Every day, in the morning and in the evening, you should spend at least half a minute trying to perceive each scent and exercise should be done regularly for as long as possible. “It seems to me a remedy that can be done without”, comments Cricelli: “The only thing is to leave the body time to completely get rid of all traces of the infection. As we study we will know more, we will develop guidelines for the treatment of this syndrome as we have done by providing indications for Covid home care “.
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