VENICE – After three years and five months, the world seems to have forgotten about the pandemic. The virus, however, has not forgotten everyone: 65 million people around the globe, i.e. according to a conservative estimate 10% of infected subjects and therefore about 330,000 individuals in the Northeast, have suffered (and in part continue to suffer) from long Covid. The disease does not present in just one form, but has at least four clinical manifestations, according to the results of the international research project “Orchestra”, coordinated by the University of Verona, which were published yesterday in the scientific journal eClinicalMedicine-The Lancet.
I SYMPTOMS
The multicenter study was conducted from February 2020 to June 2022 in Italy, France, the Netherlands, Spain and Argentina, thanks also to funds from the European Commission. Among the 1,796 patients enrolled, 57% men, 1,030 accused at least one symptom 12 months after the infection. The most frequent ailment, so much so as to be complained of by 42% of the sample, was chronic fatigue syndrome, characterized by tiredness, headache and memory loss. 23% were instead affected by respiratory problems, in particular cough and dyspnoea. The diffusion rate of chronic pain syndrome (22%) related to muscles and joints is similar. Finally, 11% showed a sensorineural deficit, related to the alteration or loss of taste and smell.
According to the researchers, led by the infectious disease specialist Evelina Tacconelli, respiratory disorders and chronic pain syndrome are those that have the worst impact on quality of life. Furthermore, women are at greater risk of suffering chronic pain and fatigue and neurological symptoms, typical of PCS (Post Covid syndrome): “Female gender, gastrointestinal symptoms and renal complications during acute infection were associated with a higher risk of developing severe PCS, while vaccination and early treatment for SARS-CoV-2 were inversely associated with outcome”. Research has in fact shown that the injection of the anti-Covid vaccine and early treatment with monoclonal antibodies or corticosteroids have reduced the likelihood of running into long Covid.
THE PERSPECTIVES
A syndrome that can torment people even a thousand days after the infection, as explained by Matteo Tosato, head of the post-Covid day hospital at the Gemelli polyclinic in Rome: “In most cases it heals after a few months, but there are patients who continue to feel bad even after three years”. What are the causes? The authors of the study note some of them: “Several hypotheses have been formulated to explain the possible mechanisms that lead to the persistence of symptoms, such as uncontrolled immune responses, inflammatory damage, coagulation alteration, direct viral effects and interactions of the virus with the microbiome and the host virome”.
On this basis, the research led by the University of Verona opens up interesting perspectives: “The evidence recognized in the “Orchestra” project, in terms of the determinants of PCS and the severity of the disease, can support the timely identification of patients at greater risk of developing PCS and therefore guide the implementation of appropriate follow-up management protocols. Confirmation that vaccination has a substantial role in the prevention of chronic fatigue syndrome post acute SARS-CoV-2 infection could further support public awareness campaign and policy. Early identification of at-risk patients could play a key role in improving patient selection in clinical trials for new preventive treatments of PCS and for epidemiological studies assessing the burden of PCS. The conclusion of the researchers is that patients who are affected by it cannot be forgotten: «There is an urgent need for new drugs to treat the sequelae of Sars-CoV-2 infection. Even if the Covid-19 pandemic draws to an end, the number of people who will suffer from PCS in the coming years ethically does not allow us to limit basic and clinical research in this field”.
THE SITUATION
According to the weekly bulletin released yesterday by the Ministry of Health, 2,731,517 infections have been officially registered in Veneto and 582,173 in Friuli Venezia Giulia since 21 February 2020. Compared to then, however, the situation is very different, so much so that on Thursday Minister Orazio Schillaci announced that “the removal of isolation for people positive for Covid is a matter of days”. At this moment, this decision would involve over 15,000 subjects in the Northeast.
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in Il Gazzettino