Long Covid emergency, cases on the rise. The treatment handbook is born: all the symptoms

Long Covid emergency, cases on the rise.  The treatment handbook is born: all the symptoms

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They are two paths that run parallel, but which arise from a common point: cases of Long Covid, a syndrome post infection with SARS-CoV-2, are growing again, especially in the United States, and also in Italy. However, on the other hand, the set of symptoms that characterize it are often comparable to those associated with other post-viral syndromes. So it’s as if they didn’t exist, they weren’t classifiable. The result? Patients often don’t know they have Long Covid and bounce from clinic to clinic with diagnoses that aren’t always accurate and a lot of confusion in their heads.

The request of US researchers

That’s why groups of American researchers are calling for i National Institutes of Health (an agency of the United States Department of Health and Human Services) establish an internal department dedicated to chronic diseases caused by infections. And the Federation of American Scientists has submitted a formal request to this effect to the NIH. And this is why a proposal was born for the care of patients suffering from Long-Covid, a proposal that comes from the eBook entitled “Guidelines for the follow-up of Covid-19 sequelae“, edited by Claudio Luciforadirector of the Carlo Dell’Aringa Work Research Center (Crilda) of the Catholic University of the Sacred Heart and coordinator of the project Pascnetand published by the publishing house Life and Thought of the Catholic University of the Sacred Heart.

Long Covid cases are rising again

Meanwhile, cases are multiplying: Covid patients who, recovered from the infection, in fact they have not recovered from the damage that the virus has caused to their organs. Symptoms that often leave doctors hesitant. A striking example comes from America. THE Centers for Disease Control and Prevention announce an “alarming increase” in Long Covid cases in recent months. Nearly 7% of American adults suffer from it, or 17.6 million people.
Elsewhere things are no better, including Italy. “The statistics collected by the WHO remind us that since the beginning of the pandemic there have been, throughout the world, over 765,222,932 cases of contagion, with almost 7 million deaths – explains Lucifora -. In Lombardy alone, the infections are there were over 4 million with almost 50 thousand deaths. Although, for the moment, we can consider the Covid pandemic challenge won, many people, even years after the infection, are still living with the debilitating effects of Long-Covid”.

Watch out for these symptoms

But how do we know if we have Long Covid? What symptoms should we refer to? The main ones are fatigue, chronic headache, mental fog, difficulty carrying out daily activities, but also cardiac and neurological problems. Just last October, the rate of Americans with long Covid was 5.3%. The increase of more than 1.5%, experts observe, indicates that this syndrome is the infectious disease that has recorded the highest growth during the winter, after the flu.
“These estimates are simply a snapshot of what happens at a specific moment – said the CDC spokesperson -. It is difficult to understand the reasons for the trend and predict the future. To be diagnosed as Long Covid, the syndrome must be symptomatic for at least four monthstherefore considering the winter infections, the cases could continue to increase.”

The eBook with follow-up guidelines

The project is moving along this path Pascnet, with a set of “Guidelines for the follow-up of the sequelae of Covid-19” aimed at patients suffering from symptoms, contained in the eBook edited by Lucifora. Health protection agencies, local social and health authorities, scientific hospitalization and treatment institutes and a representation of general practitioners are involved in the initiative.
“The results of the first phase of the project, obtained thanks to the collaboration between clinicians from the main healthcare and research institutions in Lombardy, are published in the volume which, in fact, presents a first proposal for guidelines for follow-up – confirms Lucifora -. The bet is that they can support clinical practice, help optimize the care of patients affected by the post-acute sequelae of Covid infection, but above all offer prospects for recovery and improve their health”.

Pregliasco: “Invasive virus beyond the acute phase”

For some time there have been those who have looked at Long Covid as an important syndrome, to be followed carefully. Certainly to be defined in its manifestation and scope. Among these is the professor Fabrizio Pregliasco, virologist, medical director of the Galeazzi Hospital in Milan. Which says: “The symptoms of Long Covid represent the elements that highlight how the SARS-CoV-2 virus is invasive beyond the acute phase. The trouble is that it is a non-specific syndrome, so it is not easy to frame it in numerical terms”.
“A recent study has already shown, with the aim of establishing the duration of Long Covid, that those who were not positive had more long-term symptoms – concludes Pregliasco -. This is an additional piece in the puzzle we are building, certainly we must not stop in studying further. We are in a phase in which we must insist, continue with studies and understand which characteristics should be included in the Long Covid classification”.

The Australian study

Speaking of symptoms and the difficulty in identifying them, confirmation comes from an Australian study from Queensland Healthsigned by a team led by John Gerrardwhich essentially notes that “one year after infection, the symptoms associated with Long Covid appear to be completely superimposable to those associated with other post-viral syndromes”. The work will be presented in April at European Congress of Clinical Microbiology and Infectious Diseases (Eccmid 2024)
Researchers interviewed 5,112 Covid-affected and symptomatic people, aged 18 and over, to assess the rate of onset and risks associated with Long Covid. It was found that “the syndrome appears to manifest as post-viral indistinguishable from seasonal influenza and other respiratory illnesses, with no evidence of increased functional limitations.”

The examination of patients who have recovered from the infection

Those who experience this complication, the scientists found, report fatigue, mental confusion, cough, shortness of breath, changes in smell and taste, dizziness and a fast or irregular heartbeat. In the work setting, 16% of the sample reported symptoms 12 months post-infection, with 3.6% reporting moderate to severe functional impairment in activities of daily living.

After considering potentially influential factors on these parameters, the analysis did not detect a greater risk of functional limitations among the positive participants compared to what was observed in the group of Covid-negative participants. “There is, however, a greater probability of functional impairment among those over 50 who presented symptoms of dizziness, muscle pain, shortness of breath, malaise and fatigue,” explain the researchers.

“Symptoms that are difficult to distinguish”

In conclusion, the problem deepens: “In health systems with highly vaccinated populations, the rates of persistent symptoms and functional deterioration are indistinguishable from those of other post-viral diseases – confirms Gerrard -. These results highlight the importance of comparing outcomes post-Covid with those associated with other respiratory infections”.

The authors of the study finally underline that “the risk of Long Covid was lower during the Omicron wave compared to other variants of SARS-CoV-2”. “Probably – they deduce – this happened because the vaccination campaign was carried out mainly during the spread of this viral strain”.

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