Long Covid, the most widespread symptoms and why it still remains an unsolved puzzle

Long Covid, the most widespread symptoms and why it still remains an unsolved puzzle


OfVera Martinella

According to estimates, it affects around 10-20% of people affected by the coronavirus. Four years after the outbreak of the pandemic, research continues to investigate disorders that last longer than 12 weeks

There are no official statistics either for Italy or for other countries and when we talk about Long Covid it must be taken into account that many questions are still unanswered. Four years after the outbreak of the Covid-19 pandemic, scientific research is tenaciously working all over the world to “solve the Long Covid puzzle”, as the title of one of the largest review studies, recently published in the journal Science. There are many pieces, certainly not all, and much remains to be done to understand how to put them together.

The variations

With one addition: several pieces of the puzzle have changed over time with the arrival of different variants of the virus. The World Health Organization has decided to officially call it post Covid-19 condition: is the condition of persistence of signs and symptoms that continue (or develop) beyond 12 weeks after the end of the acute phase of the disease. Millions of people have suffered and are still suffering from it.

The numbers

«According to several studies, this condition, which precludes a full return to the previous state of health, can affect up to 1 in 2 people, but the most shared estimates say that about 10-20% those who have contracted the Sars-CoV-2 infection experience long-term sequelae” says Sergio Harari, professor of Internal Medicine at the University of Milan.

How long? «Weeks or monthsbut numerous cases of persistent Long Covid are documented, that is, people who have never recovered” specifies Harari, who is also director of Pneumology and Internal Medicine at the San Giuseppe Multi-Medica Hospital in Milan.

Considering that the confirmed cases of Covid-19 in our country to date are more than 25 million, between 2.5 and 5 million Italians have also experienced Long Covid (estimates for Europe are around 17 million).

However, some things appear clear, starting from the fact that disorders can affect anyone: children, adults and elderly, men and women, no epidemiological differences emerge between the different ethnic groups. «We also know that those who have been vaccinated suffer less from Long Covid and that those who have had a serious infection are more at risk: especially those who are hospitalized (and even more so those who have needed intensive care) are more likely to have sequelae. unwanted – says Alessandro Nobili, head of the Department of Health Policies at the Mario Negri Institute of Pharmacological Research -. And that different variants of the virus (such as Delta, Omicron, etc.) seem to correspond to equally long-term consequences. In particular, the loss of taste and smell especially affected those who became infected at the beginning.”

Despite these few certainties, it must be said that several cases of Long Covid have been recorded in those who contracted the infection in a medium-mild form because to date (after massive vaccination and the attenuation of the severity of the virus) the majority of people have not suffered from Covid-19 in its severe form.

Over 200 symptoms

To considerably complicate the picture, there is the fact that post Covid syndrome can affect practically the entire body and that have been cataloged about 200 symptoms. The data collected by the “Long-CoViD project” coordinated by the Istituto Superiore di Sanità take a snapshot of the most frequent symptoms in Italy in December 2023: asthenia (chronic tiredness or fatigue), respiratory fatigue And shortness of breath (dyspnea), sleep disorders And of memory, joint and muscle pain, difficulty concentrating.

Categories at risk

Evaluating the information on millions of people who have been diagnosed with post-Covid syndrome, some categories emerge that are more exposed to the risk of developing it in a severe form: those who are older, women, those who are obese or overweight, those who suffer from other diseases (such as diabetes, high blood pressure, asthma, for example).

Diagnostic tests

«A large part of the difficulty also lies in the fact that in the face of many different symptoms there is no single diagnostic test – explains Amedeo Capetti, head of the Covid re-evaluation clinic at the Sacco Hospital in Milan -. And then in the vast majority of people the disorders last a few months (on average a year). «In our clinics, however, we mainly follow patients who have permanent problems – he adds -. Exhaustion e brain fog they are the most long-lasting, debilitating and disabling. We have people who have even been forced to leave their jobs and there is no specific treatment.” The neurological consequences, but also the neuromuscular ones, are difficult to frame and trace back to Long Covid, so those who suffer from it often also suffer the frustration of not receiving a diagnosis.

The therapies

What therapies can be prescribed? «We evaluate case by case – concludes Capetti -. For the exhaustion 70-80% of patients appear to have improvements with supplements that reduce oxidative stress. And we understood that fatigue is “up and down”, sometimes it seems to disappear, but other times it comes back. For the loss of taste and smell (especially prevalent in the Long Covid of the first wave) we have no remedies: most recover quickly, but there are those who take 12 months (going through alterations that are difficult to bear), those who do not recover completely and a minimal share of people who, after four years, have not yet regained these senses”.

March 9, 2024 (modified March 9, 2024 | 7:39 pm)

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