Rome, May 16, 2021 – Virus infections Sars-Cov2, variants included, can also give a hard time to those who are healed. Thousands of people, once the acute phase has passed, continue to complain of tiredness, difficulty concentrating, nausea. Is called Long Covid the syndrome that haunts those (unvaccinated) who have contracted the Covid-19 in symptomatic form, they would like to get out but are bothered by the consequences at a distance. Healing, in these cases, takes time and patience. Let’s see how doctors deal with the problem, remembering the importance of getting vaccinated (obviously for those who have not yet come into contact with the coronavirus) without forgetting (for everyone) the recommendation to maintain normal precautions when meeting strangers, or walking crowded places.
In Italy half a million people have experienced chronic fatigue, and a push comes from Covid. Umberto Tirelli, director of the Tirelli Medical Group Clinic in Pordenone, a guest at the Maurizio Costanzo Show, spoke about it. At the moment, resolutive therapies for slow-resolution Covid are ignored, the strategy consists in the use of symptomatic drugs, aids, ozone therapy, lifestyle changes. It is important to contact the specialist doctor with specific expertise.
The most common symptoms are: exhaustion, fog in the head, problems with concentration and memory, sleep difficulties, to which gastrointestinal disorders are added depending on the case, impaired lung vital capacity with retrosternal pain and breathlessness, loss of the sense of smell and taste, with anomalies in the perception of odors and flavors. Particular caution is required in patients with chronic neurological, oncological, respiratory, endocrinological, metabolic, cardiopathic, nephropathic and hypertensive pathologies.
While the lethal forms predominantly afflict the adult and elderly population, the long Covid can affect everyone without distinction, regardless of the personal data. In pediatric age, for example, only 5% of people get Covid and of these 6% have a symptomatic picture. Although it is a disease with a benign course for most of them, some show signs and symptoms such as headache, cough, breathlessness even after weeks and months after being negativized.
Cases of Long Covid could depend on the immune system, according to specialists from the Coronavirus Immunology Consortium and the British Society for Immunology. In an article in the New Scientist, a study from the University of Birmingham, UK, was published, which analyzed the wear and tear of the immune system of 46 people who had been hospitalized with a severe form of Covid-19. Three months after discharge, a significant number of these showed signs of premature immunosenescence, due to stress on the immune defense system.
The survey considered Covid patients between 30 and 68 years old, the immune system was compared with a similar group that had not had Covid-19. Immunosenescence usually begins around age 60, but in these cases it has been hypothesized that the virus attack prematurely ages the motor that regulates antibody production. The apparatus that protects us from infections and tumors may have a biological age different from the age one, a forty-year-old could have an immune age between 20 and 60 years. Studies initiated by the pathologist Claudio Franceschi, professor emeritus of the University of Bologna, had identified markers typical of young people in the blood of over 100 year olds, relating longevity with the efficiency of the immune system, a happy intuition that returns to the fore in times of pandemic.
Weakness, breathlessness, joint pain, tachycardia, dullness, speech difficulties, are the symptoms that usually affect those who are healed (technically negativized) but have had a high viral load. Diseases that could have consequences on the respiratory, cardiovascular and renal functions. Long Covid syndrome requires periodic check-ups, as we have seen in the case of Silvio Berlusconi, who even after complete recovery is subjected to periodic examinations, with hospital admissions for checks at the San Raffaele in Milan.
Avoid doing it yourself, avoid falling into commercial traps, rely on the specialist who, after a careful medical history, tests and physical examination, will be able to formulate the appropriate prescriptions, depending on the organs and systems involved (drugs and supplements must be taken following the indication of the attending physician).
Asthenia (fatigue) with difficulty in resuming normal occupations is one of the symptoms often complained of even by young people, after months, perhaps one of the most widespread inconveniences in Long Covid. The approach is sometimes empirical, drugs, titrated supplements (as long as they are prescribed by the doctor), biophysical techniques are tried depending on the case, we repeat any therapy must always be followed by the specialist, the family doctor and the pharmacist, for their respective skills .
Carlo Ferrarese, director of Neuroscience (University of Milan-Bicocca, San Gerardo Hospital of Monza) presented a multicentre study, called Neurocovid, sponsored by the Italian Society of Neurology (SIN), recording all the possible neurological complications arising both in hospitalized patients in the acute phase of the disease, both in patients treated at home, and putting them in relation to the alterations of the respiratory and circulatory parameters, of the blood values.
The chronic Covid-19 syndrome, sometimes found in individuals with multiple sclerosis, involves a slower recovery, with a tendency to easy fatigue. Generally it is advisable to continue the therapy set by the neurologist, and a multi-specialist consultation that includes, in the case, a rehabilitation cycle.
Generally the consequences related to the prolonged lockdown and the stress due to virosis add up. People with cognitive impairment (Alzheimer’s) struggling with Covid-19 experience a more pronounced decline in memory, a marked worsening with difficulty in dressing, inability to tidy things up, lack of initiative. The return to the starting conditions is very difficult.
Headaches that recur must be studied at a specialist level by contacting the reference headache center to understand whether it is a pre-existing relapsed (i.e. exacerbated) manifestation or arisen as a complication of the infection: the treatment changes depending on the differential diagnosis.
Alessandro Padovani, Director of the Neurological Clinic, University of Brescia, reports that following the first wave, persistent symptoms, especially of a neurological nature, have been reported among the survivors of Covid-19. In many cases it is a real persistence (Long Covid) while in other cases it is a question of symptoms or after-effects (Post Covid). In the Covid-Next study, the percentage of patients previously hospitalized with distantly reported disorders is higher than 70% of cases. Recurrent symptoms include asthenia (weakness), cognitive and concentration deficits, sleep disturbances, myalgias (muscle pains) followed by depressive disorders, loss of autonomy, visual disturbances and tingling. In hospitalized subjects with a less demanding course, the most frequent symptoms 6 months after infection were depressive / anxious disorders, insomnia, difficulty concentrating, present in over 30% of the sample.
After some time, perceptions such as nausea, strange tastes, unpleasant odors may persist, probably linked to the persistence of the virus in the peripheral nerve branches of the trigeminal. They should generally die out after six months without the need for specific therapies.
A study published in the British Medical Journal, focusing on work in internal medicine departments (internists) reveals that the risk of developing respiratory problems in those who have been hospitalized for the first time for Covid compared to the general population is multiplied by 6 (30% of discharged developed lung deficiency), to develop diabetes for 4.8, major cardiovascular problems for 4.8, kidney disease 1.5, liver 0.3. The doctors of the De Gasperis Foundation recommend remote checkups, especially for heart patients.
During the webinar “Covid-19 Organopathy” organized by Motor Health it was seen that up to 10% of patients suffer from symptoms that last more than a month, one in 45 patients (2.2%) develops symptoms that persist for longer 3 months. Currently around 4 million people are reported with sequelae and disease with chronic sequelae worldwide. Both patients who have had a severe, mild and / or moderate infection are affected. A part of these patients have a permanence of the nested virus that determines a continuous cytokine rain with an inflammatory state and, if it comes to immunodepression, also to the reactivation of the disease with aggravation.
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