Long covid: What to watch for up to one year after infection – 09/06/2022

Long covid: What to watch for up to one year after infection – 09/06/2022

If there is a difficult discussion in scientific circles, it is about the elongated covid, but it is becoming impossible to stop facing it. Meanwhile, the population, that is, people like you and me, have lost a little bit.

Whoever caught Sars-CoV-2 – and, in the omicron age, unfortunately, we’re talking about half of us – having something different is already a cause for controversy. Because, deep down, could Kovid-19 be? And if you take a positive test one day, not to mention the first year, what should anyone care about in the first few months?

According to CDC (Centers for Disease Control and Prevention), In the United States, one in five people under the age of 60 who have covid-19, including children and adolescents, will develop coronavirus infection late or persistently. And the proportion increases when one in four people is in their sixties or older.

If so, look at the size of the problem before you: as of yesterday, 8th, there were 31.3 million patients with Covid-19 in Brazil and 534 million in the world. Consider that one-fourth to one-fifth of all of these people can be long-term covid.

In principle, under that label, almost anything new that appeared after the infection was beneficial, and so we are talking about a list of over two dozen unpleasant symptoms, some of which are really complicated, such as difficulty holding your breath. .

But, late last year, the WHO (World Health Organization) decided to hold this hut a bit and define the logic for doctors to tell if someone has a really chronic covid condition. An important part of this criterion relates to the duration of complaints.

Long covid, by definition

Issue 1: The WHO criteria means that you have shown symptoms that appear with the diagnosis of Covid-19 and have not disappeared even after 12 weeks, that is, three months after the radius of infection, as if they had come to stay. .

But the symptoms that appear only after you are already free of Sars-CoV-2 are also valid, but apparently they have no other cause and they are also more than 12 weeks, which is the date of infection. “Zero” of that number.

If it disappears before that time, we are no longer talking about the long coward, but about the expected and tedious recovery from the equally boring disease.

Just that No! Second point: these symptoms must last for at least eight weeks or two months. Where I want to go: A person who has had a headache for a month and a half, even though the discomfort has exceeded 12 weeks, does not develop into a long coid according to WHO guidelines. And all because he didn’t have a headache for two whole months. Passed? It wasn’t a long coward, it was a boring recovery and duration.

In short, the complaint should last for two months without much struggle and should be present three months after the diagnosis of Covid-19.

Final details: WHO considers respiratory problems, heart problems, such as the famous myocarditis, which is infinitely common after Sars-CoV-2 infection, and neurological problems as long as they get in the way, as part of the definition of chronic covid. People’s daily lives, such as fatigue and memory problems, in a very significant way.

According to Dr. Max Igor Lopez, coordinator of the Infectious Diseases Outpatient Clinic at the Hospital Das Clinic, Faculty of Medicine, USP (University of S साo Paulo) and advisor to the Brazilian Society of Infectious Diseases, no one alleviates the disease. Those who have symptoms that do not fit into these conditions, from skin problems to body aches.

“The WHO’s idea, at the moment, is to focus on what is most important, to direct the profile to care for public and private health,” he supports. “Respiratory complications, for example, are more serious.”

Therefore, in the first year after SARS-CoV-2 infection, observation of the first three months is important – even to tell if you have covid or have been for a really long time.

However, as the infectologist identifies himself, some of the problems escape the most up-to-date WHO criteria and are subject to intense scrutiny for even longer periods of time.

Pay attention to blood pressure, blood glucose and liver health

“One of the problems with talking about the long covid is that you should always try to prove that there is a causal relationship between what the person has and the covid-19,” says Dr. Max Igor Lopez. “With Omni, it’s going to be very difficult, because in the next two, three months, everything that appears, 50% of Brazilians will think it’s because of this kind of infection, and it’s going to be hard to separate.”

Next to the team investigating long-term covid at Hospital das Clinicus da USP, they say that many studies in this area focus on specific health problems that have arisen since covid-19 and compare what happened earlier.

“But to avoid confusion, we always compare people who went through the same stage, in the acute phase of the transition. For example, before and after those who needed ICU, we look and we analyze independently who lived in a normal place. Hospital beds. Hospital, this Without grouping. “

Thus, they confirmed the world-wide notion: the frequency of diagnoses for diabetes, hypertension, and liver changes is higher in the postoperative period, although none of these are considered long-term.

“We can’t say that coronavirus is the cause. But, somehow, the reactions caused by it or the body can increase a person’s tendency to develop these three problems,” says the doctor. “Maybe the person is hypertensive or diabetic, but Covid-19 will speed up the process.”

For him, at this stage of the championship, finding a mechanism leads nowhere. “Let’s be pragmatic: the clear message is that, knowing that hypertension, diabetes and liver problems are more likely to appear, physicians and patients need to recognize the importance of monitoring for two years after Covid-19. The most important year.” He recommends taking exams every six months during this period.

Helps to avoid vaccination?

Recently, a study was published Nature medicine And since the researchers signed Veterans Research and Education FoundationIn the United States, about 34,000 people were vaccinated against Sars-CoV-2 last year.

They were tested six months after infection and, according to scientists, the entire vaccination schedule reduced the risk of chronic covidosis by only 15%. Somewhat disappointing results. But will it happen?

One of the criticisms of the work is to report the spread of symptoms associated with chronic colic, however, without checking whether the person has already felt something similar before catching the coronavirus – sometimes, for example, there were pre-existing anxiety crises. Appreciated only when he fell ill. Although their immunity was already low on the eve of the booster season, the research also included people who had been vaccinated for a different time.

“But one of the curiosities of these and other studies was that patients who, for whatever reason, were prescribed prescription anti-inflammatory drugs at home after discharge – in this case, corticosteroids – were less frequent in chronic covid,” said Dr. Max Igor Lopez. Called.

This suggests that the persistence of inflammation caused by SARS-CoV-2 is indeed an important factor in the development of long-term covid and suggests potential preventive strategies that should of course not be applied to the left and right, but in such cases. Patients who had more serious conditions. “Long covid is more common among them,” assures epidemiologists.

Therefore, in fact, most research reports suggest that the symptoms are milder when the covid appears in vaccinated people for a long time. “And their duration is also shorter,” the doctor was informed.

In the daily routine of the hospital, he has recently found very few cases of persistent and acute symptoms, which are capable of confusing people’s routines. This change can be attributed to the advancement of vaccination. After this trawler revolving around a micron, we hope to catch another kind of Long Cowid wave.

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