Long covid: what we know about it and how best to treat it | health

middleuh was written for a long Covid. Sufferers describe a continuing problem with social media that persists for weeks after infection. Meanwhile, research to find the cause is continuing, and various theories are emerging.

So now what do we know about the long Covid, the risk of infection and the best way to treat it? Guardian Australia spoke with leading doctors working with long Covid patients, including long Covid and post-Covid clinics, to better understand the latest evidence.

What is a long corona?

although the world health The WHO (Organization), the UK’s National Institute of Health Research, and the US National Institute of Health (NIH) all have long definitions of corona, all of which are slightly different and quite vague.

WHO Define post covid or long covid It occurs in people who are still experiencing symptoms 3 months after initial Covid-19 infection, and these symptoms cannot be explained by alternative diagnoses. The NIH states that the symptoms are “a wide range of …

How long is the corona diagnosis period?

Dr. Respiratory Physician at the Post-Coronavirus Clinic at the Royal Melbourne Hospital. Megan Rees said there are no long-term diagnostic tests for Covid as of yet, which means other diseases must be ruled out first. She has a team of experts working together to make sure she’s not experiencing any other problems, such as other respiratory problems or underlying heart problems.

“Sometimes people think they have symptoms that can lead to a chronic long covid state when they first come, but we try to get people to have a recovery mindset rather than assuming they have a long covid in the first place,” Rees says. .

“We are promoting our clinic as a Post-Covid clinic and not a Long Covid clinic, because at the end of these assessments you will not necessarily be the one diagnosed with Long Covid.”

People are often reassured by the clinic’s multidisciplinary approach and when they hear that most patients improve and recover over time, she says.

Rees says people hospitalized for Covid-19 have sometimes been given corticosteroids, and symptoms can include anxiety and lack of sleep. Using machinery and staying in the intensive care unit for long periods of time can also cause fatigue and muscle weakness. Sometimes persistent symptoms are not due to the long-term coronavirus, she says, but to the burden on the body being admitted to the hospital.

Lethargy and fatigue are among the most common symptoms people experience at the clinic, said Professor Anthony Byrne, a thoracic surgeon at the St. Vincent Hospital in Sydney’s post-COVID clinic.

“However, there are a number of conditions that need to be considered and ruled out before labeling patients as long covid,” he said, “because there are 100 different medical causes of lethargy and fatigue, including undiagnosed sleep apnea, undiagnosed diabetes, depression, and anxiety.” said he says

This accurate diagnosis is important because different conditions can be treated differently if other conditions are causing the symptoms.

How likely is someone to get coronavirus?

Vaccination and Fortification Seems to protect from the long Covid. Estimates of people with Covid to develop a long Covid are between 5% and 30%, but applying this prevalence to the general population is problematic.

Some lengthy Covid studies recruited patients before vaccination was available, and those patients may have contracted the more serious strain of the virus earlier. This group’s long Covid epidemic cannot be applied to vaccinated patients who have recently been infected with Omicron.

Not all lengthy Covid studies are well designed with control groups. The control group consists of people similar to the participants in the study, except that they do not have the condition in question.

Dr. Kate Gregorevic, geriatrician and internist, said this control group is really important when looking at long-term symptoms of coronavirus, such as fatigue, which are present in about 20% of the population anyway. By comparing the long Covid group to the control group, we can determine whether post-Covid symptoms are actually more common than expected in the general population.

Some lengthy Covid studies use a wide range of symptoms, from fatigue to gastrointestinal upset, shortness of breath and brain fog. The severity of these symptoms also varies, and Gregorevic notes that this lack of specificity leads to more people being studied, but depending on how the study is designed, this larger size will always result in a stronger study outcome, or if all participants have longer symptoms due to Covid.

Sometimes studies ask participants to self-report their symptoms, and while these studies can be useful, they can also have strong limitations. Questions about bias and validity.

“It’s important to always remember that correlation is not causation,” says Gregorevic. She is concerned that some lengthy Covid research findings are not being put into context. “I’ve seen scary headlines that aren’t supported by research data.

“Some of those headlines give very high estimates of the rates of long-term Covid, but they don’t mention that they refer to studies of people hospitalized, including ICU. It would be completely wrong to assume that he had a mild illness.”

What did the Australian study find?

Professor Gail Matthews of the Kirby Institute is a Senior Research Fellow. to adaptive studies Screening patients for the long-running coronavirus, which has been going on since mid-2020.

under study In a study published in January, her team looked at blood samples from people with and without COVID-19. They found that eight months after infection with Covid-19, some symptomatic participants had elevated levels of the type of protein their cells make in response to the presence of the virus.

This protein usually disappears when the infection goes away, but in long-term patients with COVID-19, the protein was still present. The cause of this needs more research.

“However, this gives biological relevance to long-term COVID-19 symptoms,” Matthews said.

The study involved 62 participants, including 31 controls who did not have long-term COVID-19. The study authors said the results now require validation in another long cohort.

“We’re going to follow up again after two years to see if these participants are starting to recover,” Matthews said. “But I can tell you that it’s not just people in the hospital who continue to show symptoms in the Adapt population.”

Matthews says it’s impossible to make strong estimates of prevalence from studies done so far, including his own.

However, given the community’s high overall number of Covid-19 cases, if even a small percentage of those infected with Covid-19 develop long Covid-19, a significant number of people will be affected. Most of these people recover, but it can take months or, in very rare cases, years.

National Covid-19 Clinical Evidence Task Force Recently published ‘Frequently Asked Questions’ About the long coronavirus and post-coronavirus, highlighting what the research found and what was not.

How long is the corona treatment period?

Royal Melbourne Hospital has two Covid clinics. One assesses the person and excludes the other explanations, and the Allied Health Rehabilitation Program focuses on therapies such as therapy, exercise physiology, diet, psychology, and even song therapy to help people use their abilities. It raises the voice and strengthens the lungs.

“We know that post-COVID symptoms can be debilitating, painful and frustrating, but we can tackle this together and our clinical experience to date shows that most patients recover steadily and gradually, but recovery times vary from patient to patient. that is quite different. ” says Rees, “We also found that many very ill people benefit a lot from reduced and graded exercise programs.”

The difficulty of treatment is that the cause of the corona has been studied for a long time. Each person may have different causes. Some theories about triggers include activation of the immune system, ongoing inflammation, and other abnormalities involving the lungs.

Professor Steven Faux, director of rehabilitation at St Vincent Hospital, said:

“Some people have common symptoms, but some people have completely different symptoms.

“For example, some people will show up as fatigue or heart palpitations. Some people present with brain fog and difficulty returning to work. In some people, the mental illness manifests itself as worsening. And some people may experience weakness and have to deal with it in a different way, such as shortness of breath or coughing.

“So we don’t come up with one thing and we fix it and everything goes away. Not at all.”

Faux says doctors are learning a lot, but the evidence for causes and treatments is advancing, meaning that “there is this kind of void without evidence, and it’s being filled with people obsessed with certain treatments and treatments.”

“You often see this being shared on the Twittersphere,” he says.

He says this is similar to how unproven treatments like ivermectin and hydroxychloroquine were initially heavily promoted as COVID-19 treatments in the early days of the pandemic, when little was known about how to care for patients.

“I think people should accept some degree of uncertainty and manage it as best as possible within the limits of the research,” says Faux. “I know that’s not what people with Corona want to hear.”

The good news is that many of those with prolonged COVID-19 are managing and improving with individual programs tailored to their needs and what they can do.

“There’s no reason for most people not to expect improvement,” says Faux.

Who is at risk of long Covid?

Byrne says evidence of the risk is still growing, and some people who have only had mild COVID-19 disease are diagnosed with long-term Covid-19, but generally “if you are older or you have certain comorbidities, such as diabetes, if you have acute symptoms, If you were in the hospital… all of these things increase your chances of developing you into a long covid.”

Faux says he’s continuing to study why, as demographics and symptoms of people with a long Covid also vary from country to country. in his clinic He also sees a high proportion of people with pre-existing mental health conditions that worsen after a Covid-19 infection.

A study recently published in the Journal of the American Medical Association’s ‘Psychiatry’ Those at the highest risk of contracting the long-term coronavirus were those with more serious illnesses, a study found.Especially those who need hospitalization, but more research is needed.

Can children get coronavirus long?

Shidan Tosif, associate professor of pediatrics at the Murdoch Children’s Institute, says there are similar problems with estimating prevalence in children as they do for adults. However, based on the number of patients, long covids are “less rare” in children than adults. The number is too low to estimate prevalence.

“We have a small number of children, mainly older children over the age of 10, who experience long-term symptoms lasting more than three months, such as fatigue, stomach pain, and headaches.”

Tosif says some children have experienced more severe symptoms that affect function, but most children who develop symptoms after three months “are doing well and get better over time,” Tosif says.

He says the factor driving some parents is the long-term fear of the coronavirus, which he understands will be “worried”. Tosif says it’s important for these parents to feel comfortable seeing a doctor with their child and take their concerns seriously.

“I tend to look for information online and try treatments that may not always be evidence-based or accurate,” he says. “I urge those parents to see their GP for evaluation and support.”

Long covid: what we know about it and how best to treat it | health

Source link Long covid: what we know about it and how best to treat it | health

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