long-term care can “significantly improve the condition of patients”

Nicolas Barizien, head of the functional rehabilitation department at Foch hospital, estimates on Franceinfo on Sunday that treatment over 24 to 48 months for patients now offers real results against the disease.

The management of patients with long-term Covid by multidisciplinary teams over the long term, “from 24 to 48 months”allows “significantly improve the condition of patients”says Sunday March 17 on franceinfo Doctor Nicolas Barizien, sports doctor, head of the functional rehabilitation department at Foch hospital and author of the book Long Covid, how to get through it (Marabout editions).

franceinfo: How many people are affected in France?

Nicolas Barizien : It’s complicated to know in France, but we have a large study carried out in England with an approximately equivalent population: at the end of 2022, it was estimated that 1.1 million people were affected by long Covid in England, with almost 60% who have a negative impact on their quality of life, 40% who have an impact on their physical abilities and 30% who have a direct impact on their ability to work. It is estimated that there are around 2 million people who have persistent symptoms, half of whom do not have a very negative impact on their quality of life, but the other half do.

When do we talk about long Covid?

It is estimated that after a month after an acute infection and the persistence of symptoms, without any other medical explanation, we begin to speak of long Covid. What is important is to treat these patients very early, using a multidisciplinary approach. Doctors will make diagnoses, but those who will provide relief and help patients move forward are nutritionists, psychologists, and physiotherapists, in particular. There are many long-term Covid patients who are unaware of it and many who are ignored, unfortunately, by our treatment capacities.

The Covars report released on November 7, 2023, led by Professor Autran, clearly shows that compared to the international “gold standards” of patient care, in France we are a little behind in this capacity to respond to management of patients’ physical activity, return to work, management of anosmia [perte de l’odorat]. There are more of them than we think, those who are mildly affected end up getting used to their little handicap. We are talking about young, active subjects, around forty, for whom we must fight to give them as normal a life as possible.

Is long Covid treatable today?

All the multidisciplinary teams that take care of patients, from the moment we start over a long period of time, from 24 to 48 months, are able to very clearly improve the condition of the patients. What bothers us a little more is that during reinfection with a less aggressive variant, these long Covid patients will have a risk of relapse. This relapse must be dealt with quickly.

Why are some people affected and not others?

We are starting to have biological explanations. A large study has just been published in the journal “Nature” in November, which shows that it affects immune cells. It shows that there is an imbalance, a disruption of the immune system probably linked to genetic factors. There is also the inflammatory reaction that it will cause: this somewhat chronic inflammation, we now know that we find stigmata inside the brain.