Four years after the first cases of what was later called COVID-19 appeared, infections continue to spread and lead to new cases of the long form of the disease. However, the mystery that still surrounds this persistent illness limits the ability of health professionals to intervene.
According to recent data released by the Canadian COVID-19 Health and Antibody Survey (CHAS), approximately one in nine Canadian adults, or 11.7% of the population, say they have suffered from long-term symptoms. term following infection with the SARS-CoV-2 virus.
The definition of long-term COVID refers to symptoms that are still present more than three months after infection and cannot be attributed to another cause.
Still according to the survey conducted by Statistics Canada and the Public Health Agency of Canada, two-thirds of people suffering from long-term COVID and who sought care say they did not receive adequate services to treat their symptoms .
Each province has adopted its own service offering to care for these patients. In Quebec, the Ministry of Health and Social Services (MSSS) has deployed a network of specialized clinics in all regions. However, we observe access and a level of care that varies from one place to another, recognizes the director of the specialized clinic for post-COVID-19 conditions at the CIUSSS de l’Estrie-CHUS, Dr.r Alain Piché.
He reports that many of his patients have to fight to be referred to his clinic because their family doctor does not believe them or does not believe in the existence of long-term COVID when scientific evidence “shows that it This is a very real evil,” specifies the professor in the department of microbiology and infectious diseases at the Faculty of Medicine of the University of Sherbrooke.
But if we are able to confirm that the disease exists, we still have difficulty explaining its mechanism. Various hypotheses are studied by scientists, including “viral persistence, low-level inflammation, vascular disorders, microclot disorders or the production of autoantibodies”, lists D.r Piche. It could even be a combination of several of these mechanisms.
Some leads suggest that the hypothesis of a persistence of the infection, that is to say that the virus is hiding in a region of the body – possibly in the digestive tract or in the central nervous system – could be preferred. Studies are underway with patients treated with the antiviral drug Paxlovid to see if it is effective. This same treatment is used as a preventative measure during COVID-19 infection in patients considered at risk.
Other drugs are also being tested with the aim of validating other hypotheses, namely treatments that target inflammation, vascularization or the production of autoantibodies.
Tame your condition
The list of symptoms experienced by patients is long and diverse. We are talking about neurological disorders, pain, chronic fatigue, shortness of breath, numbness. As many of these symptoms are “subjective” and difficult to measure by the various medical tests available, this adds to the distress of patients.
For the Dr Alain Piché, the first thing to do with a new patient is to listen to them and believe them. “Patients will already feel better,” he says.
If the symptoms vary, the overall picture is still “fairly typical”, notes the microbiologist-infectious disease specialist.
You must still make sure to eliminate other possibilities before making a clear diagnosis. The signs of long-term COVID sometimes resemble those of other post-infection syndromes such as myalgic encephalomyelitis which can be associated with mononucleosis infection or even Lyme disease.
Then, if we do not yet have specific medication, we manage to improve the daily lives of patients through rehabilitation. The Dr Piché explains that many patients suffer from post-exercise discomfort. We must therefore teach them to split their efforts to alleviate their ailments.
A way of adapting to one’s condition which would allow many people to live better with their long COVID while waiting to be able to get rid of it.
Other luckier patients will see their symptoms disappear after six months or a year without much explanation. Which adds another layer to the mystery of long-term COVID.
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