Covid Long: Several hypotheses to explain this phenomenon that affects millions of people

Covid Long: Several hypotheses to explain this phenomenon that affects millions of people

Posted on Sunday 02 October 2022 at 07:00

Long-term Covid disease manifests with symptoms such as chronic fatigue, shortness of breath or even brain fog, after several months of infection with the Covid-19 virus, many teams around the world are working to understand the causes.

“Covid Long” remains a mystery to research, even if it is Several hypotheses are on the table to explain it. The phenomenon, in both 2020 and 2021, affected 145 million people worldwide, according to the US-based Institute for Health Metrics and Evaluation.

Europeans are expected to be affected by “at least 17 million people,” according to a recent WHO estimate. This would represent Between 10 and 20% of people who have contracted the virus.

Fatigue, cough, shortness of breath, intermittent fever, loss of taste and smell, difficulty concentrating, depression … Long-Covid disease is manifested by one or more symptoms from a long list, generally within three months after infection and It lasts for at least two months. The syndrome affects twice as many women as men. “There are no symptoms specific to Covid long illness, but they still have certain characteristics: they flip With fatigue lingering in the background, it appears to be exacerbated by intellectual or physical exertion and becomes rarer over time,” summarizes Olivier Rubino, an infectious disease specialist at Torcoing Hospital Center and long-term COVID coordinator at the agency.

Many teams around the world are working to understand the causes of these symptoms. In France, for example, the Hôtel-Dieu (AP-HP), the University of Paris and Inserm launched a study at the end of 2020 on the protracted Covid within the “ComPaRe” group: “2,500 patients are being monitored very regularly, which should allow us to understand the differences in the manifestations of the disease over time”, explains Dr. Vit-the Tran, co-researcher with the group. But the diversity of symptoms and their non-specific nature makes research difficult. So far, Scientists are studying several hypotheses.

Several hypotheses

One of them is Persistence of the virus in the body in some individuals. And so, at the beginning of September, a study published in Clinical Infectious Diseases concluded that the spike protein (the key that allows SARS-Cov 2 to enter cells, editor’s note) was present in patients with long-term Covid disease. This indicates viral replication or the persistence of viral remnants long after the initial infection. Live virus or virus remnants can maintain inflammatory activity, possibly at the origin of symptoms. These results, however, are not Not found by other teams.

There are other ways. The virus would have disappeared after infection, but the initial inflammation, once it started, could have caused an infection Immunodeficiency. The “tissue damage” hypothesis raises the role of the primary infectious episode in the appearance of permanent lesions in certain organs. Studies have also shown damage to blood vessels as a result of infection.

Care course at Hôtel-Dieu

For each of these hypotheses, The data is not very strong yet,” We won’t find a single reason to explain Covid’s long illness, says Olivier Rubino, betting we won’t find a single reason to explain Covid’s long illness. “The causes may not be exclusive, they can be linked, and even some succeed in the same individual and are different in different individuals,” he says. So it is difficult to find a solution for these long time covid patients.

At the Hôtel-Dieu in Paris, a protocol called “CASPER” was introduced for a year care cycle For patients for a half-day: “They meet with an infectious disease specialist or internist, a psychiatrist and then a doctor who specializes in sports rehabilitation,” explains Professor Brigitte Rank, an internal medicine specialist, at the origin of this circuit. “In the team’s trial, the majority of symptoms can be attributed to ‘somatic functional disturbances’ (symptoms are caused by malfunctioning of the central nervous system, editor’s note). The behavior is often associated with supervised physical activity.” “Patients are called again after three months: most of them are better, More than half of them say they are cured,” Professor Rank details. “But about 15% didn’t improve at all,” she admits.

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