The odyssey without end “patient Covid-long”

L’odyssée sans fin des patients «Covid-longs»

L’odyssée sans fin des patients «Covid-longs»

Six months after its appearance in China, the list of symptoms caused by the COVID-19 continues to grow and thousands of people of all ages are still feeling its effects after weeks or even months.

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11 July 2020 9h22

Updated at 19: 45

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The odyssey without end “patient Covid-long”

AFP

Agence France-Presse

PARIS — They are dubbed the “Covid-long”, the patients “long-term” or “after J20”, these patients who suffer from persistent symptoms long after the infection by the coronavirus.

Six months after its appearance in China, the list of symptoms caused by the COVID-19 continues to grow and thousands of people of all ages are still feeling its effects after weeks or even months.

For Jenny Judge, psychiatrist medico-legal in London, it all began in march, with fever, cough, headache and breathing difficulties.

These symptoms “classic” is being added progressively, in waves, heart palpitations, skin rashes with a burning sensation, auditory hallucinations and “toes Covid”, with lesions and itching.

“Now I am in a digestive phase”, she explains to the AFP, the 111th day of his odyssey.

More than 12 million cases of COVID-19 have been identified worldwide, resulting in approximately 550,000 deaths. Six million patients are listed as “healed”.

But this does not fully reflect the reality.

According to a study out of 143 Italian patients out of the hospital, published Thursday in the medical journal the Jama Network, 87% were still suffering from at least one symptom 60 days after the beginning of the disease. Fatigue and difficulty breathing most frequently.

Another study published last week by the public health agency of the United States showed that out of 350 respondents in two to three weeks after having been tested positive, approximately 60% of the inpatients and one-third of the patients at home were not healed.

The affected organs in severe forms of COVID-19, or the sequelae of stay in the icu may explain that the people in hospital are still in need of care.

But the sick stayed home often have no explanation for these persistent symptoms and sometimes face the disbelief of their employers and physicians, in particular, in the absence of a diagnostic test is positive or if their symptoms do not fit into the official description of the health authorities.

“These people feel really helpless. Some may feel fatigue very debilitating,” observes Tim Spector, professor of genetic epidemiology at King’s College London, at the origin of an extensive project of surveillance of the symptoms of the COVID-19.

3.8 million Britons have downloaded the app, launched in march, but also more than 300 000 in the United States and 186 000 in Sweden.

19 symptoms that have been identified and up to one in 10 patients still had symptoms after 30 days.

Tim Spector is estimated that some 250 000 of britain could be suffering from COVID persistent. He considers this disease to be “even more bizarre” that autoimmune diseases rare disease like lupus, which presents a wide variety of events, that he studied when he was a rheumatologist.

“Some people just have skin problems, others have diarrhea and pain in the chest, it is really very unusual.”

“It could be you”

Support groups bring together thousands of people on social networks and key words have emerged in several languages, such as the #apresJ20 and #apresJ60 in French.
Many say that they struggle to be heard in the medical profession, in particular those fell sick at the beginning of the epidemic, when few tests were made, and who do not therefore have medical proof of their infection.

Even as a doctor, Jenny Judge admits to having faced scepticism at the hospital. A doctor had suggested that her elevated heart rate could be due to anxiety.
It explains, in part, by the fact that hospital doctors are only beginning to see the arrival of these patients, the symptoms of which were so far not considered serious enough to justify a follow-up to the hospital.

But this woman of 48 years old, without medical history, there is also a part of denial.
“If you accept that a person like you, who is a medical doctor who has taken all the precautions, is still sick after more than 100 days, is that it could be you”, tip-t-it.

False hopes

The situation is improving, however, as studies focus on the topic and that a growing number of people bear witness to their journey.

Paul Garner, professor of infectious diseases at the Liverpool School of Tropical Medicine, has started writing a blog in the British Medical Journal, frustrated to see that he was still sick after a month, while the official information talked about symptoms during two weeks.

He suffered from headache, atrocious, shortness of breath, tingling in the limbs and was once believed to lose consciousness: “I thought I was dying, it was scary at this point.”

The more hard to bear was the confusion and changes of mood, ” says this doctor of 64 years, up here in good health.

It took several times of false hopes, like day 45 of her illness where, feeling better for a few days, he decided to do the sport at home.

“Crash! Monday: “myself felt ill damn the whole day, as a result of the training,” he says in his journal.

Based on the scientific literature dealing with the chronic fatigue syndrome, he has developed a routine of alternating efforts light and rest.

Interviewed on day 96 of his illness, he spoke of a gradual improvement, but it is concerned that vulnerable people could be pressured to return to work before being ready.

It is not yet known if these persistent symptoms are caused by the virus itself or by immune response exaggerated in the body.

According to Tim Spector, some of the patients in the long course and still have traces of virus in the body, but it is unclear whether this means that they are still contagious.

“There will soon be rapid tests at airports, does this mean that they can never travel because they stay positive?”, if he asked.

A study published in 2009 on 233 patients of SARS, another coronavirus, showed that after four years, 40% of the patients reported to suffer from depression or chronic fatigue.

“The implications for rehabilitation and assistance tailored for victims of SARS, or COVID-19 are obvious”, underlines Yun Kwok Wing, professor, the Chinese University of Hong Kong, one of the authors of this study.

The young, the less risk of developing a severe form of the COVID-19 or dying, must be aware of the fact that the disease can also weaken them for months, writes Jenny Judge.

“It is a kind of Russian roulette, we don’t know yet what is it that makes some people have a disease longer”, she says.

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