Covid-19. What management of persistent symptoms?

“More than half of patients still present with initial symptoms of Covid-19 four weeks and 10% after six months “, Advances Dominique le Guludec president of the High Authority for Health (HAS). These figures are based on British data, the prevalence in France is under study but a priori close.

“Even mild forms can cause prolonged symptoms “, acknowledges Dr Pierre Gabach, Head of the Good Practices Department at HAS. He worked with doctors and patient associations to develop a first salvo of “Quick responses” intended for general practitioners, disconcerted by these patients “Often very worried”, with heterogeneous symptoms: fatigue, difficult breathing, loss of taste or smell, chest pain, nausea, etc.

For each of the most common symptoms, management avenues are indicated. “Without having to embark on cascades of examinations”, underlines Pr Dominique Salmon, infectious disease specialist at the Hôtel-Dieu, very invested in the investigation of these cases. Little prescription medication, physiotherapy, psychological support …

“Persistence of at least one sign”

One of the criteria for the diagnosis could be the persistence of at least one sign of the Covid presented during the illness. And if this has not been objectified (by a test) that this “probable” Covid is manifested by at least three signs suggestive of the pathology.

Because lack of clear biological markers (they are under investigation), it is not easy to determine what is Covid or not. “Psychosomatic disorders do not seem to be the majority, but we often deal with patients so frightened by their symptoms that they do not dare to resume physical activity. While this may increase the troubles. “

70% of women

The most affected population: “70% of young women, often allergic », Notes Professor Salmon. A profile that can be found in other countries. Are there hormonal, immune, genetic susceptibilities?

In most cases, the symptoms go away within a few months. Not always. Does the recognition of these prolonged disorders (the HAS avoids the term “long Covid” used by associations) open the way to recognition of long-lasting affection? “We’re not there yet” , says Dr Gabach.

In its indications to doctors, the HAS specifies that they will also have to disentangle what is the complications of Covid (in particular cardiac and pulmonary) and what is prolonged symptoms. It also specifies that exclusion diets (avoiding certain foods) such as cures for food supplements can have counterproductive effects.

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