2023-09-24 13:47:54
The mystery of “Long Covid”… Analysis and Discoveries “Covid” affects the brain, heart, lungs, intestines, and joints… sometimes simultaneously, sometimes intermittently, and sometimes serially, in June 2022, during a conversation between Lisa Sanders; Internal medicine physician at Yale University, and her friend Erika Spatz; A cardiologist, the latter mentioned that she and a group of doctors are thinking about opening a private clinic for “long-term Covid” patients at Yale, and that they are looking for an internist to manage it. The devastating effects of “Covid”, but the problem, according to Spatz, is the number. Since the pandemic, she and her colleagues in the pulmonary and neurology departments have been meeting with “long-term Covid” patients at Yale, but in an urgent and emergency manner, to the point that some doctors have become overwhelmed by the number of patients requesting help to reach them. So much so that they have difficulty scheduling appointments and treating their patients who come in with other problems such as lung cancer, asthma, heart disease, and dementia. “Long-term Covid” patients, in general, have been living in misery for a long time. Because the disease affects the brain, heart, lungs, intestines, and joints – sometimes simultaneously, sometimes intermittently, and sometimes sequentially – so they move from one specialist to another. The problem is that none of them are able to listen to their full suffering, or have the experience to solve all their complaints: the unlimited pain, the constant fatigue, the confusing test results, and the one-time treatments. “There are people who have been unable to tell their story to anyone but their partner or parent for years, and these are every doctor’s nightmare,” Sanders said. “Long-term Covid” threatens the entire medical system. This controversy ignores 65 million people around the world, for whom the pandemic is still a real daily torment, and to date there are no studies that provide confirmed and comprehensive answers about what “long-term Covid” is and how it can be treated, so; These people need clarity from someone who dedicates himself to caring for them. Spatz and her colleagues proposed an alternative model: a clinic headed by an internist who devotes a full hour to listening to each patient, who is responsible for developing a treatment plan, constantly communicating with the primary health care team concerned with the patient, and referring him to specialists when needed. But the idea was not brilliant; Because the clinic may not obtain a patent, nor financial profits, nor awards. When Sanders heard the idea from her friend, she was excited; Because listening to patients who suffer from complex problems and solving them is her favorite hobby and her primary interest, on which her career was built. Sanders teaches internal medicine at Yale University and writes a monthly column called “Diagnosis” in the New York Times Magazine that was the inspiration for the popular television series “House.” Furthermore it; The doctor wrote two books about medical diagnosis, and appeared in a documentary series on the Netflix platform entitled: “Diagnosis” in 2019. The “Covid” Mystery: Sanders found in the “Covid” clinic proposal what she was looking for. But her work there placed her in the heart of the unknown at the same time as scientists began to make some discoveries. In May 2022, immunologist Akiko Iwasaki, also from Yale University, and his colleagues published a report in the journal Nature Medicine that included “long Covid” in the family of “post-acute-infection syndromes.” )». A small percentage of people who have survived infection with common viruses (such as Ebola, dengue, polio, influenza, and Epstein-Barr) for years experience symptoms similar to those experienced by “long Covid” patients, such as extreme fatigue, brain fog, and joint pain. Inflammation, dizziness, intermittent sleep, and mood disorders. The same applies to those infected with the giardia parasite. Iwasaki’s report indicates that these symptoms are not only real; but also pathogenicity; Because the form of its activity in the body, the reason behind it, and the mechanisms that support it at the cellular level are similar. If scientists can determine why common infectious diseases become chronic diseases in some people and not others, they may be able to develop treatments that target the main causes rather than the symptoms. Iwasaki promised that “Long Covid” provides science with an opportunity to define the origin of chronic disease that follows infection, and thus help millions of people. The report published in the journal Nature Medicine coincides with Sanders’s interest in unknown cases. The internist explained that “many people suffer from diseases for which we do not have names, and of course there are no tests for them.” The difficulty of defining long illness, but even Sanders herself was not prepared to work in the circumstances of the scarcity of information that scientists and doctors have about “long Covid.” There is no blood test for the disease, and health officials are unable to date to define it, and the Centers for Disease Control and Prevention describes it as “signs, symptoms, and cases that persist for some period of severe (Covid-19) infection.” The Centers for Disease Control and Prevention definition indicates that patients suffer from “long Covid” if symptoms persist for at least four weeks after the original infection. For its part, the World Health Organization adopts the same definition, but with a different time frame, as it considers a “long-term Covid” patient to be one whose symptoms begin or continue 3 months after the original infection. Sanders considers this difference important; Because she wants to define patients who actually suffer from “long Covid,” not those who need longer to recover from their original illness, and for this reason, she uses the World Health Organization’s definition in the clinic. “Long-term Covid” has accumulated something like an encyclopedia of symptoms. A research paper published by the eClinical Medicine website describes more than 200 different symptoms of the disease. When patients talk about their recent condition, it seems as if they are possessed by demons. Sanders said that one of her patients could, in days; She walks 700 steps from her car to her office door, and sometimes she cannot, and another patient’s annoying ringing in his ears turns into deafness. The internist explains, “People come with strange symptoms, such as internal trembling, and they say that they are shaking inside. This does not apply to one person, but to many.” There are several reasons behind the most common symptoms of “long Covid”… For example, brain fog indicates a failure of memory and perception and a loss of the ability to concentrate. This may be due in part to “chronic fatigue syndrome,” which shares many symptoms with long-term illnesses such as Covid. The symptom may be the result of another disease, such as sickle cell anemia, diabetes, or Alzheimer’s, or perhaps a side effect of a medication, or perhaps aging, menopause, stress, or even lack of sleep. Furthermore, the term “chronic fatigue syndrome” has become popular to describe work burnout, pandemic fatigue, boredom, feelings of dissatisfaction, or even the effect of staying up late. Today, more than ever, Sanders relies on the details provided by patients to make her diagnosis. That is, it is like a process of deletion and reduction, and for this reason “she learned to be silent and listen.” Causes of “Long Covid” “Covid-19” turns into “long Covid” in about 10 percent of cases, and scientists still do not know the reason. Growing evidence suggests that the virus, or part of it, remains in “reservoirs” in organ tissues for a long time, which means that the virus itself may be the cause of the symptoms, or that it may stimulate an autoimmune response, as the Epstein-Barr virus does. Scientists also believe that “Covid-19” may activate other viruses that have been dormant for decades in the body and awaken them to cause symptoms. It may be caused by some infections. Iwasaki revealed that “laboratory mice that suffered a minor infection with (Covid-19) also suffered a slight inflammation of the lungs that coincided with major brain damage.” The theoretical reasons or motivations may not be exclusive; Rather, they are sequential, conflicting, and even individual. Because “long Covid” may express itself differently depending on the environment of each host. But for researchers to succeed in developing targeted treatments, Sanders must discover, write prescriptions, and propose uncomplicated, existing solutions. The clinic currently shares its headquarters with the wound management team at Yale; That is, her patients share the waiting room with people recovering from injuries, but she is supposed to move to a new, larger place next October. * “New York Magazine” – “Tribune Media Services”
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