Luis Manuel Entrenas, head of the Pneumology service at Quirónsalud Córdoba Hospital.
Persistent covid can affect approximately 10 percent of patients who had Covid-19, rising to 15 percent in patients who had severe disease. This has been highlighted by the head of the Pneumology service at Quirónsalud Córdoba Hospital, Luis Manuel Entrenas, who has insisted on the “importance of vaccination”, since the possibility of developing persistent covid is reduced by half in people who have completed the vaccination schedule.
Entrenas explained that the term persistent covid, according to the definition made by a group of international experts and recently published in the scientific journal The Lancet Infectious Diseases, refers to the symptoms that occur in people with a history of infection Probable or confirmed COVID-19 infection, usually three months following onset, that last for at least two months and cannot be explained by an alternative diagnosis.
According to the specialist, it is therefore a new pathology that it is important to distinguish from the followingmath of covid that appear following suffering from the disease in a serious way, generally with the need for admission to the ICU, although some patients with sequelae also suffer from this persistent pathology. This syndrome is characterized by continuation of symptoms weeks or months later of the initial infection, or by the appearance of symptoms following a time without them, between 4 and 12 weeks. In many circumstances, the symptoms overlap with the sequelae, which increases the prevalence.
50% of people with persistent covid are over 35 years old
On the other hand, Entrenas has stressed that the appearance of persistent covid is not related to the severity of the initial infection, so can affect both mild and severe patients hospitalized and, normally, they do not have a history of previous pathologies. The reasons that can lead to this pathology focus on three hypotheses, that of viral persistence, which causes a chronic inflammatory state, the inflammatory hypothesis (permanence of viral remains that promote inflammation), and the immune disorder hypothesis, in which the patient’s immune system overreacts, causing an autoimmune problem.
What is possibly happening, as explained by the specialist, is a combination in different proportion of these three hypotheses, thus causing the appearance of different clinical forms of highly varied intensity and affectation. Data from the Ministry of Health indicate that approximately 1 in 5 people have any symptoms following 5 weeks of infection and 1 in 10 people have some symptoms following 12 weeks following being infected.
Persistent covid can affect anyone regardless of age, sex and condition, although the 50 percent of patients are between 36 and 50 years old and most are women. Cases in minors are also beginning to be described, despite the fact that among this group the severity is usually less.
Most frequent symptoms of persistent covid
Multiple symptoms have been described that can fluctuate or persist over time, worsen with physical and mental exertion and cause limitation of functional capacity. The most common are tiredness, malaise, muscle and joint pain, dizziness, fever and sleep disorders. Among the respiratory symptoms, the most common are cough and shortness of breath, digestive symptoms such as diarrhea, loss of appetite and stomach pain may also occur.
Among the dermatological are rashes, hair loss and weakness in the nails, among the neurological ones, headache, difficulty concentrating, loss of taste and smell, paresthesias and changes in mood. Difficulty swallowing may also occur. ringing in the ears, dry eyes, and conjunctivitis, as well as cardiovascular such as palpitations and changes in blood pressure.
Entrenas has highlighted that the problem with these symptoms is that many are poorly measurable. For example, there is no marker in an analysis that “makes persistent covid easily diagnosable with symptoms such as shortness of breath, headache or ringing in the ears.” when they have five or more symptoms during the first week of Covid-19 disease there is a greater predisposition to have persistent covid and in those over 70 years of age, loss of smell can predict its appearance.
Therefore, no specific treatment available for these patients, so treatment is generally symptomatic. Medications are distinguished that are intended to combat the inflammatory disorder by combating the main action of the virus, the cytokine storm. “In patients who have suffered a severe covid, corrective measures must be implemented for nutritional deficits, for the replacement of muscle mass and add rehabilitation and even treat psychological damageTherefore, care for these patients must be multidisciplinary. Including in a very important way Nursing professionals, who know how to value home care very well, support for family members and caregivers, as well as detect the care needs that may appear”, he highlighted.
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