2023-11-09 13:09:53
09 November 2023
The Committee for Monitoring and Anticipation of Health Risks (Covars) denounces in an opinion “unsatisfactory” treatment of patients suffering from post-Covid syndrome (PCS) when there are hundreds of thousands of them in France. The committee puts forward recommendations to finally recognize the disease and support patients.
More than three years following the start of the Covid-19 pandemic, “several hundred thousand people” in France suffer from long Covid, or post-Covid syndrome (PCS). They represent around 10% of infected people, according to figures put forward by the Committee for Monitoring and Anticipation of Health Risks (Covars). However, France “did not sufficiently appreciate the reality of the post-Covid syndrome”, denounces the committee in an opinion of November 7. And populations at risk still remain under-detected: children, adolescents, the elderly and people with comorbidities.
A post-infectious syndrome already observed
The committee recalls that the SPC is indeed a “organic reality” not somatoform disorder – a mental disorder characterized by increased attention to physical symptoms. Post-infectious syndrome (POS) has already been observed in other pathologies, such as Ebola, chikungunya or West Nile.
Le Sars-Cov-2 “enters human cells by interacting with its receptor on the cell surface: angiotensin-2 converting enzyme”, we read in the notice. He is thus able to touch “the nasal cavity, lungs, gastrointestinal tract and eye, as well as the cells lining the capillaries of the central nervous system, heart, pancreas and adrenals”. An invasion of the body which brings together the necessary conditions for the occurrence of IPS.
For affected patients, the impact on daily life is very debilitating, in the private, educational and professional spheres. According to Covars, their support is “unsatisfactory” with a chaotic care pathway, caregivers’ lack of knowledge on the subject, and patients who no longer have confidence in these professionals. “patients feel stigmatized by their symptom”, points out the Covars opinion.
Train caregivers and students in SPI
Covars issues a panel of recommendations including funding dedicated to SPC and more broadly to post-infectious syndromes, “poorly recognized and poorly supported in our country”. The committee insists on the need to train caregivers and integrate the issue of SPI into medical studies. It is also recommended to set up a multidisciplinary care pathway and comprehensive management of all the consequences of the disease on the patient’s daily life.
More than 200 symptoms of PCS are now known. One of their characteristics is their fluctuation over time. Although 91% of patients recognize that their condition improves very gradually over months and years, they experience relapses. “frequent and disabling weeks” and this even a year and a half following infection. Although the causes of PCS are poorly understood, several hypotheses are among the most plausible: “protected viral persistence, chronic inflammation, immune dysregulation, damage to the central nervous system, an imbalance of the intestinal flora, microvascular damage or even a modification of energy metabolism”.
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