What is the so-called Long Covid? In principle, we can consider it a new disease or a variation of Covid19 in its two possibilities up to now: asymptomatic and acute. For a time it has been thought that the covid could leave, and in fact does leave, sequels, but what has begun to be called persistent or long covid is not properly a sequel. The person has symptoms, generally mild, but they do not end, they persist over time. And for a long period, months even. There are people who have had Covid and continue to have these symptoms. Or even people who think they haven’t had it, even CRP negative, they do. And, in addition, with the latent and prolonged infection in time.
Dr. Lorenzo Armenteros, Covid-19 spokesperson for the Spanish Society of General Medicine points out: “There is still no definition of persistent Covid because it is a new disease, but we could say that, with the data we have, it is a complex Multifactorial symptomatic that affects certain people for more than the time considered normal for the duration of the disease. These symptoms remain over time, not only those that we consider classic, but also many others that may appear during the period in which the disease continues. “
We have not found, at least in most of them, a specific damage like what we could consider a sequel. In most of these patients, what persists is the symptoms, either the initial one, or one that appears over time. If we follow the normal process of a disease in which we see a possible syndromic or symptomatic onset, an evolution, a theoretical reduction of symptoms and a cure, we see that this is the natural process of any disease or any pathological process in which they intervene , not only the mechanism that initiates the infection, but the defense mechanism that our body has. However, in this case there is an alteration, this mechanism is broken. What would be the process that tends to cure disappears, and what remains is a symptom complex maintained for a longer time than usual. In some cases with, at times, the paradox that in this type of patients we do not find any organic marker of the disease, but that does not mean that they do not have them: it is very likely that, at the present time, new research will have to be carried out to find certain markers that tell us why in some patients there is a tendency to cure, in others to extreme worsening and in other types of patients they produce a sustained symptomatology over time “
Some people with persistent Covid syndrome may have undergone a PCR and tested negative and no antibodies are found in their body either, but that does not mean they do not have the disease, it has not been detected.
Persistent Covid has inflammatory and neurological characteristics and can affect the vascular system. The problem is that medical research knows what happens but not why it happens. Moreover, in many cases, patients who come to the consultation have been diagnosed with these persistent symptoms as cases of anxiety or continued stress and reactions of the body to it.
Dr. Armenteros says that a recent study gives credibility to a theory: that of the so-called autoantibodies. It could happen and this is another hypothesis that in certain people this type of autoantibodies persists and could cause the persistence of symptoms.
Dr. María Eugenia Diaz points out that when faced with a person with symptoms of this type, we cannot say that the disease has passed and they are sequelae. It’s something new. People who go to the office feel that they are sick, no matter if the symptoms seem more or less serious. And not everyone has the same symptoms. There are more than 200 recognizable and differentiated, although there are no more than a dozen the most common.
More research is necessary because we do not really know if this symptom is due to something endogenous, we do not know the neurochemistry of these Log Covid patients, or if it is more of an exogenous type because these people are seeing how their life is changing and they have a notable disability in your family life or in your work life.
Everything we are experiencing requires an adaptation that we must go through and some sensations and emotions that may appear are totally normal, but they must not be diagnosed simply as a psychological disorder, but rather
Regarding the symptoms, they fluctuate in time and intensity. You can go three days without a headache and suddenly a very severe headache appears.These symptoms can disable us for family, work and personal life.
We are faced with an unresolved inflammatory response. Today, in the 21st century, we understand how the immediate, active response of inflammation is resolved naturally. And there are anti-inflammatory therapies and pharmacopoeias that for decades have been essential and continue to be, but we must begin to address these situations of chronic inflammation not only by fighting the symptom but also by helping the body to promote the elimination of the cause. And for this, it is necessary to research and prove to actively promote the natural mechanisms of active resolution of inflammation.
What are the symptoms of Long Covid?
There is a point that is important to highlight, which is the fluctuation, this is something that we did not see until now, people who have significant dyspnea in a short period of time, it reduces after a few hours and can be after days without having the symptom.
It would be important to listen empathically to these people and recognize the symptoms they have, not only on a psychological level, which should not be hidden either, but recognize that they are having symptoms on a physical level.
We are talking about a disease that will require the collaboration of primary care doctors, medical specialists, physiotherapists, psychologists and neuropsychologists in order to work on recovery.
There is a new disease that must be recognized and, above all, we must investigate because many of the causes are unknown and the treatment that these patients will require is not known.
The role of the family doctor, who are the ones who will receive the patient in the first instance, is fundamental. We may not have sufficient knowledge of the issue or its solutions, but whoever manifests this situation must be made to feel that it is nothing imaginary, that nothing is invented nor is it an anxiety problem before what we are experiencing.
And a ray of hope. We have been knowing for 25 years why inflammation becomes chronic. What is known and measured can be intervened and therefore immunonutrition solutions are already beginning to be available to activate the mechanisms of natural active resolution of inflammation, which can accompany any immunosuppressive treatment. Let us work rigorously, scientifically, with data and evidence, because we are facing a new situation that cannot be swept under the rug and encompassed in what it is not. The so-called “long Covid” is not an acute disease but it is not a sequel either.