More than three years after the start of the Covid-19 pandemic, millions of people infected with SARS-CoV-2 still present persistent symptoms several weeks, even several months, after being infected. These chronic forms of infection fall into the category of post-infectious syndromes and are called post-Covid syndrome (PCS) or more commonly long Covid. According to the World Health Organization definition, these symptoms cannot be explained by another diagnosis. Often, this state, which must be distinguished from the frequent after-effects after severe Covid-19 with resuscitation, is distinguishable from the person’s previous state.
“The care of people suffering from SPC remains to be improved, it is unsatisfactory”, judges the committee for monitoring and anticipation of health risks (Covars), in its latest opinion, submitted on Tuesday, November 7, to the Ministry of Health. health and made public on Wednesday 8. This work, co-led by Yvanie Caillé, founder of the Renaloo patient association, and Xavier Lescure, infectious diseases specialist at Bichat hospital (AP-HP), also emphasizes great geographical heterogeneity and considers the “incomplete” training of health professionals. Consequence: “Patients face care pathways that are too complex and too often erratic”, even chaotic, and sometimes feel stigmatized, which leads to a crisis of confidence in healthcare professionals.
The variability of the disease makes it a complex subject with no less than two hundred symptoms, according to the scientific literature. Abnormal fatigability, neurological symptoms (headaches, cognitive disorders, feelings of dizziness, etc.), anxiety and depressive disorders, etc. The manifestations can fluctuate over time. “Patient associations, which have become experts, also emphasize the sometimes disabling nature of the disease,” underlines the opinion, with social and economic repercussions. “The consequences in terms of dropping out of school, loss of productivity, prolonged sick leave, adaptation to work, loss of work, resignation, are real,” it is recounted in the opinion. SPC affected around 10% of infected people and “still seems to impact several hundred thousand people in France on a daily basis,” notes Covars.
A tendency to psychiatrize symptoms
The subject, complex, is “sensitive”, in the words of Professor Lescure. The objective of this opinion, which required several months of work, numerous hearings (health professionals, patient associations, health agencies, etc.), is “to go beyond the controversy to propose positive, pragmatic and operational solutions for patients,” specifies the infectious disease specialist. “Some internists and psychiatrists sometimes tend to psychiatrize symptoms and consider that they are somatoform disorders [somatic symptoms without organic explanation],” he explains. Certainly, the symptoms are similar, but it is important to distinguish the two, not to “mix them up”.
