Shortness of breath, increased sensitivity to pain, forgetfulness – some people are still struggling with significant limitations months after contracting Covid 19. There are now initial experiences that help those affected.
After an infection with the corona virus, one is actually considered to have recovered. But many of those affected still have to struggle with physical complaints months later. Symptoms include concentration problems, loss of smell, sleep disorders, tachycardia or physical fatigue. “Around ten percent of all people infected with the virus develop long-Covid symptoms,” says neuroscientist Prof. Dr. Martin Korte, author of the book “Long Covid – if the brain fog stays” (DVA). The doctor explains how to minimize the risk of long-Covid illness, which therapies are currently available and how those affected can restore their physical and mental fitness.
Over a million people in Germany suffer from Long Covid. How are the symptoms expressed?
Prof. Dr. Martin Korte: The most common are neurological symptoms such as fatigue, i.e. extreme, persistent tiredness, brain fog, memory and concentration problems, loss of smell, muscle and headaches or sleep disorders. In addition, there is tachycardia and dizziness, shortness of breath, shortness of breath and rapid physical fatigue.
Which people are at higher risk of contracting Long Covid?
Two thirds of all patients are women. Most are under 60 years old and often had comparatively mild courses of Covid-19. But people with diabetes, atopy and other autoimmune diseases are also among the risk groups. In contrast to life-threatening courses of an acute Covid-19 disease, which mainly affects older men over 60 years of age.
How does Long Covid show up in children?
We can assume the same spectrum of symptoms as in adults. But overall it’s poorly studied. In general, the course appears to be milder and the Long Covid subsides more quickly. But it’s a myth to say kids don’t get Long Covid. More research is urgently needed here.
Can long covid also occur after vaccination?
Yes. There is post-vac syndrome, but it is very rare. For comparison: About ten percent of all people infected with the virus develop long-Covid symptoms, but only 0.02 percent of all vaccinated people. Here, too, biomarkers are urgently needed in order to be able to clearly differentiate between diseases that occur randomly after vaccination and Long Covid.
How to minimize the risk of contracting Long Covid?
A triple vaccination against Sars-CoV-2 reduces the risk by 15 to 50 percent. The data situation is still unclear. What is certain is that vaccination means risk reduction, but vaccination alone cannot prevent Long Covid. Basically, the most important thing would be to prevent infection, and for me it still applies here to wear an FFP2 mask indoors that are poorly ventilated and where the distance rules cannot be observed.
What therapies are there?
So far there are no established, causal therapies. It is being tested whether immunosuppressive drugs against autoimmune diseases also help in long-Covid patients. In this context, it is also being investigated whether antihistamines, which are normally used against hay fever, can contain the symptoms of Long Covid. The first promising studies are also available with hyperbaric oxygen therapy. Here, 100 percent oxygen is used in a hyperbaric chamber – and this should not only increase blood saturation with oxygen, but also stimulate the formation of new vessels (angiogenesis). They could then replace blocked vessels caused by the virus.
Vaccination during long-COVID has also been shown to reduce symptoms in a subgroup of patients, as has administration of the antiviral drug PaxlovidR. This could be because the renewed stimulation of the immune system by vaccination or by medication against Sars-CoV-2 finally eliminates the residual virus from the body.
How to restore physical and mental fitness?
You have to differentiate here whether you suffer from fatigue syndrome or one of the other long-Covid symptoms. Because fatigue patients have to economize with their strength, otherwise they suffer massive relapses. They must learn to manage their reduced energy reserves, take more breaks, and only exert themselves in a very targeted and deliberate manner. For everyone else, the following applies: breathing exercises, slow build-up training or coordination exercises that are good for both the physique and the ability to concentrate mentally. If you want to start exercising again, you have to start well below your previous level and slowly increase the training volume carefully, especially heart rate controlled.
What specific exercises are there?
Those who have suffered a loss of smell can do exercises. For example, capturing different smells in bottles and smelling them again and again to recognize familiar smells. In the course of a Covid-19 illness, many patients get used to breathing incorrectly, far too shallowly, in order to avoid pain when breathing in and out. The therapeutic approaches here are breathing exercises, especially diaphragmatic breathing. The deep inhalation and the concentrated exhalation must be practiced again.
Prof. Dr. Martin Korte is Professor of Neurobiology at the TU Braunschweig. He also conducts research at the Helmholtz Center for Infection Research in Braunschweig and is one of the best-known brain researchers in Germany.
