Long COVID is indeed a public health problem. In 2023, Public Health France published the results of a study indicating that nearly 2 million French people suffered from persistent symptoms of COVID-19.
Some people who have contracted SARS-CoV-2 may in fact present symptoms after 12 weeks following infection. Symptoms that persist for at least two months and cannot be explained by any other pathology.
A survey carried out in Mexico confirms that the main manifestations of long COVID-19 appear at the neurological, psychiatric, cardiovascular, pulmonary, gastrointestinal and musculoskeletal levels. The main risk factor identified is the diabetes-hypertension-obesity triad.
Symptoms
In the survey, 97% of participants reported, after the resolution of the acute condition, the persistence of neuropsychiatric symptoms such as fatigue or weakness (75.9%), anxiety and nervousness (65.5%), memory problems (65.3%), headaches (56.7%), poor concentration (55.7%), and depression or sadness (55.2%) %). Additionally, 82.8% reported persistent cardiovascular symptoms (palpitations), 71.4% pulmonary symptoms (persistent cough), 79.8% gastrointestinal symptoms (abdominal pain), and 49.8% musculoskeletal symptoms (arthralgia). ).
A study led by researchers at Columbia University in New York in the United States showed that women and people with a history of acute myocardial infarction or stroke are at increased risk of developing long COVID-19 . Researchers have also found that SARS-CoV-2 can lead to the onset of cardiovascular disease.
Support
While some treatments appear promising, there is currently no specific medication against long-term COVID-19. Specialists therefore recommend taking preventive measures to avoid contracting SARS-CoV-2, for example by avoiding enclosed and crowded spaces and considering getting vaccinated.
Since long-term COVID-19 is considered an incurable symptomatic illness, doctors primarily treat the symptoms experienced by their patients. Several molecules have been shown to be beneficial:
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metformin: a study presented at the IDWeek 2024 congress showed that metformin administered within a week of SARS-CoV-2 infection reduced the risk of long COVID or six-month mortality in people by 53%. non-diabetics or prediabetics, attributing its benefit to its anti-inflammatory and antiviral properties.
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Low-dose naltrexone: Its anti-inflammatory properties have been shown to improve symptoms such as fatigue, poor sleep quality, mental confusion, post-exercise malaise, and headaches.
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selective serotonin reuptake inhibitors and antidepressants: Persistence of COVID-19 is associated with low levels of serotonin in the body. This has led to these medications being considered essential for its treatment.
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modafinil: this medication has been shown to be effective in the treatment of fatigue and neurocognitive deficits caused by long COVID, as it acts on the control of the release of inflammatory cytokines by preventing excessive stimulation of neurotransmitters. Its use is recommended in specific cases due to drug interactions.
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Antihistamines: They have been observed to improve symptoms in 29% of patients with this syndrome. Mast cells release histamine when they degranulate, which causes inflammation. For example, famotidine blocks histamine receptors, which relieves mental confusion, shortness of breath and tachycardia.
This subject is still under study in order to clarify the concepts and recommendations that will allow general practitioners and specialists to offer an adequate clinical and therapeutic approach to their patients. To find out more:
This article was originally published on the Spanish edition of Medscape. It was translated, using several editorial tools, including AI, in the process. The translation was reviewed and adapted by the Editorial team before publication.
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