09/02/2021 at 1:30 PM CEST
At this point in the pandemic, the coronavirus has already become a public health problem in its most visible facet. The high number of infected, hospitalizations and deaths that it continues to cause.
But there is another facet of SARS-CoV-2 that experts have been putting on the table for some time as an issue that will affect public health in the long term, the Long Covid or Persistent Covid.
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Patients who have passed the infection with more or less severity that are affected by very disabling symptoms such as general malaise, asthenia, constant fatigue, chest pain, headache and anosmia.
But other symptoms also persist such as
Cardiac (palpitations, hypertension, tachycardias) Coagulation (hematomas, microthrombosis) Dermatological (urticaria, alopecia, skin rashes) Ophthalmological, musculoskeletal and, of course, psychological problems.
The study of this pathology is focusing many scientific meetings of all specialties, such as the congress of the European Society of Cardiology (ESC for its acronym in English).
This event has dedicated one of its sessions to reviewing the most frequent cardiovascular manifestations of Covid-19.
And it is that beyond tiredness, fatigue, dyspnea (shortness of breath) and the feeling of generalized weakness,
“Orthostatic postural tachycardia syndrome, which is characterized by a sustained increase in heart rate with minimal effort, is one of the most common manifestations among patients with persistent Covid, from a specifically cardiovascular point of view,” explains the Dr. Héctor Bueno, vice president of the Spanish Society of Cardiology (SEC).
Long COVID includes more than 200 symptoms of fluctuating course that cause a third of patients to be unable to return to work or resume normal physical activity.
Normal diagnostic tests for disabling symptoms
One of the most typical problems of persistent Covid is the dissociation between symptoms and tests health objectives.
“It is common for patients to have severe weakness and asthenia, yet the results of the cardiopulmonary or muscle function assessment tests are quite normal,” says Dr. Bueno.
As the vice president of the SEC puts it: “Long COVID is a major problem. In the first place, at the individual level because of the impact it has on the people who suffer from it and on their quality of life. On the other hand, at the scientific level because the exact mechanisms involved are not known and more research is needed. And thirdly, at the healthcare level because we do not know how to treat or prevent these symptoms. And finally, at the health system level because it has an impact on readmissions, medical care and consultations.
Precisely, the experts have reviewed the rehospitalization rates from some countries. In Europe, the United Kingdom stands out, where Covid has caused 30% of readmissions, compared to the 4% of Spain, passing through 10% of Italy.
For Dr. Bueno, readmissions have a lot to do with the functioning of the system.
«If you discharge early, the readmission rate is higher. Spain, after the first wave, may have been more conservative and did not discharge patients as quickly. Although this is only a hypothesis. What is unlikely is that the disease is different from one country to another, “he reflects.
Impact of COVID-19 on the heart
Among the acute generalized consequences of COVID-19, the most frequent are pneumological and inflammatory symptoms.
«When it comes to the heart, we have the myocarditis (inflammation of the myocardium) and also thrombotic phenomena, such as pulmonary thromboembolism and arterial thrombosis like a heart attack or a cerebrovascular accident ”, details the cardiologist.
These conditions revert relatively soon, but a small proportion of patients maintain some degree of persistent myocardial damage.
Furthermore, a Swedish study published in The Lancet magazine has shown that patients who have suffered Covid-19 have a three times higher risk of suffering a heart attack heart attack or stroke.