Long Covid, the immunologist: “Neurocognitive after-effects are worrying”

The post Covid problem exists and we also detect it in Italy. We have many sequelae after some time from infection and hospitalization, but not in the percentages observed by the study, conducted in China, at least as regards respiratory after-effects in particular. Instead, we note iquite importantly, the neuropsychiatric manifestations of Long Covid. Insomnia, anxiety and even depressive manifestations: those are still quite persistent “. Patrizia Rovere Querini, immunologist, responsible for the Covid-19 hot spot of the Irccs San Raffaele Hospital in Milan, sketches the picture at Adnkronos Salute, looking at the results of a Chinese study published in ‘ The Lancet Respiratory Medicine ‘, the survey with the longest follow-up conducted so far, which also showed the persistence of at least one symptom in 55% of former Covid-19 patients even after 2 years.

“The two series, Italian and Chinese, cannot be easily compared because the populations are different: we have older and more overweight patients, they have younger and in a male-female ratio with more women. However, among our patients, 70% of our patients were already well at 6 months, had had a good recovery. We then had 20% with still mild dyspnea and alterations, and another 10% with more important manifestations. our analysis was compelling because we invited everyone to check up and there are not a few patients we have seen, about 500 who had been hospitalized “.

The manifestations of Long Covid “more on the neurocognitive front are prevalent in the long term – explains Rovere Querini – Syndromes such as cognitive fog above all, to give an example. In this case these manifestations persist in 30% of the population, after one year . The cognitive fog has often ended up in the spotlight for the stories of those who have lived it. And this expression of the Long Covid, the neurocognitive part, warns the expert, “is independent of gravity. Since our clinic was opened “also to outpatients who had not been hospitalized in the facility,” many patients who have had mild Covid, treated at home, have also arrived with this syndrome. Many are young, aged 25-30 and up. In our series, these manifestations are a little more prevalent in women, who in the end had a less severe Covid than men. Here, it is this aspect of the post Covid that strikes me and worries me the most: that prevents the patient, even when young, from returning to his previous personal and working life “.

“I have had patients – continues Rovere Querini – that they had also very demanding jobs that are now struggling to regain their position in the world. People who have to change jobs for one with less responsibility or who continue to do their job with difficulty “. Like a managerial woman who held a thousand meetings a day, very successful and always dynamic:” she had to hire a secretary because after Covid, when he left the meeting he could no longer even remember what he had decided. It went on like this for a semester. This is the cognitive fog, it is difficult to understand how invalidating it can be if you do not live it. “It means talking on the phone and when the conversation is closed, not remembering what you said to each other. It means” proofreading manuscripts for a living and suddenly no longer able to evaluate them, because the words are no longer evocative as before. “Everything slows down, everything is more difficult.

And anyone could potentially be exposed to this type of problem, confirms the specialist. “And I don’t get the feeling that vaccinated patients who have milder forms are entirely free from these sequelae,” she notes. This lack of clarity can last for weeks, but even months. And it is “treatable, with exceptions that require to be followed longer. Not all forms are mild, in some cases it is necessary to undergo cognitive therapy and other treatments. There are exercises that serve to rehabilitate the patient, which according to our psychiatrists are also very effective. But it’s important to talk about it, we need awareness at the level of society and give people time to heal. ”

Everyone, even in the world of work, needs to know that the problem exists and that it can take some time for it to pass. “Patients must have time. And that it is clear that it does not depend on how serious the Covid has been. In my opinion we must put in place the health resources so that these people can have access to all the treatments they have. I don’t think there are still many Long Covid clinics where there is the possibility of having a psychiatrist, psychotherapist, and the necessary figures, managed with the national health system. Perhaps this aspect should be enhanced, because patients are truly happy when they are followed in this path of recovery, even by psychiatrists who can support them and calm them. The system has made exemptions, it has put benefits, but perhaps it has not watched over the creation of the necessary structures. It seems we lack a little, that there is a significant demand “.

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