Bad Nauheim / Friedberg (pm). “Long Covid” describes a phenomenon that has been occupying doctors of various disciplines for months: the persistent health impairment of people suffering from Covid-19 due to long-term effects, the occurrence of which does not follow any rules known up to now.
The GZW internist Prof. Dr. Robert Voswinckel organized digital training “Covid-19 and Long Covid – a multidisciplinary problem” as part of the “Akademie am GZW”.
Radiologist Dr. Andreas Breithecker introduced the subject of Covid-19.
According to him, what is noticeable about Covid-19 pneumonia is the slow healing tendency.
Emergency physician Dr. Achim Jackel. Blood coagulation phenomena with the development of venous thrombosis and pulmonary embolism as well as the “on-site” coagulation of the blood in small blood vessels, especially in the lungs, are particularly common.
Regardless of the severity of the disease, studies have often shown inflammation of the heart muscle with symptoms even after weeks. In severe cases, an increased number of heart enzymes can be measured regularly in the blood, signs of overload and inflammation of the heart muscle.
Jäckel named age as risk factors for a severe course, but also high blood pressure, diabetes, obesity and heart failure.
Pregnant women should be vaccinated
Dr. Anika Rifi described the changes that the pandemic has imposed on obstetrics. Virus transmission from mother to child has so far been ruled out, and the majority of pregnant women experience the SARS-CoV2 infection without symptoms. Compared to non-pregnant women of the same age, however, pregnant women would have a six-fold increased risk of intensive medical treatment and a 20-fold increased risk of being ventilated in the event of illness; premature birth is increased by a factor of 1.8 among Covid 19 patients. That is why the Society for Gynecology and Obstetrics recommends vaccinating women who want to have children as well as pregnant and breastfeeding women with the mRNA vaccine.
Among the neurological consequences of the SARS-CoV2 infection, Prof. Tibo Gerriets highlighted the loss of smell and taste, which could last for months. However, the long-term symptom of severe exhaustion, the chronic fatigue syndrome, is more restrictive. This is observed in more than half of the initially hospitalized patients for six months after the illness. Headaches and memory disorders are frequent.
These symptoms could not yet be convincingly explained; a persistent inflammatory reaction in the brain is suspected.
Dr. From the perspective of the psychiatrist, Michael Putzke reported on the burden on people after Covid-19 infection. There is currently a significantly higher rate of anxiety disorders and depression compared to comparable diseases such as influenza or pneumonia. Affective problems such as anxiety, insomnia and dementia are reported in the over 65-year-olds, and psychoses do not occur in high numbers. However, mentally ill people have a significantly increased risk of developing Covid-19 and dying from it; they should be considered at risk.
Prof. Voswinckel described the course of the virus infection in the lungs, the diffuse alveolar damage caused and the healing strategies of the lungs, which could result in complete healing, but also in a misdirected development with excessive inflammation or scarring. The cortisone preparation approved for treatment, dexamethasone, can reduce inflammation and scarring.
Further research into causes is needed
The first controlled studies on the healing tendency of the lung changes in initially seriously ill patients showed a slow healing process with incomplete improvement over 60 to 100 days of follow-up with then still visible changes in 50 percent of the cases. A large number of post-Covid patients with shortness of breath during exercise show no abnormalities in the lung CT or in lung function; only seven percent of patients who were initially hospitalized showed a clear tendency towards scarring, which could possibly be improved with short-term administration of cortisone. Further research into the causes of the persistent under-resilience in some people after COVID-19 is necessary, emphasized Prof. Voswinckel.
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