The Academy of Medicine publishes its analysis on the management of the sequelae linked to Covid-19. Lungs, kidneys, brain … Several organs can be affected by more or less reversible consequences.
Since the start of the epidemic, more than 105,000 people have been hospitalized, including 18,500 in intensive care. For some patients, despite the recovery, the fight against the Covid-19 is not over. While the SARS-CoV-2 surveillance indicators are scrutinized by health authorities, the Academy of Medicine publishes its analysis and recommendations on the aftereffects linked to Covid-19.
“We must clearly distinguish the sequelae of people in intensive care, who have been intubated, who have suffered anoxia, that is to say poor oxygenation of the brain (…). They can also have fibrosis, an inflammatory reaction healing at the lung level “, details Professor Patrick Berche, member of the Academy of Medicine.
“Besides that, there are sequelae of pulmonary fibrosis during mild Covid, for example in patients who have had 5/6 days of cough, fever. We do not yet know the frequency of these cases precisely”, continues -he.
“Time bomb”
In a press release published on July 17, the institution explains that “fibrosis causes a decline in respiratory function, an extension of lesions on the CT scan and an increased sensitivity to respiratory infections”. “Concretely, with this respiratory insufficiency, these patients will be tired, breathless. It is a time bomb of the Covid 19”, estimates professor Patrick Berche.
Another disorder noted: an inflammation of the heart muscle, called inflammatory myocarditis, “often found in resuscitation patients”, notes the press release.
Possible damage to the heart, kidney, brain
“The virus multiplies in endothelial cells, that is, those that line blood vessels. This can have consequences for the heart, but also for the kidney, with moderate kidney failure which can worsen, and for the brain “, details Patrick Berche.
“This brain damage can result from three factors: a lack of oxygenation, strokes with a blocked artery because Covid-19 causes coagulation disorders. Finally, it can be a multiplication of the virus itself in neurons often by a path that comes from the olfactory nerve, the virus rises and causes damage locally or in other places.
“Mislabeled disorders”
Apart from these identified sequelae, the consequences of “poorly labeled disorders” can arise after “an acute phase often short”, notes the press release from the Academy of Medicine, which advocates monitoring these sequelae through a cohort study.
“Patients come back to see their doctor because they are not well: the virus has disappeared from their body; but they have muscle pain, fatigue at the slightest effort … It is probably a reaction of the immune system that causes these prolonged forms. “
“It is difficult to make the share of what amounts to the consequences of Covid-19 and other causes. Despite paracetamol, psychological support and renutrition, treatment is difficult,” notes the Academy of Medicine.
Signs of restlessness, confusion, sometimes inattention
In addition to possible physical sequelae, psychological consequences can reach patients leaving intensive care, then convalescence.
Doctors in Strasbourg reported that more than half of 58 intensive care patients showed signs of agitation and confusion, sometimes with inattention and disorientation. Brain scanners revealed possible inflammations. These observations, published in The New England Journal of Medicine on April 15, have since been confirmed by other French and American specialists.
Patients are not the only ones potentially affected by psychological disorders. The Academy of Medicine believes that “this is also the case for health care workers subjected to extended working hours and increased responsibilities resulting in fatigue, anxiety and lack of sleep; children and young adults with disabilities who have left their institution children; children deprived of school; and students whose studies have been interrupted. “
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