Last week on our response platform NUjij we asked what you wanted to know about the post-covid syndrome. Here are the answers to your most pressing questions about the disease.
What are the chances that you will get post-covid syndrome?
If symptoms persist for more than three months after a corona infection, it is referred to as post-covid syndrome. It is not known how many people get the disease. Estimates in the Netherlands vary widely: from tens of thousands to hundreds of thousands of patients.
Researchers from Radboud university medical center and UMC Groningen concluded last year that one in eight Dutch people have long-term complaints after a corona infection.
Why does one get it and the other doesn’t?
The scientific journal Nature published a summary of the main results of post-covid research at the beginning of this year. It identifies several risk factors that may increase the risk of long-term complaints. For example, women are more likely to get post-covid than men.
People with type 2 diabetes, an autoimmune disease, connective tissue disorders such as rheumatism, ADHD, chronic hives, chronically inflamed nasal mucosa, mononucleosis and Q fever would also have a higher chance of getting post-covid. The same applies to people who do not take enough rest after having had corona.
Despite this, a third of post-covid patients were healthy and had no chronic conditions. To be clear: these are still assumptions for the time being. More research is needed to prove this. What is certain is that the post-covid syndrome can affect people of all ages.
Postcovidsyndroom
Het postcovidsyndroom stond tot voor kort bekend als langdurige covid of long covid. Op advies van de Gezondheidsraad is de naam veranderd en spreken we nu van het postcovidsyndroom als het gaat om aanhoudende klachten na corona. Post betekent ‘na’ in het Latijn. De klachten komen namelijk ná corona.
Does the loss of smell and taste fall under the post-covid syndrome?
Yes. About 5 to 20 percent of people with a loss of smell or taste after corona suffer from this for so long that it falls under the post-covid complaints. You can follow training courses to regain the sense of smell and taste, but these have not been proven to be effective.
Does a new corona infection exacerbate the health problems of post-covid patients?
Preliminary research shows yes. After a new corona infection, the chance that the existing post-covid complaints will increase increases. Also in patients who have had the first corona shot and have been boosted once or twice. This is shown by a study that Nature published in November.
This is one of the first studies on this subject. The link between a reinfection and post-covid syndrome has not yet been thoroughly investigated. Biological factors may play a role. It may also be that doctors simply register a backlog of post-covid patients.
Does the corona shot reduce the risk of post-covid?
Studies are inconclusive on this. According to a British study non-vaccinated people are not significantly more likely to develop post-covid syndrome than vaccinated people. Other studies show that vaccines provide partial protection. With an injection, the chance of post-covid would decrease by 15 to 41 percent.
The impact of the vaccine on people who already have post-covid has been studied in a Japanese study. The injection relieved the symptoms in about 17 percent of the patients. The complaints actually increased in 21 percent. The rest experienced no change in complaints.
Out RIVM study into the post-covid syndrome, it turned out last summer that vaccinated people (under the age of 65) report loss of smell and taste less often than non-vaccinated people. There was no difference in other complaints. More research is needed into the exact influence of the vaccines on the post-covid syndrome.
Hoe ontstaat het postcovidsyndroom?
Artsen en onderzoekers weten nog altijd niet precies wat de oorzaak is van het postcovidsyndroom. Wel zijn er verschillende theorieën. De Nature-studie heeft die samengebracht tot vijf categorieën:
- Postcovidpatiënten hebben een ontregeld afweersysteem. Het lichaam valt zichzelf steeds aan door een achtergebleven coronavirus of een ‘slapend’ virus, zoals het Epstein-Barrvirus (dat pfeiffer veroorzaakt).
- Door het coronavirus ontstaan piepkleine klonten in het bloed. Organen krijgen zo minder zuurstof. Dat kan pijn in het lichaam en vermoeidheid geven.
- De hersenstam of een zenuw in de hersenen (nervus vagus) is aangetast door het coronavirus. Patiënten houden er neurologische klachten aan over.
- Virusdeeltjes blijven over in allerlei organen (zoals de buik, longen, nieren of darmen), die klachten blijven veroorzaken.
- Het coronavirus heeft de balans tussen goede en slechte bacteriën in de darmen verstoord. Daardoor neemt iemands afweer af.
Is there a treatment that has been proven to work against post-covid?
Because we do not know how post-covid arises, there is still no treatment against the disease that has been proven to help. Practitioners can currently only help patients deal with the complaints, which vary widely.
So what works for one person will not necessarily work for another. For example, doctors refer patients to an occupational therapist, physiotherapist or remedial therapist. Others may benefit from an antidepressant.
There is no scientific evidence for alternative treatments such as oxygen therapy that they help against the disease.
Welke klachten vallen er allemaal onder postcovid?
Postcovidpatiënten hebben uiteenlopende klachten. In totaal zijn er zo’n tweehonderd klachten bekend. Dit zijn de meest voorkomende:
- Vermoeidheid
- Concentratieproblemen
- Geheugenproblemen
- Kortademigheid
- Overgevoeligheid voor licht en geluid
- Hoofdpijn
- Somberheid en prikkelbaarheid
- Slaapproblemen
- Spierpijn
- Duizeligheid
Is post-covid care reimbursed?
Restorative care for people with post-covid syndrome, such as physiotherapy, speech therapy and occupational therapy, can be reimbursed from the basic package. At the request of the Lower House, the regulation that had been introduced for this purpose has been extended until 1 August next year.
How large is the group of post-covid patients who are now incapacitated for work?
In November, the UWV reported that about a thousand post-covid patients had been declared fully or partially incapacitated for work. They had been ill for at least two years at that time. The UWV examines who is entitled to a disability benefit or a WIA benefit.
What do we know about post-covid in children? Do they have the same symptoms as adults?
Children can also get post-covid syndrome. It is not clear how many children are involved, because there is no registration of the number of patients. Children often have the same diverse complaints as adults.
Károly Illy, president of the Dutch Pediatric Association, supports a joint approach to the post-covid syndrome. But he emphasizes that attention must be paid to children’s patients. For example, certain treatments can be given to adults, but not to children. “A child is not a small adult,” he says.
According to Illy, no research is currently being done in the Netherlands that specifically focuses on post-covid syndrome in children.
