The International Long COVID Awareness Day on March 15 served as a reminder that long COVID is often unrecognized by physicians and remains understudied. The #AprèsJ20 Association COVID Long France denounced political disengagement.
Clinician Awareness Gap
Where does care for long COVID stand? ANRS Emerging Infectious Diseases (a French research program focused on emerging infectious diseases) reviewed the state of knowledge about the condition on International Long COVID Awareness Day.
“Long COVID was recognized by the World Health Organization (WHO) nearly 6 years ago; you can’t say there is no definition!” said Pauline Oustric, president of the association #AprèsJ20 Association COVID Long France. “Yet we still see denial and a tendency to psychologize this disease.”
Long COVID is thought to affect 400 million people worldwide (including about 2 million in France), ie, roughly 6% of the population. It can affect patients of all ages, with or without preexisting medical conditions, and even after a mild COVID infection. Symptoms that persist for at least two months generally begin within three months of infection. “Patients often experience a medical odyssey, as general practitioners see few cases and have limited knowledge of the disease,” lamented a public health researcher. “They’re told test results are normal, even though diagnostic tools exist in research — but not in routine care: There is a disconnect between science and practice, and it is only widening.”
Up to a Hundred Symptoms
“Not every patient necessarily has neurological, cardiac, or pulmonary involvement, but all of those organ systems can be affected, and we observe up to a hundred symptoms,” said Mireille Laforge, PhD, who is a researcher at the French National Center for Scientific Research. Several mechanisms are suspected: Are there viral reservoirs in the entire population that some control and others do not, or reservoirs present only in certain individuals? Questions about persistent tissue inflammation, vascular and endothelial damage, and possible mitochondrial dysfunction are also avenues of research. “It is now important to mobilize scientists and to determine the biomarkers associated with the pathophysiological mechanisms,” Laforge added.
Partial Recognition
“Yet, research projects are receiving less funding, pediatric forms are not recognized, and we are seeing political disengagement regarding this disease,” Oustric said. “But what creates long COVID is the coronavirus itself — it’s not a problem of stress, temporary tiredness, or poor mental health, even though aggravating factors exist: it is an organic, real disease. Employers, schools, and frontline health professionals must therefore be involved.”
The WHO has pledged to debunk false ideas about the condition.
A major problem for patients is that there are no curative treatments for long COVID — only symptomatic management. As a result, there is a care pathway for adults, published by the French National Authority for Health, and a pediatric care pathway is being drafted.
This story was translated from Medscape’s French edition.
<
Leave a Reply