“We know it exists, the data is solid. But…” In the long labyrinth of Covid

More than two years after the Covid-19 pandemic, millions of people infected with SARS-CoV-2 are still showing persistent symptoms weeks or even months after being infected. Do we see more clearly in what is called long Covid? Olivier Robineau, infectologist at the Tourcoing hospital center, coordinator of the Covid long action at the ANRS-Emerging Infectious Diseases (EID), answers bluntly: “We know it exists, the data is solid. But there are debates about the mechanisms of the long Covid, the causes, the treatment. » There are still many gray areas.

The World Health Organization (WHO) proposed, based on the Delphi method (the consultation of a group of experts), a definition in October 2021, and speaks rather of a “Post-Covid-19 state”, defined as symptoms that usually appear within three months of infection and last for at least two months. They cannot be explained by another diagnosis. Often this state contrasts with the previous state of the person. This definition can evolve according to the state of knowledge, specifies the organization.

“A field of research is emerging on post-infectious syndromes such as those that can be found after mononucleosis or SARS or Ebola-type infections, or even certain cases of influenza. Symptoms overlapemphasizes Lisa Chakrabarti, director of research in the Virus and Immunity unit of the Institut Pasteur.

“Rapid influx of knowledge”

The variety of symptoms makes it a complex disease. It has become a research topic in itself. Since the first publication on the subject in September 2020, no less than 2,000 scientific articles have been published, according to the Scopus database. “Everyone felt this urgency to be able to work on this issue. With Covid, we have never seen in science such a rapid influx of knowledge, new treatments, vaccines. We hope that it will be the same for the long Covid, even if it is a little more complicated because we are still looking for the pathophysiological causes. underlying »explains Mayssam Nehme, chief physician of the department of primary care medicine at the University Hospitals of Geneva (HUG).

Prevalence is not so easy to estimate. Between 10 and 30% of the people who presented Covid-19 would be affected. A wide range that can be explained by the types of populations studied and the definition of the disease, which varies by job.

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