A year and a half after infectologist Fernando Gatti, head of the Infectology service at Hospital Israelita Albert Einstein, in São Paulo, diagnosed the country’s first covid case, he says that what most calls his attention today is the disease. they are the complaints of patients after the acute condition, the so-called post-covid syndrome.
“In Brazil, I do not know an estimate, but, in general, 20% to 40% of moderate and severe patients can develop the syndrome, so it is a very considerable number”, he says. superior pathways without compromising the lung, they do not develop the post-covid syndrome”, he completes.
The syndrome occurs 1 month after the acute phase of the disease. Even not being infected anymore – the virus remains in the body for ten days, explains the infectologist -, the patient still has the impression that he has covid, presenting symptoms such as weakness, indisposition and cough.
“It seems that the person continues with the disease, but it is no longer the effect of the virus, but what it has already caused, from tissue damage, and the body will have time to recover from this very serious condition that it had. it’s the 12 weeks post-covid,” he says.
“In the lungs, for example, this condition of residual cough and chest pain are closely related to the inflammatory process that is decreasing and the body recovering from the virus lesions”, he adds.
The infectologist observes that, when certain medications are used during treatment, such as corticoids, which lead to a drop in immunity, the virus remains in the body for longer, but even so, the syndrome is not related to its presence; she is later.
“Weakness, cough and chest pain, which sometimes appear after four weeks of the disease, maybe the person doesn’t care so much, as they disappear after 12 weeks. But the important message is: it’s not normal. After 4 weeks , it is not normal for you to keep these symptoms, you should see your doctor,” he advises.
Weakness to easy crying
The most frequent complaints are weakness, indisposition, cough, memory alterations, skin lesions, thromboembolic phenomena and renal alterations, according to Gatti. Other common problems related to post-covid syndrome are anxiety attacks and depression. “It is a situation in which the person lived an imminent risk of death, I would even say that it is post-traumatic stress”, he says.
The post-covid syndrome is treated according to the symptoms, explains the infectious disease specialist. It is recommended that, after hospital discharge, the patient maintains medical follow-up so that he can be referred to the appropriate professional. Respiratory changes should be treated with respiratory physiotherapy, lack of appetite, with a nutrologist, skin lesions, with a dermatologist, and mental health issues with a psychiatrist, advises Gatti.
“Sometimes, the doctor detects that the patient has signs of depression, sleep disorders, early awakening, indisposition for things, easy crying. If he detects some signs of mood disturbance, he asks a psychiatrist for help, who comes with medication for depression or anxiety,” he says.
Secondary bacterial infections can also be part of the post-covid syndrome picture. “Some studies show that 20 to 30% of post-covid patients evolve to some type of secondary bacterial infection, for example, pneumonia, otitis, urinary infections”, he says.
“They are closely related to the issue of the virus initially causing tissue damage and then, as there are bacteria colonizing the body surfaces, these secondary infections end up developing”, he adds.
If there is no follow-up after hospital discharge, post-covid syndrome may worsen, emphasizes the infectologist. He highlights that untreated depression can increase the risk of suicide and symptoms such as weakness and memory impairment, compromising personal relationships and professional life.
Most recover in 3 months
Medical follow-up after hospital discharge can be done by the SUS, highlights the doctor. “It is important for the patient to return to a general practitioner for an assessment of the need for rehabilitation. In the public health system, in the AMEs you can also find other specialists, such as psychiatrists and dermatologists, for this follow-up”, he recommends.
Gatti explains that studies that evaluated the post-covid quality of life showed that, in this 12-week period that covers the post-covid, the patient has an 80% decrease in quality of life. “This greatly impacts daily life, work and family life, because of the associated psychological issue”, he says.
There are no hospitalized patients to treat the syndrome, he stresses. According to him, the problem should not impact hospitals. “This patient hardly ever returns to the emergency room to complain about this. He will look for the doctor who discharged him, who accompanied him. He will avoid the emergency room for fear of getting the covid again. This person does not want to expose himself again in the environment where the virus may be circulating”, he argues.
According to him, 80% to 90% of patients recover from the syndrome within 3 months and 10% within 6 months, entering the so-called chronic phase. “When there is a longer period, the doctor will need laboratory and imaging tests to check if there was a progression of covid-19 in relation to sequelae”, he says.
It is not yet known whether the post-covid syndrome caused by the Delta variant can be more intense or more prolonged. “There are still no studies […] a speculation, as we are talking about the same virus, the tendency is that there is post-covid syndrome with Delta, but I cannot say if it will be even more frequently than the other variants described above, but it will definitely continue to have post-covid syndrome “, ends.