Recovered but not healthy: Long Covid still in focus

The corona incidences are increasing, the fear of a summer wave is spreading – the diffuse clinical picture of Long Covid is fueling uncertainty. Experts see room for improvement when it comes to education about long-term consequences.

The corona infection is not always history when the recovered status is reached. For some people, the long-term consequences cause great suffering, frustration – and, above all, helplessness.

Because even after more than two years of Corona, knowledge about Long Covid is still patchy. While numerous studies aim to approximate the clinical picture, experts warn about the supply situation. How experts currently view the disease and how information offers should bring light into the darkness:

The German patient guidelines define complaints that persist for more than four weeks after the corona infection as “Long Covid”, and they last longer than twelve weeks as a “Post Covid” subtype. A statement by the Federal Government’s Corona Expert Council from May states that, according to studies, the majority of those who have been treated in intensive care units with a severe course of Covid 19 develop long-term complications. Even after a mild infection, ten percent met the post-Covid criteria.

Hundreds of thousands of people affected in Germany alone

Jördis Frommhold, lung specialist and chief physician at the Median Klinik Heiligendamm, assumes that there are hundreds of thousands of long-Covid sufferers in Germany. There is consensus in expert circles that full vaccination protection clearly reduces the risk of long-term consequences after a corona infection. According to an English study, basic vaccinations and boosters reduce the long-Covid risk by 50 percent, according to an Israeli study by two thirds.

Nevertheless: Federal Health Minister Karl Lauterbach (SPD) recently pointed out via Twitter based on British data that many vaccinated people in the omicron wave were also affected by Long Covid. Even so, without vaccination, the number would be much higher, he made clear.

Diffuse clinical picture and complex diagnostics

Frommhold emphasizes how great the gradation of possible symptoms is – many restrict little or no restriction in everyday life, others could, in extreme cases, lead to long-term incapacity to work or bedridden. Christoph Kleinschnitz, director of the neurological clinic at the University Hospital Essen, reports in an interview with the dpa of a “huge basket of symptoms”. In everyday clinical practice, he saw over 500 long-Covid patients, and the data from over 170 was included in a study recently submitted for publication.

One of the most common symptoms is a pathological tiredness known as “fatigue”. Impairments in performance and memory, concentration or a “brain fog” (brain fog) also often occur. Word-finding disorders and other cognitive limitations are often complained about, as well as general weakness, shortness of breath or shortness of breath and persistent coughing.

The Expert Council paper states that “structural organ abnormalities often remain after a severe course of Covid-19, but are rarely found after a mild course of the disease”. Lauterbach recently warned that there was increasing evidence from studies that Long Covid could be associated with ongoing inflammation of the brain.

More offers and information for those affected

In its paper, the Expert Council calls for the expansion of nationwide offers for people with subsequent complaints. In view of the increasing number of those affected, the supply of care is far from sufficient. Special outpatient clinics and rehabilitation clinics would have to be established. In addition, more research funding and targeted education are needed.

The Federal Center for Health Education (BZgA) recently launched an information offensive in cooperation with the Federal Ministry of Health through an online portal. Those affected will find well-founded information, tips for support and everyday recommendations here. The portal also provides information on support offers in the work context.

In principle, Kleinschnitz finds broad information offerings such as this useful and points to the usefulness of further training on the subject. In the future, an interactive exhibition in Berlin will also offer an innovative way of making it possible to experience the disease, at least for a short time. Simulations such as body suits are intended to illustrate fatigue or shortness of breath.

Expert: “The one pill” will never exist

But what is known about the therapy? According to Kleinschnitz, the best way to deal with the disease is with a concept that includes various disciplines of medicine and psychology. “The one pill against Long Covid, in my view, there will never be.” The first step is “listen, take it seriously, investigate thoroughly”.

From an expert’s point of view, the following applies: those affected should not withdraw and should remain in everyday life as much as possible, but by no means overwhelm themselves. Long Covid is often also a problem of the meritocracy, says expert Frommhold in this context. Doctors try to alleviate the individual symptoms of those affected. Certain breathing techniques can relieve shortness of breath or shortness of breath, and physiotherapy can help with muscle weakness.

In most of the patients he knows, the symptoms are significantly improved or even gone after six or nine months at the latest, says Kleinschnitz. But some would have to struggle with symptoms for much longer. However, he also points out that, from his point of view, many of those affected should first start with psychological and psychotherapeutic treatment before sometimes strenuous and very expensive medical therapy methods are chosen.

He doesn’t want to be misunderstood: “It doesn’t mean that people imagine or simulate their symptoms.” Symptoms and suffering are clearly there. “We only believe that the genesis, mostly in very long-term cases, is less organic and more mental and psychological.”

Looking to the future: Long Covid as a perennial favorite?

According to the expert panel, the ailments associated with Long Covid are likely to put a long-term strain on society and the health and social security system. Neurologist Kleinschnitz is cautiously optimistic. “There is no reason to despair of Long Covid.” He assumes that at least 80 percent of those affected recovered within a “reasonable period of time”. “Long Covid needs to be taken seriously and addressed. But as a society, we’ll get this under control within the next five or ten years.”

dpa

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