Post-Covid conditions are difficult to diagnose and treat – 03/10/2024 – Health

“To this day I feel lung weakness, my breathing is not the same and I have bouts of forgetfulness and a lot of physical fatigue”, says beautician and cosmetologist Edilaine Lopes Lazo, 44, diagnosed five times with the new coronavirus between 2021 and 2023. An oncology patient, she had post-Covid conditions, previously called long Covid.

According to experts interviewed by Sheet, these symptoms do not depend on the severity of the infection and have a well-known diagnostic spectrum. Patient tracking, however, is essential to improving care.

“The Covid situation today is relatively calmer, but it is not completely controlled. Cases continue to exist, vaccines control the severity of the disease, but they do not completely control the infection”, says neurologist Augusto Penalva, honorary professor at the Emílio Ribas Institute.

The doctor states that protocols, especially treatment protocols, need to be monitored to monitor the evolution of the disease and improve patient care.

“Very little has been implemented from a diagnostic point of view in public health. There are some diagnostic and therapeutic strategies, but they are still extremely complex for large-scale implementation”, says the doctor.

Penalva says that important monitoring already exists, such as NeuroCovBr, but the diversity of individuals’ responses to the virus demands the greatest possible coverage. NeuroCovBr monitors one hundred patients from three macro-regions of the country and has professionals from eight institutions.

Alexandra Boing, epidemiologist at the Federal University of Santa Catarina (UFSC) and coordinator of the Epidemiology Commission of the Brazilian Public Health Association (Abrasco), reinforces that Covid-19 is still a health problem in Brazil. “To illustrate the seriousness of the situation, in 2024, there were more than 300 deaths from dengue, while Covid-19 has been responsible for more than 1,500 deaths so far, an average of 200 per week”, points out Boing.

For the epidemiologist, there is an accumulation of old and new challenges added to the current dengue crisis. “It is crucial to improve health surveillance, including expanding publicly available testing, genomic surveillance, vaccination and improving indoor air quality,” says the expert.

There is no data on how many infected patients may be affected by post-Covid conditions, but estimates from studies, according to Boing, indicate somewhere between 10% and 40% of cases. In the city of São Paulo, for example, in 2022 there were 557 people reported with four and, in 2023, 358.

According to the Ministry of Health, post-Covid conditions are a range of clinical manifestations following acute infection that can be defined as symptoms that continue or develop four weeks or more after initial contact with Sars-CoV-2 “and not may be justified by an alternative diagnosis”.

“Most patients with post-Covid conditions progressively improve over time, but some may experience post-Covid conditions lasting months or even years,” said the ministry. A consensus from the United Nations (UN), according to the ministry, also established that it is impossible to predict how long the condition may last.

Covid can cause prolonged, for example, neurological disorders (loss of smell and taste, memory and concentration, headache), cardiovascular and respiratory disorders.

Edilaine Lazo says that her symptoms are “terrible”, but that, due to her low immunity condition and allergies to pre-existing medications, her treatment consisted of just lots of rest, food, antibiotics and pain medication. Assisted at all stages by the Unified Health System (SUS), the patient states that she was always well supported and there was no delay in treatment.

The ministry says that the federal government has developed and financed clinical research and population-based surveys in partnership with institutions and universities “to better estimate the frequency of these conditions”. One example is the Epicovid 2.0 study, carried out in partnership with the Federal University of Pelotas (UFPel) and whose data collection is scheduled to begin in the second week of March.

Another front is to expand vaccination coverage, which in 2024 included the Covid-19 vaccine in the National Vaccination Calendar to increase protection for babies over six months and children under five years of age.

For Boing, the best way to avoid post-Covid conditions is still to prevent infection through vaccination and non-pharmacological measures, such as ventilation of environments and adequate patient management, with investment in research to understand the pathogenesis of Covid.

Penalva also bets on vaccination to ensure increasingly milder conditions and less viral invasion. “It’s the big secret for you to avoid both acute illness, chronic illness or later complications of Covid infection,” says the neurologist.