“We know it exists, the data is solid. But…” In the long maze 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 infection. Do we see more clearly what is called Covid Long? Olivier Robineau, infectiologist at the Tourcoing Hospital Center, coordinator of the long Covid 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 a definition in October 2021 according to the Delphi method (the consultation of an expert group) and speaks more of one “Post-Covid-19 Condition”, defined as symptoms that usually appear within three months of infection and last at least two months. They cannot be explained by another diagnosis. Often this state contrasts with the person’s previous state. This definition may evolve based on the level of knowledge, specifies the organization.

“A field of research is emerging on post-infectious syndromes, such as those found after mononucleosis or infections of the SARS or Ebola type or certain influenza cases. The symptoms overlapemphasizes Lisa Chakrabarti, Research Director of the Viruses and Immunity Unit at the Pasteur Institute.

“rapid flow of knowledge”

The variety of symptoms makes it a complex disease. It has become a research topic in its own right. According to the Scopus database, no fewer than 2,000 scientific articles have been published since the topic was first published in September 2020. “Everyone felt this urgency to be able to work on this topic. With the Covid, we have never seen such a rapid influx of knowledge, new treatments and vaccines in science. We hope that it will be the same with 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 family medicine at the Geneva University Hospitals (HUG).

Not so easy to estimate the prevalence. Between 10% and 30% of people presenting with Covid-19 would be affected. A wide range that can be explained by the types of population studied and the different definition of the disease depending on the work.

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