Covid long, the steep road to recovery

How much longer will this last? When this question torments her, Gwendoline Rodriguez makes sure to sweep it away, “so as not to be depressed”. Since being hospitalized for Covid in April 2021, this 34-year-old mother has “the impression of living in the body of an old lady”. “I, who used to be the type to run around with my 5-year-old boy, find myself having to balance my efforts. Sometimes it gets better. And then suddenly, I walk for fifteen minutes and I collapse. Some days, horrible migraines keep me in place. It’s been a year” is sorry for this educator specializing in autistic children, who has never been able to return to work.

→ INVESTIGATION. The mysteries of the long Covid

Fatigue, shortness of breath, cognitive problems, digestive disorders, headaches… According to the definition of the health authorities, the long Covid designates a constellation of symptoms occurring after an infection with Sars-CoV-2 and persisting beyond four weeks. For many, however, these difficulties drag on for several months. This is illustrated by the work carried out by researchers from the University of Paris Cité and the Assistance Publique-Hôpitaux de Paris with 968 patients. Published on April 5 in NatureCommunications, their study calculates that 85% of them saw one or more of their symptoms persist after twelve months. For 60% of patients, the impact on personal, professional and social life is qualified as ” Very important “.

The importance of psychological follow-up

“It’s difficult for the patients to live with, but you shouldn’t imagine that everyone is in a catastrophic state, tempers Doctor Leonardo Astudillo, at the head of a multidisciplinary consultation dedicated to the long Covid within the Saint-Exupéry clinic in Toulouse. Symptoms may take time to improve, but in most cases there is improvement. »

Even if some ailments are more difficult to treat than others, recognizes this specialist in internal medicine. “Some people have a problem of shortness of breath linked to the fact that their bronchial tubes are constricted. By giving them bronchodilators, we increase their respiratory capacity and physical activity becomes easier. It is more complex for chronic fatigue or concentration disorders, which are very common in these patients,” points out the doctor, who insists on the benefits of time.

→ INVESTIGATION. “The long Covid folded me like a schoolbag”

“Take mononucleosis, in which we find this mechanism of post-infectious fatigue. Some people take a year to recover. It’s long, but we get by, he wants to reassure. We could also compare it to a facial paralysis of viral origin. For months the patient will not be able to move his face, then gradually the nerve will recover. After six months it will be better, and after a year much better. »

A path of patience which, according to him, makes psychological follow-up essential. “The people we receive have sometimes had to stop working, have become socially isolated. They need to speak and especially to be heard. »

A gradual return to normal

“The improvement of patients lies largely in this work of listening”, confirms Doctor Philippe Laurent. For the head of pneumological rehabilitation at the Aressy medical clinic (Pyrénées-Atlantiques), involved in the management of the long Covid for more than a year, “The important thing is to support the patient towards resilience. This does not mean giving up but taking note of one’s condition, accepting one’s limits, while seeking to overcome them”. However, he refrains from talking to his patients about healing. “I prefer to say that things will gradually return to normal. »

→ EXPLANATION. Covid-19: the unpleasant surprise of repeated infections

A return to normal that Amélie Perrier is just beginning to touch. Co-founder of the AprèsJ20 association, the first dedicated to the long Covid in France, this press officer found a stable job last February, more than two years after her infection and the appearance of the first persistent symptoms. A rebirth? “Physically it was hard, because I still suffer from various inflammations, but morally it did me a lot of good”, says this 44-year-old Breton woman, still followed in internal medicine in Lannion as well as by several private practitioners (physiotherapist, osteopath, psychologist, etc.).

“Let’s say that I accepted not to be the same anymore. I will probably never run a marathon again, even if my physios believe in it. But I’m no longer out of breath as soon as I speak, I go back to the cinema, I walk, I make plans… To tell you the truth, I even got married! »

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“Efforts for care must be accentuated”

Dr Jerome LarchéCovid long referent at the Occitanie Regional Health Agency

“It is not reassuring to see that a large majority of people suffering from long Covid still have symptoms a year later. This should not distract us from the efforts made to improve and standardize care throughout the territory. On the contrary. We are likely heading towards a chronic disease, with all the difficulties that this entails in terms of diagnosis and follow-up. We must therefore continue and even step up our efforts. »

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