Dans la terminologie médicale officielle le #covid_long ou #post_covid est appelé : #affection_post-COVID-19
▻https://www.who.int/fr/news-room/questions-and-answers/item/coronavirus-disease-(covid-19)-post-covid-19-condition
#post_covid-19_condition en anglais
#Long_COVID: major findings, mechanisms and recommendations | Nature Reviews Microbiology
▻https://www.nature.com/articles/s41579-022-00846-2
The incidence is estimated at 10–30% of non-hospitalized cases, 50–70% of hospitalized cases and 10–12% of vaccinated cases.
Long COVID is associated with all ages and acute phase disease severities, with the highest percentage of diagnoses between the ages of 36 and 50 years, and most long COVID cases are in non-hospitalized patients with a mild acute illness, as this population represents the majority of overall COVID-19 cases.
#Long_COVID Added to List of Autoimmune Diseases — The Autoimmune Registry
▻https://www.autoimmuneregistry.org/long-covid-announcement
The Autoimmune Registry has determined that biomarkers of immune system activity similar to those seen in many autoimmune and autoinflammatory diseases justify the inclusion of Long COVID on its list of diseases.
New study offers clues as to how long COVID affects the heart
▻https://www.houstonpublicmedia.org/articles/news/health-science/2022/08/19/431146/new-study-offer-clues-as-to-how-long-covid-affects-the-heart
A study from Houston Methodist found some patients with lingering COVID-19 symptoms aren’t getting enough blood to their heart when exercising or doing physically strenuous activities.
The ability of endothelial cells, which play a key role in dilating the arteries and helping get blood to the heart, was diminished by 20 percent among the 101 long COVID patients who participated in the study.
“When a patient exercises, they need a little bit more blood delivered to the heart to be able to provide blood to the entire body," said Dr. Mouaz Al-Mallah, a cardiologist and co-author of the paper. “But in some patients with COVID, we noted that it’s not increasing to the degree that it should be.”
The majority of long COVID patients in the study reported symptoms doctors suspect could be cardiovascular-related. Through PET scans, they found these patients were twice as likely to have unhealthy endothelial cells that line the side of the heart and blood vessels.
Ça donne vraiment envie de l’attraper…
Dr. Deepti Gurdasani sur Twitter :
▻https://twitter.com/dgurdasani1/status/1545485595257995269
L’argument de l’#incertitude pour justifier une inaction criminelle
Of course if you’re going to take an abelist approach that sacrifices the lives of thousands & the health of millions (disproprotionately poor, ethnic minorities, and clinically vulnerable) & worsens health inequalities then you need to justify this by invoking ’uncertainty’.
Origine des hépatites aiguës infantiles : données manquantes et hypothèses prudentes – Libération
▻https://www.liberation.fr/societe/sante/origine-des-hepatites-aigues-infantiles-donnees-manquantes-et-hypotheses-prudentes-20220514_C45REY6WNFHRHKAYCOHRSDFHSU/?redirected=1
▻https://www.liberation.fr/resizer/YSZtpoiBDhiVr1IlOgZV47FAjSo=/1200x630/filters:format(jpg):quality(70)/cloudfront-eu-central-1.images.arcpublishing.com/liberation/BRAXNWHDEVH6HC7FXTASWNQAYE.jpg
Lundi, le masque ne sera plus obligatoire dans les transports, après avoir été abandonné dans les lieux clos. Lundi, la campagne vaccinale des enfants sera toujours au point mort, avec la fermeture programmée des derniers grands centres vaccinaux. Lundi, le Covid sera toujours invisibilisé, comme si la crise était dernière nous. Pourtant, cette volonté sur le passé de faire table rase se heurte à un épineux problème : celui de l’incidence anormalement élevée d’hépatites infantiles de cause indéterminée, dans les suites (corrélation n’est certes pas causalité…) d’une vague omicron ayant particulièrement touché les enfants. La publication de nouveaux rapports épidémiologiques est l’occasion de faire le point sur la situation avec Claude-Alexandre Gustave, biologiste médical :
Protocole français biaisé
Les enquêtes se poursuivent, mais après s’être distinguée à l’international avec son incapacité à mettre fin au délire national autour de l’hydroxychloroquine, la France reste une nouvelle fois en marge de la communauté internationale puisque la Direction générale de la santé (dont le directeur Jérôme Salomon est porté disparu depuis juillet 2021, en pleine pandémie) n’a toujours pas corrigé son protocole d’enquête épidémiologique publié le 3 mai suite à la définition de cas recherchés publiée par Santé publique France le 28 avril 2022. Pour faire court, le protocole français est biaisé. Il impose l’inclusion sélective des cas positifs pour l’adénovirus, et exclue du recensement de ces hépatites infantiles tout autre virus sauf en cas de co-infection adénovirale. Ceci conduit à une cohorte artificiellement 100% positive pour l’adénovirus. A l’opposé, les enquêtes internationales sont alignées sur un protocole « inclusif » qui n’exclut que les virus des hépatites A à E et reste « ouvert » à toutes les autres hypothèses sans a priori.
Notre protocole reste donc incompatible avec les protocoles communs à l’UKHSA, ECDC et OMS. Les données épidémiologiques françaises ne pourront donc pas contribuer à l’enquête internationale. C’est pourtant un enjeu crucial, car l’identification correcte de l’étiologie de ces hépatites conditionnera leur prise en charge et déterminera donc le pronostic des enfants atteints. A moins que cette épidémie dans l’épidémie ne s’arrête, génie français oblige, à nos frontières.
#covid_19 #post_covid #hépatites_aiguës_infantiles #enfants #Pays_desLumières
Covid pandemic sparks steep rise in number of people in UK with long-term illness | Health | The Guardian
▻https://www.theguardian.com/society/2022/mar/05/covid-pandemic-sparks-steep-rise-in-number-of-people-in-uk-with-long-te
More than a third of working-age people in the UK now suffer from a long-term illness, with new figures showing a dramatic rise since the pandemic began. Post-Covid conditions, including long Covid, breathing difficulties and mental-health problems, are among the causes, according to disability charities and health campaigners.An Observer analysis of the Office for National Statistics’ (ONS) labour market status of disabled people figures shows that nearly 14.2 million people in the UK aged 16 to 64 said they had a health condition lasting for at least 12 months in 2021 – a rise of 1.2 million during the two years of the pandemic.
Levels of long-term ill-health had been rising more slowly before the emergence of Covid, at an annual average of about 275,000 cases a year between 2014 and 2018, but the rapid increase over the last two years highlights the health problems facing the UK, says the disability charity Scope.
Reduced Incidence of #Long_COVID Symptoms Related to Administration of COVID-19 Vaccines Both Before COVID-19 Diagnosis and Up to 12 Weeks After | medRxiv
▻https://www.medrxiv.org/content/10.1101/2021.11.17.21263608v1
In this study, patients who had been vaccinated prior to COVID-19 infection were significantly less likely to have long-COVID symptoms. This result applies even if only a single dose of the vaccine is documented, regardless of the manufacturer of the vaccine. Although these results show that other factors, such as demographic factors and chronic conditions, also influence the likelihood that an individual will exhibit long-COVID symptoms, vaccination status had a consistently and substantially larger effect on this outcome than any other factor measured.
Furthermore, patients whose first vaccination occurred within 12 weeks after COVID-19 diagnosis were significantly less likely to have long-COVID symptoms than if they had remained unvaccinated. This finding is consistent with the hypothesis that a vaccine may accelerate clearance of the remaining SARS-CoV-2 virus from specific body compartments or reduce part of the body’s immune response related to development of long-COVID (3).
Do vaccines protect against #long_COVID? What the data say
▻https://www.nature.com/articles/d41586-021-03495-2
Vaccines reduce the risk of developing #COVID-19 — but studies disagree on their protective effect against long COVID.
[…]
And while the data trickle in, Alwan worries that countries with high vaccine coverage will put COVID-19 testing on the back burner as concerns about hospitalizations and deaths decrease and as more people receive boosters. That not only hurts efforts to determine the influence of vaccination on long COVID, but also means that those with long COVID after a mild or asymptomatic infection might not have the documentation they need for treatment. “It’s important to get that lab confirmation for care,” she says. “Otherwise, people struggle a lot.”
Reduced Incidence of Long-COVID Symptoms Related to Administration of COVID-19 Vaccines Both Before…
▻https://seenthis.net/messages/937758
The effectiveness of vaccination against long COVID A rapid evidence briefing
▻https://seenthis.net/messages/949683
Two studies tie long #COVID-19 to severe initial illness | CIDRAP
▻https://www.cidrap.umn.edu/news-perspective/2021/09/two-studies-tie-long-covid-19-severe-initial-illness
Mais :
“It is notable that #long-COVID features were also recorded in children and young adults, and in more than half of nonhospitalized patients, confirming that they occur even in young people and those who had a relatively mild illness,” the authors wrote.
Sources :
Symptoms and Health Outcomes Among Survivors of COVID-19 Infection 1 Year After Discharge From Hospitals in Wuhan, China | Chronic Obstructive Pulmonary Disease | JAMA Network Open | JAMA Network
▻https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784558
Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19
▻https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003773
Twelve-month systemic consequences of #COVID-19 in patients discharged from hospital: a prospective cohort study in Wuhan, China | Clinical Infectious Diseases | Oxford Academic
▻https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab703/6352408
Conclusions
Physiological, laboratory, radiological or electrocardiogram abnormalities, particularly those related to renal, cardiovascular, liver functions are common in patients who recovered from COVID-19 up to 12months post-discharge.
#Covid-19 : Lila Bouadma, du Conseil scientifique, s’attend à « 50.000 contaminations d’#enfants par jour » à la rentrée
▻https://www.bfmtv.com/sante/covid-19-lila-bouadma-du-conseil-scientifique-s-attend-a-50-000-contamination
[La] forme longue de la maladie pourrait […] être un problème majeur chez cette catégorie d’âge. "Même si on imagine que c’est moins et qu’il y a 4 à 10% qui font des #Covid_long, ça fait des conséquences pour ces enfants…
Ah ! Je croyais qu’on n’attrapait pas le covid à l’école avec le Blanquer protocole !
#Blanquerment
Suivi des patients ayant survécu après une hospitalisation pour #covid-19
1-year outcomes in hospital survivors with #COVID-19: a longitudinal cohort study - The Lancet
▻https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01755-4/abstract
Findings
1276 COVID-19 survivors completed both visits [6 months, 12 months]. The median age of patients was 59·0 years (IQR 49·0–67·0) and 681 (53%) were men. The median follow-up time was 185·0 days (IQR 175·0–198·0) for the 6-month visit and 349·0 days (337·0–361·0) for the 12-month visit after symptom onset. The proportion of patients with at least one sequelae symptom decreased from 68% (831/1227) at 6 months to 49% (620/1272) at 12 months (p<0·0001). The proportion of patients with dyspnoea, characterised by mMRC score of 1 or more, slightly increased from 26% (313/1185) at 6-month visit to 30% (380/1271) at 12-month visit (p=0·014). Additionally, more patients had anxiety or depression at 12-month visit (26% [331/1271] at 12-month visit vs 23% [274/1187] at 6-month visit; p=0·015). No significant difference on 6MWD was observed between 6 months and 12 months. 88% (422/479) of patients who were employed before COVID-19 had returned to their original work at 12 months. Compared with men, women had an odds ratio of 1·43 (95% CI 1·04–1·96) for fatigue or muscle weakness, 2·00 (1·48–2·69) for anxiety or depression, and 2·97 (1·50–5·88) for diffusion impairment. Matched COVID-19 survivors at 12 months had more problems with mobility, pain or discomfort, and anxiety or depression, and had more prevalent symptoms than did controls.
Interpretation
Most COVID-19 survivors had a good physical and functional recovery during 1-year follow-up, and had returned to their original work and life. The health status in our cohort of COVID-19 survivors at 12 months was still lower than that in the control population.
Understanding #long_COVID: a modern medical challenge - The Lancet
▻https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01900-0/abstract
Most evidence about long COVID has been limited and based on small cohorts with short follow-up. However, in The Lancet, Lixue Huang and colleagues report 12-month outcomes from the largest longitudinal cohort of hospitalised adult survivors of COVID-19 so far. Including adults (median age 59 years) discharged from Jin Yin-tan Hospital in Wuhan, China, this study advances our understanding of the nature and extent of long COVID.
At 1 year, COVID-19 survivors had more mobility problems, pain or discomfort, and anxiety or depression than control participants (matched community-dwelling adults without SARS-CoV-2 infection). Fatigue or muscle weakness was the most frequently reported symptom at both 6 months and 12 months, while almost half of patients reported having at least one symptom, such as sleep difficulties, palpitations, joint pain, or chest pain, at 12 months. The study shows that for many patients, full recovery from COVID-19 will take more than 1 year, and raises important issues for health services and research.
First, only 0·4 of patients with COVID-19 said that they had participated in a professional rehabilitation programme. The reason for such low use of rehabilitation services is unclear, but poor recognition of long COVID and lack of clear referral pathways have been common problems worldwide. Second, the effect of long COVID on mental health warrants further and longer-term investigation. The proportion of COVID-19 survivors who had anxiety or depression slightly increased between 6 months and 12 months, and the proportion was much greater in COVID-19 survivors than in controls. Third, the outcomes from this cohort cannot be generalised to other populations—eg, patients not admitted to hospital, younger people, and those from racially minoritised and other disadvantaged groups who have been disproportionately affected by the pandemic. Research in these populations needs to be prioritised urgently.
Twelve-month systemic consequences of COVID-19 in patients discharged from hospital : a prospective…
▻https://seenthis.net/messages/927734
Thread by chrischirp on Thread Reader App – Thread Reader App
▻https://threadreaderapp.com/thread/1418696473177362432.html
Prof. Christina Pagel sur Twitter : "#LONG_COVID THREAD:
The people running the BBC Horizon “Great British Intelligence Test” challenge on over 80,000 people took the opportunity to see if they could detect any differences by whether people had had covid or not..." / Tw
[…]
10. What if by the time there can be no doubt of long term problems in many people who’ve had covid, we’ve allowed millions more infections leaving hundreds of thousands more people affected.
ONS estimated 634K people with long covid that impacts their life in June.
11. For comparison, c. 260K people are diagnosed with diabetes & 500K with heart disease each year.
I worry that we are creating a chronic disease tragedy right now.
The Silent Pandemic - YouTube
▻https://www.youtube.com/watch?v=3hplyClO1qw
Cognitive deficits in people who have recovered from #COVID-19 - EClinicalMedicine
▻https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00324-2/abstract
:quality(70)/cloudfront-eu-central-1.images.arcpublishing.com/liberation/BRAXNWHDEVH6HC7FXTASWNQAYE.jpg){kind=link}
Findings
People who had recovered from COVID-19, including those no longer reporting symptoms, exhibited significant cognitive deficits versus controls when controlling for age, gender, education level, income, racial-ethnic group, pre-existing medical disorders, tiredness, depression and anxiety. The deficits were of substantial effect size for people who had been hospitalised (N = 192), but also for non-hospitalised cases who had biological confirmation of COVID-19 infection (N = 326). Analysing markers of premorbid intelligence did not support these differences being present prior to infection. Finer grained analysis of performance across sub-tests supported the hypothesis that COVID-19 has a multi-domain impact on human cognition.
Interpretation
Interpretation. These results accord with reports of ‘#Long_Covid’ cognitive symptoms that persist into the early-chronic phase. They should act as a clarion call for further research with longitudinal and neuroimaging cohorts to plot recovery trajectories and identify the biological basis of cognitive deficits in #SARS-COV-2 survivors.
#covid_long (l’OMS dit COVID longue) #post_covid #neurologie
The four most urgent questions about long COVID
▻https://www.nature.com/articles/d41586-021-01511-z
It seems unlikely that the virus itself is still at work, says Evans. “Most of the studies have shown that after a few weeks you’ve pretty much cleared it, so I very much doubt it’s an infective consequence.”
However, there is evidence that fragments of the virus, such as protein molecules, can persist for months7, in which case they might disrupt the body in some way even if they cannot infect cells.
A further possibility is that long COVID is caused by the immune system going haywire and attacking the rest of the body. In other words, long COVID could be an autoimmune disease. “#SARS-CoV-2 is like a nuclear bomb in terms of the immune system,” says Steven Deeks, a physician and infectious-disease researcher at the University of California, San Francisco. “It just blows everything up.” Some of those changes might linger — as has been seen in the aftermath of other viral infections (see ‘What is the relationship between long COVID and other #post-infection syndromes?’).
Still, it is too early to say which hypothesis is correct, and it might be that each is true in different people: preliminary data suggest that #long_COVID could be several disorders lumped into one
Strain on NHS as tens of thousands of staff suffer #long_Covid | NHS | The Guardian
▻http://www.theguardian.com/society/2021/apr/03/nhs-feels-strain-tens-thousands-staff-long-covid
La diminution du nombre de cas de covid ne doit pas faire oublier les #covid_long
... a detailed report [...] showed 1.1 million people in the UK were affected by the condition.