The figures indicate that the emergence of vaccination marked a before and after in the covid pandemic. A recent study published in the journal The Lancet Infectious Diseasesprepared by researchers from the Center for the Analysis of Global Infectious Diseases at Imperial College London, points out that in 2021 the vaccination of part of the world’s population (much less of the entire population) prevented death of 19.8 million people.
However, over time it has been known that vaccines, although effective, do not prevent contagion (nor reinfection), although they do prevent serious illnesses. And they do not prevent the occurrence of cases of the covid persistseven if it seems that he minimizes them.
We have serious cases of all waves, even the sixth, but in smaller numbers”
Serious cases of the disease continue to be recorded, although less. “We have serious cases of all waves, even the sixth, but in smaller numbers,” he explains to the vanguard Dr Lourdes Mateu, coordinator of the persistent covid unit at the Germans Trias hospital. “It is possible that with vaccination, persistent covid cases, although there are no official figures, have decreased. But we continue to see them, and serious photos too”, reiterates- he.
Mateu even defends that there could be cases of the penultimate wave of covid, the sixth -in which the omicron variant broke out-, waiting to emerge due to the time lag that exists between when the patient detects that something is not working well (ie the persistence of symptoms) and goes to the doctor. “It’s still very early,” he said.
Although we still see the predominance of women in the middle ages, there is now a wider age range”
To date, he has not observed any change in the profile of the patients: they continue to see middle-aged women more widely, between 40 and 50 years old, which is the classic profile of a patient with persistent covid. . But he understands that, in his case, these data may be “somewhat skewed”, since in his unit – in which they have treated more than 700 patients and are currently monitoring around 500 – they generally receive patients with the most severe symptoms.
Those who observe a slight change are the doctors of the Spanish Society of General Practitioners and Family Doctors (SEMG), who care for patients with different degrees of involvement.
“Although we still see the predominance of middle-aged women, now there is a wider age range: we also see children, men and the elderly,” explains Dr. Pilar Rodríguez Ledo, vice- President of SEMG.
Understand that there are various factors that could explain this new reality. It must be taken into account, he argues, that in the first wave, the one that left the greatest number of people affected by the persistent covid, “the elderly died very frequently in the acute phase”. Also the diagnosis in children “was rare, and that is that diagnostic tests were not carried out on them. Now there is a wider distribution,” he reasons.
Where the two, Rodríguez Ledo and Mateu, coincide is in emphasizing that the symptoms presented by patients have not changed compared to previous waves and that the ranking of the most prevalent symptoms is maintained.
In this sense, they do not observe any variation in the diagram published by several researchers in August last year in the journal Scientific reportsof the group Nature, where they showed the most common symptoms. The most widespread remains fatigue which, according to the cited study, affects 58% of patients. Next come headaches (44%), attention disorders (27%), hair loss (25%), dyspnea (shortness of breath, 24%), ageusia (loss of taste, 23%), anosmia (loss of sense of smell, 21%). ), polypnea (rapid breathing, 21%), joint pain (19%), cough (19%), sweating (17%) and memory loss (16%).
Fatigue continues to be the most common symptom, although it is often not the most debilitating.
“Fatigue continues to be the most prevalent symptom across all patient subgroups, although it is often not the most disabling,” says Dr. Mateu. “There are many patients who suffer from it, but the symptom with a high prevalence and which invalidates them the most is neurocognitive impairment: memory loss, difficulty planning, concentrating, brain fog…”, adds he.
In this sense, in his hospital they plan to launch up to three studies to learn more about this neurocognitive affectation. In the first, which will be done in primary care, not only will patients be studied using neurocognitive tests, but they will also undergo magnetic resonance imaging and a fundus examination to see damage to small blood vessels.
With the second, they intend to investigate the epigenetic alterations that may be associated with the pathology. Finally, and as a third project, they have in mind to develop an application to detect and treat patients with neurocognitive disorders. They hope to have the results of the three studies in 2023.
In the unit coordinated by Dr. Mateu, they have not detected, in the last patients who have come to them, a decrease in the number of symptoms they suffer from compared to patients in previous waves – “it should be noted that we we usually treat the most serious conditions”, reiterates-; but in the SEMG (where they have information on patients with different degrees of involvement) they perceived, “although it remains to be verified with figures and records , that patients who have developed persistent covid due to the fourth or fifth wave have a clinic with fewer symptoms and, perhaps, less intense, ”points out Rodríguez Ledo. “Those in the first waves could present up to 36 different symptoms in six months,” he recalls.
Fencing Dr. Matthew
There is still a long way to go to know the causes of the persistent covid
In any case, there is still a long way to go, according to Dr. Mateu, to discover the causes of the persistent covid.
“Sometimes we made a mistake by including the whole group of patients with persistent covid in the analyses. What we are doing now is analyzing it by phenotypes (by its different clinical forms). Not all patients behave in the same way and probably the causes of the persistence of the virus are different,” he concludes.