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Covid, from fever to myalgia: problems still healed after a year

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Fatigue, asthenia, fever, myalgia: these are some of the symptoms of ‘long Covid’. “More than a year after the beginning of the Sars-CoV-2 pandemic, an important number of people affected by Covid-19 present clinical manifestations that do not end in the first weeks of the acute symptomatic phase, but can be prolonged, precluding a full return to previous state of health. This condition of persistence of symptoms, which can affect subjects of any age and with varying severity of the acute phase of the disease, has been recognized as a specific clinical entity, precisely called ‘long Covid’ “. The point is made by the Higher Institute of Health (Iss) in the report ‘Interim indications on the management principles of Long-Covid’ published online. “This condition, although broad and variable in symptoms, required the creation of local diagnostic and assistance paths based on a multidisciplinary approach – clarifies the ISS – The report summarizes the current framework of this new condition and provides general indications for the its taking charge, in line with the recommendations provided by the World Health Organization “.” The clinical manifestations of ‘long-Covid’ are very variable and to date there is no consensus on their characteristics – the ISS experts recall – since the symptoms attributed to this condition are numerous and heterogeneous and can affect subjects of any age and with varying severity of the acute phase of the disease The lack of a precise definition of this condition and the breadth of the symptom spectrum make epidemiological evaluation difficult. The great variability of symptoms and clinical signs, in fact, can occur both individually and c he in different combinations. They can be transient or intermittent and can change their nature over time, or they can be constant. In general, it is considered that the more severe the acute disease, the greater the risk of being the entity of symptoms over time “. The possible manifestations of long-Covid can be divided into two categories:” General manifestations and organ-specific manifestations. Among the former are found: persistent fatigue / asthenia, excessive fatigue, fever, muscle weakness, widespread pain, myalgia, arthralgia, worsening of perceived health, anorexia, reduced appetite, sarcopenia – specifies the ISS – Among the latter : lung problems such as wheezing, breathlessness and persistent cough. Among the other symptoms are also described cardiovascular, neurological, gastrointestinal, psychiatric disorders “.” The identification of the ‘long-Covid’ patient is very important – the experts remark – Precisely in consideration of the wide range of symptoms and conditions that characterize him , the evaluation of people affected by this condition must be multidimensional and include numerous clinical, functional, cognitive, psychological and nutritional aspects “.” It is essential – it is emphasized – to carry out an evaluation of the complete clinical history that includes: history of Covid -19 acute (suspected or confirmed); nature and severity of previous and current symptoms; timing and duration of symptoms from the onset of acute Covid-19; history of other health conditions; current and previous drug treatment; evaluation of the specific signs and symptoms of ‘long Covid’; assessment of the psychological impact of Covid-19 and ‘long-Covid, with particular attention to the appearance of symptoms of anxiety, depression and social isolation; assessment of the impact on nutritional aspects, changes in body weight and loss of interest in eating and drinking, particularly in older people; assessment of the presence of new cognitive symptoms or brain fog, using a validated screening tool to assess cognitive status “.” These elements represent a minimum set of assessments to be carried out in patients presenting or reporting signs or symptoms attributable to Covid-19 present for more than 4 weeks from acute infection. This information can be collected by healthcare professionals or through self-completed, self-administered questionnaires by the patient. For older people or people who may have difficulty reporting signs and symptoms it is important to involve a family member or caregiver in the assessment “, concludes the ISS.

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