A health worker attends to a patient in a critical care unit. / EFE | Video: Atlas The most repeated sequelae, which more than a million Spaniards would suffer, are loss of taste and smell, muscle pain and general fatigue The acute phase has been overcome and, thanks to the efforts of health professionals and scientists, the percentage of cases has been reduced serious and above all the number of deaths, the great problem left by the coronavirus pandemic is to determine the volume of patients with persistent covid and the class and intensity of its sequelae. An essential step for the health system to design and articulate a response to what seems like for years to come will be one of the most serious health problems. A group of researchers from the Netherlands has brought a remarkable advance in this fight to quantify the prevalence and characteristics of long-lasting covid. The work led by Professor Judith Rosmalen, from the University of Groningen, concludes that 12.7%, one in eight of those infected with SARS-CoV-2, maintain a permanent sequel at least eight months after the diagnosis of the contagion. of the disease, according to the results published in the prestigious scientific journal ‘The Lancet’. This prevalence, transferred to the Spanish reality, would suggest that more than a million Spaniards would suffer some kind of persistent covid, a proportion that, if it can be confirmed, should set off the alarms of those responsible for health given the enormous dimension of the problem. The data squares with the estimates advanced until now by some experts and preliminary works, which limited between 10% and 15% of the positive patients with serious lasting sequelae. The work makes two other great contributions. It specifies what the characteristic sequelae generated by covid are and clarifies that these are symptoms that reach their peak approximately three months after infection and that, from then on, stabilize and become chronic. The most repeated persistent ailments are loss of taste and/or smell, which is detected in 7.3% of patients, muscle pain, which affects 7.3%, and general fatigue or tiredness, which attacks the 4.9%. The other specific ailments derived from the virus are chest pain, difficulties or pain when breathing, tingling in the hands and feet, sore throat, the sensation of alternating hot and cold, and the sensation of heaviness in the arms and legs. . The researchers also detect that another series of very frequent symptoms in the acute phase of the infection then disappear as a specific and recurrent sequel. On this list would be fever, headache, nausea and vomiting, dry cough or digestive disorders and diarrhea. Twenty-four controls in 16 months It is a pioneering investigation. In addition to offering a specific figure for the prevalence of persistent covid, it manages to determine the main sequelae of the disease and the relevance and frequency of each one. It achieves this because it studies positives for SARS-CoV-2 of whom it knows their previous medical situation, its evolution in the subsequent 16 months and whose symptoms it compares with those suffered by uninfected citizens of the same sex, age and territory, to whom which also monitors in parallel. This allows researchers to rule out previous symptoms, those that coincide between those infected and those who are not infected, or to discard others such as the stress derived from confinements and restrictions, common to all and unrelated to the coronavirus. The Groningen team managed to get 76,422 citizens from the north of the Netherlands already involved in a large health study called ‘Lifelines’ to participate in the analysis, 4,231 of whom have an official positive for SARS-CoV-2 and whom they compare with 8,462 uninfected with equivalent characteristics. They were subjected to 24 questionnaires between March 2020 and August 2021 -weekly, fortnightly or monthly, depending on the case- in which they controlled the evolution of 23 symptoms derived from contagion. Limitations The researchers themselves warn of two limitations that make it necessary to qualify their results. They only study patients infected by the alpha variant, the main one of the first wave, so it is unknown if the delta and omicron, responsible for most of the pandemic infections, have a similar impact. For the same reason, the observation of a sample of patients closed in the first weeks of the epidemic, have no results on the effect of the initial vaccination and the reinforcements on the evolution of the disease. It is unknown if it decreases, as many experts intuit, the appearance of long-lasting covid. In any case, Aranka Ballering, another of the main signatories of the investigation, believes that the work makes it clear that “long-lasting covid is an urgent problem with a growing number of victims” that forces health authorities to give equally concrete responses. and urgent. Rosmalen considers that new research is necessary that pays special attention to the study of mental health symptoms generated by the disease, such as depression and anxiety, and in others that have not been able to be evaluated in this work, such as the so-called «brain fog», with a loss retention capacity, or insomnia.
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