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The Road to Recovery - How Patients Are After Covid-19

2020-06-05T21:19:59.792Z


The vast majority of people survive an infection with the Sars-CoV-2 coronavirus unscathed. It can be different after severe illnesses - but little is known about the extent of possible consequential damage.


The vast majority of people survive an infection with the Sars-CoV-2 coronavirus unscathed. It can be different after severe illnesses - but little is known about the extent of possible consequential damage.

Berlin (dpa) - Tens of millions of people worldwide have already survived an infection with the corona virus. The number of unreported cases is considered high, also because Sars-CoV-2 often causes little or no symptoms.

However, if the Covid-19 disease caused by the virus takes a more severe course, the patients are often still not fully recovered after weeks. Can lifelong consequences of millions of people worldwide be expected?

Overall, little is known about the late and long-term consequences of a corona infection, says Peter Berlit, General Secretary of the German Society for Neurology. Initial knowledge about possible neurological consequences had only been gathered in the past few weeks. "They weren't known before, because the disease is still young."

As the pandemic progresses, researchers are finding out more and more about the course of disease and consequential damage in Covid 19 patients. Patterns and relationships are recognizable. An overview:

PATIENTS WITH A Mild History WITHOUT HOSPITAL STAY

The World Health Organization (WHO) estimates the proportion of mild cases to be around 80 percent of all cases. For those infected who notice something of the virus, cough (49 percent) and fever (41 percent) are among the most common symptoms, similar to a flu infection, according to the RKI.

"The patients we spoke to reported that the symptoms were sometimes very severe," says Matthias Kochanek, senior physician at the Cologne University Hospital. They would have lasted for about 10 to 21 days. "In many patients, the duration felt longer than is known from normal flu, for example," says the intensive care doctor. However, this value could not yet be considered secured.

It is known that many patients quickly feel fit again after a mild course of infection. "Most of the patients then reported to us that they were completely resilient again," said Kochanek. The recovery also depends on the individual case and possible concomitant diseases.

So far, doctors know little about the changes in taste and smell that some patients noticed, even with mild courses. "Observational studies show that this problem will regress in the majority of patients in two to three weeks," says neurologist Berlit. In about five to ten percent of cases, the disorder persists longer.

According to an analysis in which the Dresden University Hospital is involved, it could be a misinterpretation that many patients reportedly report changes in taste perception in parallel to olfactory disorders. Most of the respondents to Covid patients can therefore more or less reliably distinguish between the four flavors sweet, sour, bitter and salty - but not flavors for which an interaction with the sense of smell is needed.

PATIENTS WITH SERIOUS DISEASES WITHOUT VENTILATION

According to the WHO, around 20 percent of corona infections are so severe that patients have to be treated in hospital. The treatment differs depending on the course of the disease. Some patients need oxygen due to shortness of breath, but can be treated in a normal ward. "These patients have roughly the same course as the patients with a mild course," explains intensive care doctor Kochanek. "Sometimes you just need a little longer to recover."

Other patients become a little more seriously ill and need a little more oxygen - for example through a small plastic tube under the nose. In comparison to a mild course, those affected would need significantly longer, about three to four weeks, to be really fit again, says Kochanek. "After these patients left the hospital, they told us that they were still tired and tired and not as efficient for a long time."

INTENSIVE PATIENTS WITH SERIOUS DISEASE AND VENTILATION

If the lung function of Covid-19 patients is so severely restricted that such a supply of oxygen is no longer sufficient with increasing difficulty in breathing, they are transferred to the intensive care unit and are put into an artificial coma with ventilation via a tube in the trachea. Such intubation carries risks.

For example, lifting ventilation is a difficult process - the longer it lasts, the more the muscles needed to breathe are reduced, among other things. With older people in particular, it is difficult to rebuild them up to their previous state. The lungs are also sensitive to excess pressure and also to the oxygen that is added to the ventilation air. Lung tissue can be irreparably damaged. Artificial ventilation can also damage other organs.

In addition to the viral disease, the tubes can also cause a bacterial infection in the lungs. Kochanek reports that almost all Covid 19 patients at Cologne University Hospital have such a second or even third pneumonia-induced inflammation.

According to experts, no reliable statements can yet be made about the long-term consequences of such pneumonia. In the case of more severe courses, such as severe lung failure and long ventilation, residual symptoms such as a reduced lung volume can be expected, says the doctor Sven Brille from the Vivantes Clinic in Neukölln.

A pattern can be seen, says Kochanek: Compared to patients with other forms of pneumonia, seriously ill Covid 19 patients would take much longer to recover. One of his first patients, 80 years old, was only recently discharged into a rehabilitation clinic. She came to the clinic about three weeks after Carnival - in mid-March.

Some patients also experience severe neurological diseases - so-called encephalopathies, i.e. damage to the brain. "This is expressed in restlessness and confusion, and memory performance can also be impaired," explains Berlit. There is also a lack of long-term knowledge. However, it is to be feared that such restrictions could remain for a long time.

Another risk is the long-term consequences of strokes, which according to Berlit are frequently observed not only in seriously ill Covid 19 patients due to a higher tendency to thrombosis. Which symptoms remained depends primarily on the affected area of ​​the brain.

The consequences of epileptic seizures, which have been observed in connection with a cytokine storm, an immune response to the corona infection, are also unclear. Can epilepsy be a permanent consequence of the infection? "It's conceivable, but we don't know yet," says Berlit.

RKI fact sheet on coronavirus, point 5, complications

WHO on comparison of coronavirus and influenza

Current RKI management report on Covid-19

Source: merkur

All news articles on 2020-06-05

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