He’s recovered but not healthy: Long Covid still in the spotlight

A patient with long-standing Covid undergoes breathing training in a rehabilitation clinic. Corona infection does not always become history once it has recovered. Photo: Friso Gentsch / dpa

Corona infection does not always become history once it has recovered. For some, the long-term consequences cause great suffering, frustration – and most of all, helplessness.

Because even after more than two years of Corona, knowledge of Long Covid is still patchy. Although numerous studies aim to approximate the clinical picture, experts warn of the supply situation. How experts currently view the disease and how information offers should shed light in the dark:

The German patient guidelines define complaints that persist for more than four weeks after corona infection as “Long Covid” and that persist for more than twelve weeks as a subtype of “After Covid”. A statement by the Federal Government’s Crown of Experts Board in May concluded that studies show that most people treated in intensive care units with severe Covid 19 have long-term complications. Even after a mild infection, ten percent met the post-Covid criteria.

Hundreds of thousands of people affected in Germany alone

Jördis Frommhold, lung specialist and chief physician at Median Klinik Heiligendamm, assumes that there are hundreds of thousands of long-standing Covid sufferers in Germany. There is consensus in expert circles that complete protection against vaccination clearly reduces the risk of long-term sequelae from corona infection. According to an English study, primary vaccinations and booster doses reduce the risk of long-term Covid by 50 percent, according to an Israeli study by two-thirds.

Nevertheless: Federal Health Minister Karl Lauterbach (SPD) recently pointed out on Twitter on the basis of British data that many people vaccinated in the omicron wave were also affected by Long Covid. Even so, without vaccination, the number would have been much higher, he explained.

Scattered clinical picture and comprehensive diagnostics

Frommhold emphasizes how large the gradation of possible symptoms is – many of them are limited by little or no limitations in everyday life, others may, in extreme cases, lead to long-term inability to work or bedridden. Christoph Kleinschnitz, director of the neurology clinic at the University Hospital in Essen, tells dpa about the “huge basket of symptoms”. He has met over 500 long-term Covid patients in daily clinical practice, and data from over 170 have been included in a recently submitted study.

One of the most common symptoms is pathological fatigue known as “fatigue”. Performance and memory disorders, concentration or brain fog are also common. They often complain of impaired finding words and other cognitive limitations, as well as general weakness, shortness of breath or shortness of breath, and persistent cough.

The Council of Experts document states that “structural organ abnormalities often persist after the severe course of Covid-19, but are rarely found after the mild course of the disease”. Lauterbach recently warned that research shows that Long Covid may be linked to ongoing inflammation in the brain.

More offers and information for victims

In its study, the Council of Experts calls for the extension of the nationwide offer for people with further complaints. Due to the growing number of people affected by the disease, the supply of care is far from being sufficient. Special clinics and rehabilitation clinics should be created. In addition, more funding is needed for research and targeted education.

The Federal Center for Health Education (BZgA) has recently launched an information campaign in cooperation with the Federal Ministry of Health via an internet portal. Here, injured people will find reliable information, support tips and daily recommendations. The portal also provides information on job-related support offers.

Basically, Kleinschnitz finds a broad information offer like this useful and points to the usefulness of further training on the topic. In the future, the interactive exhibition in Berlin will also offer an innovative way to experience the disease, at least for a short time. Simulations, such as coveralls, are intended to illustrate fatigue or shortness of breath.

Expert: “One Pill” will never exist

But what is known about therapy? According to Kleinschnitz, the best way to deal with the disease is through a concept that encompasses the various disciplines of medicine and psychology. “The only pill against Long Covid, in my opinion, will never be.” The first step is “listen, take it seriously, examine it carefully.”

From the expert’s point of view, there is a rule: victims should not withdraw and stay in everyday life as long as possible, but not overwhelm. Debt Covid is also often a meritocracy problem, says the Frommhold expert in this context. Doctors try to alleviate the individual symptoms of those affected. Certain breathing techniques can relieve shortness of breath or shortness of breath, and physical therapy can help with muscle weakness.

Most of the patients he knows improve significantly or even go away after six or nine months at the latest, says Kleinschnitz. But some people would have to deal with symptoms for much longer. However, he also points out that, from his point of view, many affected people should first begin psychological and psychotherapeutic treatment before choosing the sometimes onerous and very expensive medical therapy methods.

He doesn’t want to be misunderstood: “That doesn’t mean people are imagining or simulating their symptoms.” You can clearly see the symptoms and suffering. “We only believe that the genesis, mainly in very long-term cases, is less organic and more psychological and psychological.”

Looking to the future: Long Covid as a perennial favorite?

Long Covid-related conditions are likely to burden society and the health and social security system in the long term, according to the panel of experts. The neurologist Kleinschnitz is a cautious optimist. “There’s no need to despair about Long Covid.” It assumes that at least 80 percent of those affected have recovered within a “reasonable amount of time”. Long Covid must be taken seriously and disbanded. But as a society, we’ll take it under control in the next five or ten years. “

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