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 its symptoms, required the creation of local diagnostic and assistance paths based on a multidisciplinary approach – the ISS clarifies – The report summarizes the current framework of this new condition and provides general indications for the 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 – remember the ISS experts – since the symptoms attributed to this condition are numerous and heterogeneous and can concern 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 symptomatological spectrum make epidemiological evaluation difficult. The great variability of symptoms and clinical signs, in fact, can occur both individually and 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 illness, the greater the risk of symptoms over time “.
The possible manifestations of long-Covid can be divided into two categories: “General manifestations and organ-specific manifestations. Among the first are detected: persistent fatigue / asthenia, excessive fatigue, fever, muscle weakness, widespread pain, myalgia, arthralgia, worsening of the perceived state of health, anorexia, reduced appetite, sarcopenia – specifies the ISS – Among the latter: lung problems such as dyspnoea, breathlessness and persistent cough. Among 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 aspects. , functional, cognitive, psychological and nutritional “.
“It appears essential – it is emphasized – to carry out, in fact, an evaluation of the complete clinical history that includes: history of acute Covid-19 (suspected or confirmed); nature and severity of previous and current symptoms; timing and duration of symptoms from the beginning of Acute Covid-19; history of other health conditions; current and previous drug treatment; assessment of specific signs and symptoms of ‘long Covid’; assessment of the psychological impact of Covid-19 and ‘long-Covid, with particular attention to 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 who present or report signs or symptoms attributable to Covid-19 present for more than 4 weeks after acute infection. This information can be collected by healthcare professionals or through self-completed and self-managed questionnaires. from the patient. For elderly people or people who may have difficulty reporting signs and symptoms it is important to involve a family member or a carer in the assessment “, concludes the ISS.