COVID-19 infection has more than 50 long-term effects

MADRID, Spain – Clinical experiences with different approaches to COVID-19, the results obtained with different therapeutic options and, most importantly, the new reality of health care – long COVID – 7 International has been the focus of recent discussions. Congress of the Spanish Accurate Health Society.

In this forum, Accuracy Health: COVID-19 Professional Debate, Mike Gonzalez, MD, a specialist in microbiology and an expert in age management medicine at the University of Granada, reviewed the latest data on long-lasting COVID. “According to the latest evidence, 9 out of 10 COVID-19 patients discharged from the hospital (87%) noticed at least one symptom 60 days after the onset of the disease, 32% showed one or two symptoms, and 55% showed three or more.” More than 50% of symptomatic cases have at least one symptom of the disease 1 year after infection.

Another study found that 12.8% of study participants who became infected continued to breathe after 6 months, even if they were not diagnosed with pneumonia, Gonzalez added.

Studies on this topic have also highlighted the main risk factors for the development of long-term COVID. “First and foremost, gender, age and even the number of symptoms” are risk factors, Gonzalez said. “Therefore, women and people between the ages of 40 and 54 suffer from long-term COVID. It is also known that the more severe the disease, the more post-infection symptoms there are.”

“If the body mass index is 25 or higher, patients with three to seven symptoms of COVID-19 in the acute phase and more than five symptoms in the first week of illness are associated with disease factors. Prolonged COVID. All of this causes health problems, which There will undoubtedly be a big problem.

Studies have shown that COVID-19 has more than 50 long-term effects, the most common of which are fatigue (58%), headaches (44%), attention deficit (27%) and hair loss (25%). ).

Of all the research projects on the subject, Gonzalez highlighted a study published in January that he said was the most relevant today “because it studies the pathophysiological factors behind all levels of symptoms, something we’ve done. We don’t know yet.”

“For example, breathing, hypoxia, fatigue, opaque glass, and pulmonary fibrosis have been linked to lung parenchyma disorders. [primarily] through the virus and secondly due to immunological microvascular disorders. On the other hand, at the cardiovascular level, up to 20 cardiovascular diseases can occur 1 year after the arrival of COVID-19. This allows us to anticipate that these patients will be in significant demand in the health care system in the coming years.

Microbioma and vagus nerve

On the digestive and intestinal systems, Gonzalez highlighted a previously unknown mechanism: the involvement of the vagus nerve and the intestinal microbiota.

“It suggests a pattern of persistent or recurrent viremia that results in the clinical evolution of non-specific symptoms associated with individual limitations in some patients,” he said. “This may make us think that the virus may have a reservoir at this level. Research in this area suggests that the vagus nerve may be involved as the cause of long-term COVID manifestations. We must not forget that it connects the brain and the gastrointestinal tract. “

In an analysis of this pilot study by a team of Spanish researchers, two-thirds (228) of the 348 participants in Gonzalez said they had at least one symptom indicating vaginal nerve dysfunction. After further evaluation of these 228 patients, the first 22 subjects with vagus nerve dysfunction were 20 women with an average age of 44 years.

“The study also showed that the most common symptoms associated with vagus nerve dysfunction are diarrhea (73%), tachycardia (59%), dizziness (45%), dysphagia (45%) and dysphonia (45%); vagus in 86% of patients.” There were three different symptoms associated with nerve dysfunction.22 In six patients, changes in the cervical vagus nerve, including nerve thickening and reactive inflammatory changes, were observed, ”he said.

Another important fact of this study was that 10 patients showed abnormal respiratory patterns and reduced maximal respiratory pressure, which, according to Gonzalez, indicated weakness of the respiratory muscles associated with the vagus nerve. “Seventy-two percent had oropharyngeal dysphagia or difficulty swallowing, and eight patients showed reduced or impaired ability to move food from the esophagus to the stomach and acid reflux.”

Recipe: Exercise

At the same conference, Wilson Martinez, MD, a specialist in sports and exercise medicine, spoke about the role of physical exercise in the recovery of people affected by COVID-19. “It is important to keep in mind that many patients with mild or severe COVID-19 do not fully recover for months or weeks after a neurological, cognitive, or psychiatric infection, and a wide variety of chronic symptoms. It is known as Post-COVID-19 Syndrome. reported from% to 20%. “

In his report, Importance of exercise in a post-COVID patient, Martinez reviewed the most recent studies showing a link between exercise in general health and SARS-CoV-2 and its effects. “These studies,” he told the audience, “discuss systemic circulatory excretions by understanding substances produced or formed by different levels of healthy physical activity (including hormones and metabolites), and how high intensity and momentum the exercise is. If done correctly, it is known that these exercises will look even better if done correctly. “

In the context of COVID-19, Martinez explained this positive effect: “SARS-CoV-2 affects the angiotensin-converting enzyme-2 receptor, which in turn causes fibrosis, inflammation, vasoconstriction, decreased neurogenesis, and cardiovascular damage. Activation of a number of chains allows it to counteract many of the symptoms of post-COVID-19 syndrome, which in a sense acts like a polyp. “

Noting the potential benefits of exercise in Post-COVID-19 syndrome, Martinez stressed that there is an improvement in the psychological component because it reduces stress, which leads to improved mood and good mood.

“At the neurological level, it stimulates brain plasticity, improves cognitive abilities, reduces allostatic load and optimizes sleep quality,” he explained. “As for the cardiovascular system, angiogenesis occurs, improves the vascular system and cardiovascular function, lowers blood pressure, normalizes dysautonomy, especially increases mitochondrial biogenesis.

In the respiratory system, it reduces respiration and improves oxygen consumption and lung function. In muscles, these exercises improve endurance, increase muscle strength and muscle mass, with better muscle coordination. , immune function in general, “Martinez continued.

Strength training is needed

Martinez stressed that there is no specific drug that produces all of these benefits. “Unfortunately, we are not trained or accustomed to writing exercises. Based on all this evidence, it is clear that it should be included not only in COVID-19 and post-COVID-19, but in prevention and treatment in general. Cardiovascular and As a helper for metabolic health, as well as for the prevention of diseases and for many pathologies.

Regarding which type of activity is most recommended for these patients, Martinez noted that “there is sufficient evidence to suggest that exercise adapted and controlled with aerobic and strength endurance exercise may be an effective multisystem therapy for post-COVID-19 syndrome.”

In this regard, Martinez stressed the need to assess the importance of strength training. “A good part of the population does aerobic exercise, but the percentage decreases when it comes to strength training, especially in women, because they associate it with the risk of excessive bodybuilding. After COVID-19, this exercise is important because one of the most worrying symptoms of this syndrome is muscle mass.” is a loss.

“A little more research is needed in this area, but it is certainly an excellent tool for counteracting and managing the many signs and symptoms that persist after being infected with COVID-19,” Martinez concluded.

Gonzalez and Martinez did not disclose any relevant financial relationships.

Follow Carla Nieto of Medscape in Spain on Twitter @carlanmartinez.

Translated from this article Medscape Spanish edition.

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