General Practice; Post-Acute COVID-19 Syndrome; Medically Unexplained Symptoms; 21 Encephalopathy; Narrative medicine; Single Photon Emission Computed Tomography (SPEC CT scan); Health Status Indicator; long covid
Abstract :
[en] Fifty-five patients who suffered from COVID-19, who were still very ill after several months, with extreme fatigue, effort exhaustion, brain fog, anomia, memory disorder, anosmia, dysgeusia, and other multi-systemic health problems have been followed in a family practice setting between May 2021 and July 2022.
Data extracted from the medical records of the 55 patients (40 women), mean age 42.4 (12 to 79 years), and a qualitative study of 6 of them using a semi-open-ended questionnaire allowed to highlight the clinical picture described by WHO as post-acute COVID-19 syndrome (PACS) also known as long COVID. We used brain single-photon emission computed tomography (SPECT-CT) in thirty-two patients with a high severity index and a highly impaired functional status, demonstrating vascular encephalopathy in twenty nine patients and supporting the hypothesis of a persistent cerebral vascular flow disorder in post COVID-19 condition.
The patients will benefit from the consortium COVID Human Genetic Effort (covidhge.com) to explore the genetic and immunological basis of their problem, as 23/55 cases don't have immunological certainty of a COVID-19 infection. There is no known verified treatment. Analyzing the data from the first 52 patients, three categories of patients emerged over time: 16 patients made a full recovery after 6-8 months, 15 patients were able to return to life and work after 12-18 months with some sequelae, both groups being considered cured. In the third group, 21 patients are still very ill and unable to resume their work and life after 18 months. The biopsychosocial consequences on patients' lives are severe and family doctors are left out in the cold. It is necessary to test the reproducibility of this description, conducted on a small number of patients. Nevertheless, identifying, monitoring and supporting these patients is a necessity in family medicine [fr] Cinquante-cinq patients atteints de COVID-19, toujours très malades après plusieurs mois, avec une fatigue extrême, un épuisement à l'effort, un brouillard cérébral, une anomie, un trouble de la mémoire, une anosmie, une dysgueusie et d'autres problèmes de santé multisystémiques ont été suivis dans un cabinet de médecine familiale entre mai 2021 et juillet 2022.
Les données extraites des dossiers médicaux des 55 patients (40 femmes), d'âge moyen 42,4 ans (12 à 79 ans), et une étude qualitative de 6 d'entre eux à l'aide d'un questionnaire semi-ouvert ont permis de mettre en évidence le tableau clinique décrit par l'OMS comme le syndrome COVID-19 post-aigu (PACS) également appelé long COVID. Nous avons utilisé la tomographie d'émission monophotonique cérébrale (scintigraphie) chez trente-deux patients présentant un indice de gravité élevé et un état fonctionnel très altéré, démontrant une encéphalopathie vasculaire chez vingt-neuf patients et soutenant l'hypothèse d'un trouble persistant du flux vasculaire cérébral dans la maladie post COVID-19.
Les patients bénéficieront du consortium COVID Human Genetic Effort (covidhge.com) pour explorer la base génétique et immunologique de leur problème, car 23/55 cas n'ont pas la certitude immunologique d'une infection par le COVID-19. Il n'existe aucun traitement vérifié connu. En analysant les données des 52 premiers patients, trois catégories de patients sont apparues au fil du temps : 16 patients se sont complètement rétablis après 6 à 8 mois, 15 patients ont pu reprendre leur vie et leur travail après 12 à 18 mois avec quelques séquelles, les deux groupes étant considérés comme guéris. Dans le troisième groupe, 21 patients sont encore très malades et incapables de reprendre leur travail et leur vie après 18 mois. Les conséquences biopsychosociales sur la vie des patients sont graves et les médecins de famille sont dans l’incertitude. Il est nécessaire de tester la reproductibilité de cette description, menée sur un petit nombre de patients. Néanmoins, l'identification, le suivi et l'accompagnement de ces patients est une nécessité en médecine de famille
Disciplines :
General & internal medicine Radiology, nuclear medicine & imaging
Author, co-author :
Jamoulle, Marc ; Université de Liège - ULiège > Département des sciences cliniques
Gisele Kazeneza Mugisha
Ayoub Zayane
Language :
English
Title :
Follow-up of a cohort of patients with post-acute COVID-19 syndrome in a Belgian family practice.
Alternative titles :
[fr] Suivi d'une cohorte de patients atteints du syndrome COVID-19 post-aigu dans un cabinet de médecine familiale belge.
Publication date :
2022
Journal title :
Viruses
eISSN :
1999-4915
Publisher :
Multidisciplinary Digital Publishing Institute (MDPI), Switzerland
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