However, the sequelae are rather rarely mentioned and hardly taken into account in decisions to combat the disease. It is high time to talk about it a little more ...
We already had a subject, complementary to this one, which spoke of non-respiratory effects: pollution-prevention-health / covid-19-non-respiratory-medical-effects-t16431.html
This subject is interested in the respiratory or non-respiratory sequelae of covid19, I recall these excellent reminders from Adrien:
Adrien (ex-nico239) wrote:For the record May 25Adrien (ex-nico239) wrote:
it seems difficult, from my point of view, to tell people who are sick not to come to be tested or treated, and to tell patients that the only acceptable therapy is doliprane until they are insufficient respiratory
The fact of not having clinical symptoms does not mean that we will not have pneumonia already diagnosable.
The respiratory attack is atypical and unique, the risks of sequelae are absolutely considerable, maybe 25% of people who have pneumonia will have sequelae like fibrosis, some will be intractable.
The mismatch between respiratory failure and pulmonary involvement and the mismatch between clinical signs and radiology had never been described at this level. The initial bleeding disorders that are likely to cause lung damage, some of which will be irreversible, were unknown.
Another layer of July 5Adrien (ex-nico239) wrote:Philippe Froguel published this very telling diagram
All the people who supposedly have NOTHING .. news 0 et cie we will find them there for decades according to their ages.
For the record in Raoult's (3700) study, a small focus on News 0 those who have "NOTHING"
Well I wish no one to have "NOTHING" like a number of them ...
Characteristics of the low dose scanner
We performed 2 LDCT tests, of which 065 (1%) detected anomalies,
were classified as minimal (928, 64%), intermediate (414, 28,6%) and serious impairment (107, 7,4%).
Among 991 patients with a NEWS-2 = 0 score who underwent a CT scan, 592 (59,7%) presented radiological anomalies, including 470 (47,4%) with minimal pulmonary lesions, 115 (11,6%) with intermediate lesions and 7 (1%) with severe lesions (Fig. S1).
In addition, among 1 LDCT analyzes performed on patients without perceived subjective dyspnea, 370 (937%) had pneumonia. Because of this intriguing result, we studied the relationships between perceived dyspnea, oxygen saturation, and LDCT results in patients
Among 1 patients who considered themselves to be dyspnea, 108 (157%) actually had oxygen saturation ≤14,2%, and 95/130 (157%) had pneumonia.
All those there, apart from Raoult who knows them?
They are in nature.
They are among those who "had nothing" in APPEARANCE.
They may be part of the CDG crew ...
Short as they were either totally ignored by the medicine the standard thing of care "ON" DON'T KNOW ANYTHING AND "ON" DON'T CARE
Besides, the academy of medicine begins to cover itself ... by doing Raoult and by putting itself now [b] finally to get the little beast from ALL the POSSIBLE sick.
You know the 98% who have so-called "NOTHING": understood to be serious or visible or felt.
Academy press release: What unusual symptoms should a Covid-19 look for?
http://www.academie-medecine.fr/communi ... -covid-19/
The main symptoms of Covid-19 are fever or respiratory signs. However, SARS-CoV-2 infection can affect other organs and be revealed by digestive disorders, pulmonary or peripheral arterial embolism, or other less typical inaugural features.
The reinforced prevention and protection plan defined by the Covid-19 Scientific Council  includes an intensification of the protocol for case detection and contact tracing. These new provisions should encourage the prescribing of screening tests if there is any doubt. Thus, certain less frequent clinical presentations should not be overlooked:
- neurological manifestations: if ageusia and anosmia are frequent, other manifestations are exceptional such as ophthalmoplegia or Guillain-Barré syndrome. Confusional syndrome, memory impairment have also been reported, particularly in the elderly, as well as ischemic strokes linked to the thrombogenic activity of SARS-CoV-2. Constrictive, erratic and long-lasting pain is probably of neurological origin.
- skin signs: pseudo-frostbite, sometimes painful, has been described since the beginning of the epidemic. More frequent in children and young adults, their development is usually favorable within a week, but they can recur. Dyshidrosis, vesicles, hives, rash, petechiae and livedo are less common.
- clinical pictures suggestive of Kawasaki disease have been described in children with initial digestive signs, including severe abdominal pain, then cardiogenic shock with a fraction of collapsed ejection, grouped under the name of pediatric multisystem inflammatory syndrome (PIMS). Skin signs are present, with erythema and flaking. The age of affected children, 9 to 17 years of age, is higher than in the usual form of Kawasaki disease.
- endocrine and metabolic disorders are probably linked to the wide organic distribution of the angiotensin 2 converting enzyme (ACE2), receptor for SARS-CoV-2: testis, ovary, hypothalamus, pituitary gland, thyroid and pancreas. Contributing to the state of deep fatigue and correlated to the severity of the disease, one can observe a deficit in testosterone production. The commonly reported hypokalemia is thought to be the result of virus binding to ACE2 and increased synthesis of aldosterone. The lymphopenia observed in certain severe forms of Covid-19 does not exclude situations of hypocortisolism, already documented during SARS. Subacute thyroiditis has been reported. Hypocalcemia can be observed, as well as hyperglycemia favored by the increase in insulin resistance and direct damage to the pancreatic gland with an elevation of the levels of amylase and lipase.
The National Academy of Medicine recommends
- explore the neurological, endocrine or metabolic manifestations occurring in a known or unknown context of Covid-19 infection
- to analyze cognitive disorders, their severity, their evolution and their persistence with the help of specific explorations;
- to evoke a PIMS in the event of intense abdominal pain and / or cardiogenic shock occurring in children or adolescents;
- to prescribe screening tests for SARS-CoV-2 (RT-PCR and serology) if there is any doubt in front of any rough, atypical or unusual clinical picture that might suggest Covid-19.
And the top coat of August 2, I kinda felt like preaching in the desert ... but so much the better if now everyone is concernedAdrien (ex-nico239) wrote:Hey, it's good ...
While the trolls drove us through pages here that 98% of people had "nothing" to justify the standard of care
Raoult warned all asymptomatic positives to be followed, even if they did not feel the slightest embarrassment because at the IHU they had taken very seriously all those who had "nothing"
Looks (once again) like he was right to be very, very suspicious of the aftermath.
Obviously at the time, most did not care.
We seem to be disillusioned
And that it is necessary, as Raoult pointed out, to set up a post-covid monitoring system ...
Like what to have "nothing", to feel "nothing" is not necessarily the sign of not being slyly affected by this filth
Cardiac sequelae in patients, even mild, of Covid-19
By attacking the blood vessels of the heart, the virus sometimes leaves marks visible on MRI scans. These small inflammations or scars could increase the risk of cardiovascular complications.
The Covid-19 epidemic is not over as specialists are already worried about the potential consequences of the disease on the body. In a July 15 press release, the National Academy of Medicine invited, for example, vigilance and the creation of a cohort for a longitudinal study of several years on the subject.
Last week, a German study published in the journal Jama Cardiology warned for its part about the risks of complications in the heart. Doctors at the University Hospital in Frankfurt performed an MRI on a cohort of 100 recently recovered Covid-19 patients two to three months after the diagnosis was confirmed by a PCR test. Result, 78% presented abnormal results. Researchers report inflammation of the heart muscle (myocardium) in 60 patients and / or the pericardium, the envelope surrounding the heart, in 22 others. Depending on the case, this is still active inflammation or scars. More surprisingly, these results are not correlated with the severity of the disease. Only two patients in the cohort were admitted to intensive care following their contamination with Covid-19, and 31 were hospitalized. The other patients suffered from a rather mild form.
“This kind of image is usually associated with a greater risk of cardiac dysfunction and the appearance of long-term cardiac insufficiency, analyzes Florian Zores, cardiologist in Strasbourg. These results raise real questions about the long-term risk of cardiomyopathies and heart failure. Unfortunately, the authors do not give us a table comparing the characteristics of patients with anomalies and without anomalies. This would have made it possible to think upstream to which patients to offer an MRI. ” Note that this is not a clinical study: scientists have not monitored the appearance of cardiac symptoms in a representative sample.
When the nervous system malfunctions like this, learning to breathe again, to adapt your heart rate properly, is not trivial.
Dr Benjamin Davido, infectious disease specialist at Raymond-Poincaré hospital in Garches
“The study included volunteers who presented symptoms (17% chest pain, 20% palpitations, 35% shortness of breath)”, explains Florian Zores. These results do not therefore mean that 78% of Covid-19 patients will experience heart problems afterwards. "Myocarditis and pericarditis are not rare," adds Benjamin Davido, infectious disease specialist at Raymond-Poincaré hospital in Garches. “Classically, myopericarditis are also viral diseases (for 90% of them). It is not surprising to find it in former patients with Covid. However, these results are very interesting, as they confirm that the virus has a particular affinity for blood vessels, which is cleverly called the vascular endothelium. This proves that these patients considered to be cured and who come to see us in consultation with fatigue or shortness of breath problems do not somatize. ”
Need for an effective post-Covid monitoring system
In an article published on July 23 in the journal Clinical Microbiology and Infection, the doctor described with his colleagues at the Hospitals of Paris a number of persistent symptoms caused by Covid-19 in AP-HP patients. “We notice that there is a very strong propensity to dysautonomia, namely a dysfunction of the autonomic nervous system. It no longer manages to perform such simple and vital functions such as breathing or adapting the heart rate to effort. Our hypothesis is that the small blood vessels have in fact been damaged by the virus and are no longer fulfilling their role of supplying the nervous system properly. "
This problem is all the more pernicious as it can persist after the virus has disappeared. “We are no longer faced with an infectious disease,” summarizes Dr. Benjamin Davido. The virus is no longer present in the body. But the damaged ships have not been repaired. Which would explain why the symptoms persist. ”
Like the Academy of Medicine, the infectious disease specialist therefore insists on the need to set up an effective post-Covid monitoring system. According to Benjamin Davido, these complications should not however be irreversible, provided rehabilitation is provided. “When the nervous system malfunctions like this, learning to breathe again, to adapt your heart rate well, is not trivial. It takes practice. Like a marathon, in a way. It's always possible, but you have to go gradually. ”