Abstract :
[en] Fifty-two patients who suffered from COVID-19, who were all 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 June 2022. Data extracted from the medical records of the 52 patients (38 women), mean age 43.2 (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-one 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 to explore the genetic and immunological basis of their problem, as 20/52 cases don’t have immunological certainty of a COVID-19 infection. There is no known verified treatment. Three categories of patients appeared over time: 16 patients have fully recovered after 6 to 8 months, 15 patients were able to resume life and work after 12 to 18 months with some after-effects, 21 patients are still very ill and unable to resume their 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.
Data extracted from the medical records of the 34 patients (26 women, range 12 to 69 years) and a qualitative study of 6 of them using a semi-open-ended questionnaire allowed to highlight the clinical picture. Brain single-photon emission computed tomography (SPECT-CT) has been used in fifteen patients with a high severity index and a functional status highly impaired.
Vascular encephalopathy has been demonstrated in fourteen of the fifteen patients and supports the hypothesis of a persistent cerebral vascular flow disorder in Long Covid.
The patients will benefit from the consortium COVID Human Genetic Effort to explore the genetic and immunological basis of their problem, as 14/34 cases don't have immunological certainty of a Covid infection. It is necessary to test the reproducibility of this description, conducted on a small number of patients. There is no known verified treatment and patients do not receive any specific help from Belgian health authorities. Neurocognitive rehabilitation and physiotherapy are not widely available. The biopsychosocial consequences on patients' lives are severe and family doctors left out in the cold.
[fr] Cinquante-deux patients post Covid, présentant 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 multi-systémiques ont été suivis en médecine familiale entre 2020 et 2022.
