Christoph Kleinschnitz chooses his words carefully. He knows he can’t go wrong with his feet. Otherwise he will cause all sorts of problems. So his first sentence is clear. There is no doubt about that. ”
Kleinschnitz has good reason to be cautious. The director of the Department of Neurology at the University Hospital of Essen recently appeared as an expert in a controversial documentary by doctor and TV host Eckart von Hirschhausen, apparently revealing some suffering from prolonged COVID. noted that symptoms may worsen in patients with Fully explained – by psychological causes. Since its emergence, patients have long viewed him as a COVID and his post-COVID deniers.
Nothing is further from the truth, says Kleinschnitz. The only thing he wonders about is the apparent frequency of his COVID and his post-COVID cases over the long term and his colleagues’ claims of having cured themselves with highly controversial treatments. . She washes away from her blood the antibodies she believed were causing her symptoms. Depending on how many treatments she needs, this could cost up to €10,000.
Kleinschnitz’s appearance in Hirschhausen’s film lasted only two minutes. However, it was enough to provoke attacks not only on him, but on his family as well.
“This case shows just how emotional this topic can be,” said Harald Prüß, director of the Department of Experimental Neurology at the German Center for Neurodegenerative Diseases, a Berlin-based research institute. says. The long-running first conference on COVID, now in Jena, central Germany, is not going to change that.
main risk factor
Scientists, doctors, and patients are very divided on this issue. As patients struggle to be recognized for their symptoms, doctors are trying to establish ways to reliably diagnose or rule out the syndrome. I’m trying to find out.
There are still many uncertainties about the long-term symptoms COVID patients experience. of increased stress? There is evidence for both explanations. Studies suggest that the virus causes changes in the brain.
However, other studies have shown that these changes disappear after patients recover from infection. At the same time, scientists have identified the most important risk factors for post-COVID onset. Along with the severity of the infection, one of the main factors is psychological issues.
There are still many areas of uncertainty, even the definition of the disease is unclear. Doctors call it long-term COVID when symptoms persist for four weeks after infection, and post-COVID when patients do not recover or get worse after three months. However, this rough description does not adequately describe the syndrome.
What is the difference between long-term COVID and post-COVID?
Peter Berlitt, secretary-general of the German Society of Neurology, says doctors need to distinguish between these syndromes more clearly. . It puts a lot of stress on the body and patients often need months of rehabilitation to recover. suffer from,” he explains.
He estimates that 15-20% of cases can be explained by PICS.
Doctors believe that even if COVID is long-lasting, it’s not necessarily a COVID-specific problem. Similar symptoms appear in patients after other severe infections such as influenza. In a Danish study, scientists compared the severity of symptoms in COVID patients to those who had suffered from other respiratory diseases and found that the majority of complaints experienced by COVID patients were also found in other groups. has been confirmed.
Except for two: changes in smell and taste, and a diminished ability to plan ahead.
Then there is post-COVID. Some international studies show that around 30-40% of COVID patients suffer from long-term symptoms, although many doctors dispute this. Data from five health insurers, which provide about half of Germany’s health insurance policies, recently showed a significant increase in both physical and mental illness after COVID-19.
“These are very interesting results, but they don’t necessarily suggest causality,” says Berlit. It is difficult to determine whether headaches three months after COVID infection are related.
Are post-COVID depression and anxiety caused by processes in the brain caused by the virus, or a result of increased stress after the pandemic?
Christian Erfurt
collective name for various symptoms
Clara Lehmann, director of the working group on outpatient care at Cologne University Hospital, believes that the number of people suffering from prolonged COVID or post-COVID is vastly overestimated. , hides a whole spectrum of different syndromes,” she said in an interview with the Science Media Center.
More than 200 symptoms are associated with this syndrome, ranging from headaches and difficulty concentrating to kidney and liver damage, heart attack, stroke and fatigue.
Akiko Iwasaki, an immunologist at Yale University School of Medicine, who also participated in the Jena conference, is investigating the cause. From inflammation in blood vessels that increases the risk of heart attack and stroke, to the immune system trying to fight off coronavirus particles still in the body, to the autoimmune reactions described in the controversial Hirschhausen documentary. I have a theory. “We are looking at all these possibilities,” Iwasaki said.
Symptoms Dismissed as Psychosomatic
Scientists think it’s plausible that COVID increases the risk of stroke and heart attack during certain periods. Viruses can attack blood vessel cells. In a study recently submitted for peer review, Iwasaki found that post-COVID patients compared to controls showed more instances of reactivated Epstein-Barr virus and other latent viruses. did.
That could explain many of the symptoms. Iwasaki was surprised she didn’t find “significantly elevated levels of autoantibodies that target the body’s own cellular proteins,” she says. , what if these autoantibodies were found in a patient’s blood or spinal fluid? “The fact that they are present does not necessarily mean that they are causing damage,” Prüß said. say.
Physicians who ignore that aspect are not caring for their patients holistically.
But what about all the other patients and their symptoms that cardiologists and neurologists struggle to explain? , says Lehmann, an infectious disease expert. French and British studies support this view. French and British scientists compared people who tested positive for COVID to those who simply believed they had it, and found that many in the latter group experienced similar levels of fatigue. .
But that’s exactly what many patients fear: their symptoms are dismissed as psychosomatic. “This does not mean that these patients imagine their symptoms,” Kleinschnitz said. say. “This means that the treatments we normally use for post-viral fatigue are ineffective for them.”
Harald Prüß believes that 20-30% of his neurological patients suffer from psychosomatic problems. Also, her Berlit, a neurologist, points to a variety of ailments that doctors treat for psychosomatic symptoms. For example, cancer, multiple sclerosis, and fatigue. “Doctors who ignore that aspect are not caring for their patients holistically,” he says. “So why should the approach we take for other serious neurological diseases be considered wrong in this case?”
What makes COVID last longer?
It is unclear which factors make people suffer from prolonged COVID or post-COVID, but they appear to be related to disease severity and specific variants. appear to have little effect on physical health.
Studies based on early data from the pandemic assumed that a significant number of COVID patients would experience long-term effects, but more recent studies have shown that they experience at least one symptom three months after being infected. It was concluded that only 6% of patients After a year, that rate drops to 1%.
The long COVID does not affect everyone equally. Some people seem particularly susceptible to long-term effects. A US study found that about two-thirds of victims were middle-aged women. Important risk factors include being overweight and pre-existing chronic or psychological conditions such as anxiety and depression, with underlying Epstein-Barr virus infection and diabetes also putting her at risk of suffering from COVID over the long term. increase the
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