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Clermont-Ferrand CHU day hospital: what do we know about the remote sequelae of a Covid-19?

The care of people suffering from remote sequelae of a Covid-19 has just started at the CHU Louise-Michel in Cébazat in the Physical Medicine and Rehabilitation Department headed by Professor Emmanuel Coudeyre(photo Thierry Lindauer)

. What do we know about the aftermath of Covid-19? How to support patients suffering from a Covid-long?

What do we mean by “Covid long”?

“We talk about ‘Covid long’ syndrome when a person keeps, at a distance from the disease, a number of symptoms that could be attributed to Covid-19. The infection is over but symptoms persist.

There is no unambiguous definition, since Covid-19 is a virus of recent appearance, the hindsight from the disease and its evolutions is insufficient. Scientifically, knowledge is still fragmented.

We are therefore talking about a syndrome more than a disease in its own right. “

What are the symptoms frequently found? “The symptoms, revealed at least three to six weeks after the illness, are not very specific and very varied. They can last for at least three months after infection. We distinguish, for the main ones,

fatigue and muscle weakness, shortness of breath, which can be associated with anxiety, sleep disorders… ”

This would concern between 10 and 15% of Covid patients?

“These are, in fact, the current data that we have. What we discovered when we launched the Covex study this summer is that there is no proportionality between the original form of the disease and the extent of the sequelae. We can have a severe Covid without major sequelae and conversely, a mild Covid with significant sequelae.

What is the objective of this day hospital?

“This outpatient care aims to enable patients to regain capacity (respiratory, muscular, etc.). These functional limitations are probably linked to the disease itself but also to deconditioning, due to sedentary lifestyle (isolation, confinement) and reduced social interactions. Low morale is a constant among these patients. The “group” effect of the care then plays an important role. The program has a priming effect before resuming independent physical activity at home. “

The first “Covid-long” patients in rehabilitation at the Clermont-Ferrand University Hospital testify

How do you integrate the day hospital?

“There are two entry points: either the infectious diseases and / or pneumology department of the CHU, or the general practitioner. This concerns patients who do not have a normal recovery and whose attending physician has demonstrated a functional impairment such as shortness of breath, asthenia justifying specific treatment.

This hospital care comes in support of the city care, because now physiotherapists, speech therapists in liberal practice are also able to help some of these patients. “

How is the program going?

“The program includes a general physical, muscular and respiratory check-up. Then over three to six weeks, in a small group of four patients, exercises are offered over three half-days per week, supervised by a physiotherapist and an adapted physical activity teacher. This takes place at the CHU Louise-Michel in Cébazat. They also offer self-exercise tips to do at home. If necessary also speech therapy rehabilitation is possible. “

Michele Gardette

There is another day hospital for Covid-long pulmonology patients at CHU Gabriel-Montpied with a diagnostic and evaluation objective. Rehabilitation with a speech therapist. Among the symptoms of Covid-19, some people mainly suffer from ageusia (complete loss of taste) or anosmia (complete loss of smell). “We have more and more calls from people who do not have spontaneous recovery of these senses that are taste or smell”, notes Bénédicte Boléa, speech therapist who, as part of the day hospital of Clermont-Ferrand University Hospital is setting up special rehabilitation for Covid-long patients, also alongside Marie-Catherine Martin, speech therapist. “We are setting up a
training olfactif


– –

with the patient who will also have to train at home, every day, for eight to twelve weeks ”, describes the speech therapist who works, for example, thanks to mental images… The objective is, schematically, to retrain the olfactory neurons affected and which regenerate every two or three months. We reinforce this rehabilitation with exercises at home. Concretely, you have to find three or four smells, smell them four times a day, for ten to fifteen seconds outside of meals, in order to avoid other parasitic odors. This for eight to twelve weeks. Spices are particularly appropriate for this exercise: pepper, cumin, curry, cinnamon, dill, Provence herbs… or mustard, etc.

“We carry out an assessment at the start of rehabilitation in order to define the percentage of smell remaining and we quantify the loss in order to note the evolution over time. But we do not have enough perspective with the Covid, so this rehabilitation remains empirical and we cannot guarantee total recovery, nor really know the benefits. ”


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