“We were expecting flu-like symptoms, fever and cough. We learned in the field that the symptoms affecting the European population are different from those which the Chinese had at the beginning of this epidemic. “
This observation, Dr. Julien Cottet, coordinator of the Covid consultation provided by the liberal doctors of the agglomeration of Chartres at the Coudray hospital, does so “empirically”, but with the experience of 1,200 consultations carried out with his colleagues since March 17.
“Flashing” chest pain and extreme fatigue
Even if cough and fever are not absent from the table, the patients who go to the consultation very often have chest pain “dazzling, which short of breath and which frighten them” and a great tiredness, describes Dr. Cottet. Dermatological manifestations have also been noted, for the past fortnight, “large frostbite on the extremities, fingers and toes, hives, which there was not in other countries”.
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Covid-19 can also be manifested by “phlebitis, pulmonary embolism or isolated neurological forms, such as stroke [accident vasculaire cérébral] or seizure, which complicates the diagnosis, “said Dr. Hervé Gorka, cardiologist at Coudray Hospital and who was co-responsible for one of the establishment’s five Covid units.
Another form of symptom should alert: loss of smell (anosmia) and taste (ageusia). Quite typical of Covid-19, they are now the subject of systematic research by practitioners.
What doctors who follow Covid-19 positive patients also see is a two-phase course of the disease.
“The patient has symptoms, at first, of cough and fever, it can subside in the first week, and by the second week, the symptoms come back and settle in for a long time.”
Dr Cottet (empty)
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With the hindsight of five weeks of consultations, doctors note that the symptoms can last from a month to a month and a half.
No specific treatment
These patients should therefore be monitored over the long term. Once out of the hospital, “when they have no more fever and they have been weaned off oxygen for 48 hours, ideally after the tenth day of the illness, because we know that there is a possibility of worsening between the seventh and the tenth day “, details Dr. Hervé Gorka. Patients continue to be called daily by a hospital follow-up unit, made up of hospital doctors, supported by retired colleagues and medical students.
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If, on the phone, the doctor judges that a symptom seems to worsen or that it seems to him that the patient is experiencing breathing difficulties, he asks him to return to the Covid consultation. This concerns, explains Dr Cottet, two to three people a day in Chartres.
On the treatment side, the medical profession is quite helpless. Apart from painkillers, to combat pain and reduce fever, and medical oxygen, “there is no specific treatment,” said Dr. Cottet.
Géraldine Sellès
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