A few weeks after having had a coronavirus infection, generally mild, patients complain of a resurgence of their symptoms. Mostly women. We are talking about the “Post-Covid Syndrome”. What to do ? Advice with Dr Nicolas Barizien, Head of the physical medicine and rehabilitation service at the Foch hospital in Suresnes.
[Mise à jour le vendredi 24 juillet à 15h07] The virus Sars-CoV-2 has definitely not finished making people talk about him. Among the people who have had benign forms of coronavirus a few weeks ago, some are now returning to see their doctor because symptoms reappear or persist. This “Syndrome post-Covid” s’observe for two to three weeks, testifies Dr Nicolas Barizien, Head of the Department of Physical Medicine and Rehabilitation at the Foch hospital (Suresnes). Is it a relapse? What to do ? What symptoms should you worry about? What risks?
“Post-Covid Syndrome is a resurgence of symptoms after infection acute by the Sars-Cov-2 virus, answers Dr Barizien. For now, the people we see are 6 to 10 weeks later. they have often has mild to moderate forms illness, either at home or in the hospital for a few days and then as things got better they were sent home. After this period of infection with fever, cough, diarrhea and all the symptoms we know of acute infection, they have been convalescent, they have resumed a normal life and now they would like to resume a completely normal life. but they start to have symptoms again. ”
“They are mostly young people, 40 to 50 years old.”
People affected by a post-Covid syndrome do not have the symptoms of acute coronavirus infection. “They are short of breath at the slightest effort, for example after going up a floor on foot, they have headache when they activate a little, in the rib cage, ribs, sternum, neck, they have the dizzy, feelings of tightness in the chest and they are tired” details our interlocutor.
→ A distinction must be made between the fatigue which resurfaces in these patients and that which persists for those who have been hospitalized in intensive care. As Dr Barizien points out “all people who spend two months in intensive care, for whatever reason, are tired and have to go to rehabilitation, there we are outside of these cases”.
While the disease Covid-19 has affected men more in its most serious forms, there “they are rather working women that we see coming back “ notes Dr Barizien. In general, this post-Covid syndrome concerns young people, between 40 and 50 years old.
“They are doing something weird which manifests itself as an upsurge in symptoms that are bothering them in their daily life.”
“No, these people don’t relapse, answers Dr Barizien. They no longer have a fever, are no longer in the acute infection, it is not the virus that starts to develop again in the body, the PCR is also negative.” Likewise, it is not a distant complication of infection: “They are doing something weird that manifests itself in an upsurge of symptoms that bother them in their daily lives.”
The Sars-CoV-2 virus can cause lung complications leading to death. When you have a resurgence of symptoms, especially shortness of breath, vigilance is essential. “The first of the complications to check for the medical profession is that the patient does not pneumonia to Sars-CoV-2, warns Dr Barizien. That he doesn’t make a embolism pulmonary or pneumonia with a common germ that can degenerate on a lung that has been weakened, it does not make a pulmonary fibrosis or a cardiac complication such as infarction or myocarditis. They are rare but there are a few. “ In most cases, for now, the results of these cases of post-Covid syndrome are normal.
“As we are dealing with a disease that we learn every day, the first thing is to consult a doctor”
“As we are faced with a disease that we learn every day, the first thing is to consult a general practitioner to eliminate a certain number of complications “, advises Dr Barizien. This is what most people do when they start having symptoms again and feel embarrassed in their daily life. “The doctor can order a blood test, an X-ray or even a CT scan and most of the time this assessment is normal so we are reassured that there are no serious complications from the coronavirus” continues the doctor.
At the Foch hospital, Dr Nicolas Barizien and his team have launched since June 12 “Rehab-covid” to take care of the patients they treated a few weeks ago from Covid-19 and whom they see coming back. “We will try to understand why they have these symptoms and treat them, explains the doctor. We will evaluate them with a battery of exams where they will meet a doctor, a physiotherapist, a psychologist and a dietitian. ” The program of the Foch hospital includes in particular:
→ the performance of a stress test by the doctor to see how the heart and breathing behave,
→ walking tests and assessment of muscle strength by the physiotherapist,
→ a check-up with a psychologist to look for post-traumatic stress syndrome: “We have people who have a very important mental load, especially women as they are the mistresses of the household, they took more care of the children, they are a little more worried about their family than the men, multiplied by the fact that these people have caught an illness that they heard on television than people would die of it, some will develop something that looks like post-traumatic stress disorder. We must not stay like that because we know how to treat him. “
“The most important thing is to manage these symptoms within 6 months of the acute infection”
→ a dietician “because many patients say that, without having been hospitalized in intensive care, they have lost 4, 5 or even 10 kilos during their infection with the coronavirus. However, in periods of rapid weight loss, we lose muscle “ which intensifies fatigue. By returning to the effort, they will rebuild their muscle mass.
And for those who were not followed up at the Foch hospital? “Our list of returning patients is already so large that we will first take care of them, but we are currently thinking about solutions to propose to our general practitioner colleagues because they have a lot of patients who come to see them with these symptoms and it is a real problem ” answers Dr Barizien. In the meantime, if you think you have post-Covid syndrome:
→ consult your doctor for the prescription of an assessment (blood …)
→ see a physiotherapist if you are short of breath : “You can do cardiac coherence exercises -the RespiRelax or Petit Bambou applications offer it- to slow down breathing and try 3-6-5 : 6 respiratory cycles in 5 minutes, 3 times a day. This forces you to breathe very slowly. If we can’t do it, that’s a good lead. You have to go see a physiotherapist who will be able to diagnose hyperventilation and suggest solutions. “
→ consult a psychologist if you feel you have a decreased interest in daily activities, a drop in concentration, sleep disorders, irritability … following (de) confinement. “Psychologists have techniques for treating people likeEMDR which works very well “ underlines our interlocutor.
Most important : “Manage these symptoms within 6 months of acute infection, recommends Dr Barizien. If we wait too long, things will escalate and it will be much more complicated to treat them. “
Thanks to Dr Nicolas Barizien, Head of the Department of Physical Medicine and Rehabilitation, Sports Traumatology at FOCH Hospital in Suresnes (92), President of the Île-de-France Regional Society for Sports and Health Medicine (SIFMED Sport Santé).
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