More and more reports of symptoms of the coronavirus that persist or recur are emerging.
[Updatedon22[Misàjourle22 May 2020 at 11:20 am]The symptoms of the coronavirus, in addition to being numerous, sometimes last several weeks, even several months. There are more and more testimonies on the longevity of symptoms or their resurgence, after having disappeared. France Bleu Sarthe recently took the example of a Le Mans suspect suspected of carrying the Covid-19 – he could not do a test – having suffered fatigue and cough for two months. France 3, for its part, relayed the case of Delphine, 48, who fell ill in mid-March. She is then a victim of the known symptoms of the coronavirus: “very dry throat, intense thirst, headaches, body aches” … But after ten days, Delphine is much better and even begins to work and do of sport, before a few days later, “the symptoms return”. “Weaker but the same, headaches, backaches, diarrhea,” she recalls, before recovering again in late May.
These testimonies call out, to the point that two studies were recently launched, each supposed to explain each phenomenon, namely the persistence of symptoms on the one hand and their resurgence on the other. Professor Dominique Salmon-Ceron, Infectious Disease specialist at the Paris hospital of Hôtel-Dieu, announced this information to the Parisian, specifying that “in most cases”, the symptoms “regress quickly and disappear but for a certain number of sick, it may take longer. “
“I am thinking of fatigue which can last more than a month, chest tightness, this feeling of weight on the chest or even anosmia, that is to say the loss of smell. begins to subside after 5 to 10 days but we see patients, even with mild forms, in whom it persists for several weeks “, explained the specialist, who evokes” several hypotheses “concerning the specific case of anosmia in Covid-19 patients who do not have a blocked nose: “a large inflammation lodged in the back of the nose or lesions of the olfactory branches”. Despite the cases of symptoms operating in yoyo, Dominique Salmon-Ceron refuses to speak of chronic coronavirus. “I would rather say that it is a subacute infection, that is to say that it remains a few weeks”, she judges.
According to the WHO, the incubation time of the virus – that is to say the time between infection and the first symptoms – ranges from one to 14 days. In more rare cases, symptoms can appear overnight. The first signs of the virus are: fever, dry cough and fatigue. These symptoms, most often mild, appear gradually, sometimes by a mild cough, or by a simple headache. Some people with the virus even sometimes have zero symptoms. It is the asymptomatic form of this infectious disease.
According to UNICEF, “in children and young people, the effects of the virus are relatively mild, with a very small proportion of them being in serious or critical condition due to the coronavirus.” In most cases, the infection is not very symptomatic or asymptomatic. If young children and babies are less affected than adults by Covid-19, they can be infected, and therefore transmit the disease.
However, pediatricians warn of the appearance of a condition close to Kawasaki disease, a vascular syndrome affecting young children, which incidentally killed its first in France on May 14. Doctors said the nine-year-old victim had contracted the coronavirus. Symptoms include severe abdominal pain, fever, diarrhea, rashes, etc. All of these are common symptoms with Covid-19. Among the few cases hospitalized for these symptoms in Ile-de-France, some have tested positive for the Chinese virus. “They did not all present typical respiratory symptoms at the initial phase. We see them arriving in a second time with a little more frustrating forms which were not described in children: digestive disorders, fever, deterioration of the general state but not necessarily notion of respiratory distress “, explained on RMC Pierre-Louis Léger, head of the pediatric neonatal resuscitation service at Trousseau Hospital in Paris.
As with seasonal flu, fever and body aches are very common symptoms of Covid-19. The level of fever varies from one individual to another, but generally the coronavirus causes a fever higher than 38 °. If you want to fight fever or pain, prefer paracetamol to anti-inflammatory drugs and ibuprofen, which are suspected of worsening symptoms in case of coronavirus. If in doubt, stay home and call your doctor.
Covid + patients have a dry, sometimes oily cough. Aurore Jégu-Pétrot, nurse, reported on BFMTV that this cough, if it becomes unmanageable, should alert: “When you see that you are coughing to choke on it you tell yourself that you are going to need respiratory aid”. However, in most cases, this cough goes away on its own. WHO advises calling your doctor if you have a dry cough.
Several ENTs alerted the authorities in mid-March of the appearance of a new symptom: anosmia (loss of smell). These losses of smell would seem to be a pathognomonic symptom, a clinical sign which alone can establish the diagnosis. This symptom is the only specific presentation of the new coronavirus. Dr. Corré, ENT at the Rothschild Foundation Hospital in Paris, theorized: “The SARS Cov-2 virus is attracted to the nerves: when it enters the nose, instead of attacking the mucosa as does the usual rhinoviruses, it attacks the olfactory nerve and blocks odor molecules. ” The doctor assured: “In the current context, if you have an anosmia without a stuffy nose, you are Covid positive, it is not worth going to get tested.”
Shortness of breath is another symptom of the coronavirus which can be a signal of worsening of the disease, which attacks the respiratory tract and can lead to severe pneumonia. This complication occurs in some patients from the seventh day, with a renewed fever, sometimes after a slight improvement phase. Shortness of breath often happens suddenly and occurs at the slightest physical exertion, such as moving around or showing the stairs. To detect it if in doubt, measure your breathing rate. Beyond 20 to 25 breaths per minute, it is a tachypnea (increased respiratory rate) and it may be advisable to consult a doctor if you have other symptoms.
A Chinese study, published in the American Journal of Gastroenterology, found that coronavirus patients may also be affected by digestive disorders. The study reports that out of 206 Covid-19 cases tested, with an average age of 55, “almost half (48.5%) went to hospital for various digestive disorders such as than diarrhea (29.3%), vomiting (8%) or abdominal pain (4%) “. Even more surprising, some patients (seven) had digestive problems … but no respiratory symptoms, which are the most common signs of the new coronavirus.
Several scientific articles have reported a link between cases of frostbite and infection with the new coronavirus. In order to confirm or deny a possible correlation, the Dermatology Service of the Cliniques Universitaires Saint-Luc (Belgium) carried out a study. 47 subjects, aged 26.5 years on average, were included in this experiment. The research team said in a statement that “more than half of them reported having had other suggestive manifestations of Covid-19 (including fever, cough, cold, digestive upset).” For each patient, several examinations were carried out, notably PCR and serological tests for the detection of Covid-19. The scientists concluded that “the nasopharyngeal smears and the Covid-19 serologies were negative for the 47 patients. The study therefore does not establish a direct association between frostbite and Covid-19.” Scientists have put forward “another hypothesis to explain the appearance of frostbite in these people: confinement and sedentary lifestyle which it implies. Immobility can indeed cause a reduction in blood perfusion in the limbs, which would contribute developing frostbite. ”
The coronavirus infection becomes worrying that people are “breathing faster than normal,” reported Dr. Pauti, who tells his patients to call 15 as soon as they notice shortness of breath. These brutal aggravations often occur between the seventh and the fourteenth day. They result in a form of bilateral pneumonia, with a very specific radiological aspect. “On CT, we can be almost certain” that it is the Covid-19, said Pauline, hospital doctor in the Paris region.
Jessica J Manson, a specialist in inflammatory phenomena at University College Hospital in London, said in the medical journal The Lancet: “There is mounting evidence to suggest that some of the patients with severe forms of Covid-19 are subjects of cytokinic shock syndrome. ” In theory, in case of infection cytokines allow regulation of the immune action. However, with the “cytokine storm”, we observe a runaway of this system which leads to a hyper-inflammatory reaction.
The new coronavirus can affect the kidneys. Alan Kliger, nephrologist at the Yale School of Medicine, reported in the Washington Post: “Almost half of those hospitalized with covid-19 have blood or protein in their urine.” More alarmingly, a survey reported by the newspaper reports that 14 to 30% of intensive care patients in New York and Wuhan (China) lose their kidney function and require dialysis. Individuals with kidney disease are more prone to these worsens. Indeed, they often have problems with diabetes, hypertension or cardiovascular disease. However, Dr. Brad Rovin, director of the nephrology department at Ohio State University, told RFI that “many cases who have never had kidney disease before, develop severe kidney damage . ” He explained, “Depending on the severity and duration of the infection while fighting Covid-19, these patients may develop chronic kidney disease.” Dr. Brad Rovin said, “I think we will see the long-term consequences of this disease in nephrology departments.”
Some patients with Covid-19 have neurological conditions. A study published in the journal of the American Medicine Association (Jama) reports that out of 214 Chinese patients 36% presented with neurological symptoms, ranging from loss of smell to nerve pain, to seizures and strokes. If these landmarks losses are sometimes due to the lack of oxygen in the blood, some health professionals suggest other hypotheses. The first is due to an abnormal immune response – a “cytokine storm” – which causes inflation in the brain called autoimmune encephalitis. The second is a direct brain infection: viral encephalitis. In order to find out the origin of these disorders, a data collection project is underway.
In addition, American doctors have noted an increase in strokes in young and middle-aged Covid + patients. In order to document this phenomenon, the Washington Post reported that three major American medical centers are preparing to publish data. Pascal Jabbour, neurosurgeon at Thomas Jefferson Hospital, said that many cases have unusual characteristics. Usually clots appear in the arteries that carry blood away from the heart. However, in Covid-19 patients, clots also form in the veins and are more difficult to treat. Sherry H-Y Chou, a neurologist at Pittsburgh University Hospital, hypothesized that these conditions were caused by “friendly fire”, that is, a disproportionate immune response. If you notice symptoms of a stroke (dizziness; numbness and sagging of part of the face, arm, leg or part of the body; speech problems …) contact 15 as quickly as possible.
Coronavirus can cause different levels of sequelae. Xavier Lescure, professor and infectious disease specialist at Bichat hospital in Paris, explained on FranceInfo: “We don’t think there will be any after-effects for people who have had weak symptoms”. On the other hand, in severely affected patients, the consequences will be indelible. The lungs are the first organs affected. A 3D video (produced by researchers at the George Washington University Hospital in the United States) reveals that the lung tissue is very largely damaged in severely affected patients. Keith Mortman, head of the thoracic surgery department, theorized: “When this inflammation subsides, it leaves scars on the lungs and creates long-term damage. This can deteriorate a patient’s breathing capacity in the future.” Autopsies confirm that severely affected patients develop pulmonary fibrosis. Xavier Lescure explained: “We see that people who die have large lesions linked to lung inflammation.”
The deconfinement was accompanied by a new procedure for people symptomatic of Coivd-19. “If you have symptoms suggestive of Covid-19 infection (cough, fever, difficulty breathing, loss of taste or smell), do something about it, don’t wait for it to pass. Contact your doctor or contact 15 so that he can refer you to an available doctor. He will then ask you questions and, if he considers it necessary, prescribe a screening test, “said Olivier Véran in his speech on May 7. Pending the results, the potential patient must isolate himself at home or at the hotel. If the test is positive, the isolation should continue “up to two days after healing of symptoms, that is to say on average for 8 to 10 days,” said the Minister of Health.
It is sometimes difficult to know how to react to symptoms suggestive of Covid-19. To overcome certain questions, the Government has put online a questionnaire to better guide potential patients. With the same objective of reassuring patients, the National Medicines Agency (ANSM) has for its part posted a simple questionnaire which allows to know the effects of a treatment on the Chinese virus. The AlloCovid platform, launched at the end of April, is a tool used to refer patients. Available by phone, on 0 806 800 540 (price of a local call), this service does not require a smartphone or an internet connection. A telephone bot asks you a series of questions, often closed, about your general condition. AlloCovid “allows, via a questionnaire of three minutes maximum, to any citizen to be informed and well oriented, 24 hours a day and 7 days a week, on what to do in case of symptoms, stay at home, call his treating doctor or, if necessary, to call without waiting for 15 “, explained to the Parisian professor Xavier Jouven, cardiologist and researcher at Inserm.
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