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To date, on June 2, 2021, 2 people in France are in intensive care. These patients are suffering the infectious consequences of Covid-825. What are the means put in place to save these patients? What are the risks of sequelae in people infected with Covid-19 ?
Covid-19 and severe symptoms
Risks of aggravation
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In some people infected with Covid-19, there is a risk of worsening the disease. This may concern the elderly or patients with chronic respiratory pathologies (pneumopathies, asthma, respiratory failure, etc.). The populations most at risk are, in general, more vulnerable and likely to develop a severe form of Covid-19 disease. Anyone with symptoms of respiratory failure (shortness of breath or choking) should immediately contact the 15. The heaviest consequence of the‘infection due to virus SARS-Cov-2 is acute respiratory distress syndrome (ARDS) and requires urgent medical attention.
Between March 1, 2020 and April 25, 2021, Public Health France identified 501 cases of children, whose median age is 7 years, in whom symptoms similar to Kawasaki disease have been observed. This condition is called MIS-C (multisystem inflammatory syndrome) also called PIMS, for pediatric multisystem inflammatory syndromes and it turns out today that these children suffered from these syndromes. The link with Covid-19 is that 387 of these children, or 77%, have tested positive for the Sars-Cov-2 virus. The others were suspected.
A 9-year-old boy from Marseille has unfortunately died. He had previously been medically taken care of for 7 days. This child had severe illness and cardiac arrest at home. He presented with co-morbidity “neuro-developpementale”And a positive serology for Covid-19. The clinical signs of this disease showed an inflammatory reaction following infection with the Sars-Cov-2 virus.
However, rigorous research is underway because not all of the children have been exposed to the coronavirus. the link between MIS-C and Covid-19 in children, is very likely, according to scientists. Indeed, the number of infected children is very low. Children represent less than 5% of those infected.
Update January 6, 2021 – The monitoring of children with myocarditis with cardiogenic shock is very rigorous. Public Health France confirms the link between PIMS and Covid-19 ” the data collected confirm the existence of a rare multisystem inflammatory syndrome in children with frequent cardiac involvement, linked to the COVID-19 epidemic “. According to Inserm, people under 18 represent less than 10% of diagnosed cases and the risk of death associated with PIMS in connection with Covid is less than 2% worldwide. |
Medical procedures to save the sick
How are patients with severe form of Covid-19 ? The intensive care unit is on the front line to ensure permanent oxygenation in patients. The latter are first plunged into an artificial coma. This loss of consciousness is caused by the doctors, the only people authorized to perform this medical procedure. The duration of the artificial coma varies between several hours and up to several weeks. The patient is then sedated before intubation. It must be intubated to protect the upper airways and be ventilated using a machine. Ventilation is a form of respiratory assistance. This helps to inflate the lungs and increase the gas exchange surface. Modern medicine is capable of saving many lives. However, this carries risks of sequelae, some of which are reversible.
What are the risks of sequelae in Covid-19 infected?
For the most part of people infected with Covid-19, no or few symptoms are felt. Doctors who answer questions about the novel coronavirus on the government website say so: “The vast majority of patients with COVID-19 recover without sequelae”. Regarding patients with a severe form of the disease linked to the SARS-Cov-2 virus, the risks of sequelae are nevertheless much higher. When a person is in an induced coma, their muscles melt. As a result, he will have to learn to walk again, with the help of a physiotherapist. It will be able, over time, to become autonomous again to feed itself. Respiratory rehabilitation sessions should also be followed. Fortunately, these consequences are temporary. When the patient wakes up, doctors diagnose him and assess the potential impact on the lungs, neurology and heart.
To date, professionals know a little more about the risk of sequelae in patients with Covid-19. First, ageusia (loss of taste) and anosmia (loss of smell) are part of the symptoms, but also temporary sequelae. Patients are also very tired, sometimes to the point of being unable to perform daily tasks. Indeed, the organism fights against the virus, causing a rather important physical weakening, for a limited time. Studies are underway to assess the potential dangers after resuscitation. It is not uncommon to see lung damage after developing a severe form of Covid-19. It is the respiratory tree (lungs, bronchi, bronchioles and alveoli), which is susceptible to significant damage. Gas exchanges (oxygen and carbon dioxide) are less efficient, resulting in more difficult oxygenation. The “cytokine storm”, this overly powerful immune response against infection, can lead to cardiovascular problems and brain dysfunction. Myocarditis and myocardial infarction could well be part of the collateral damage, in particular due to the formation of blood clot. There is, according to an observation made in a New York hospital, risks of renal failure. This pathology appears rather in obese or diabetic people. In addition, some patients are agitated after resuscitation, and may be confused. This disorientation may be the result of side effects associated with treatment and being in an induced coma during resuscitation. |
And in the long term?
Update November 10, 2020 – The Association Tous PartenairesCovid, made up of patients, families, caregivers and researchers has launched the research project “LONG COVID FOLLOW-UP”, with the aim of identifying and identifying the consequences of the consequences of the Covid-19 disease. Each person who has contracted the infection is invited to answer two questionnaires and share their experience of the pathology. The purpose of this Association is to represent patients suffering from long form of Covid-19 or “Covid long” and meet their needs. |
Update October 7 – Some patients experience symptoms persistently, sometimes a few months after their “recovery”.. Chronic fatigue, persistent cough, muscle pain… So many characteristic signs that are still present in these former infected with Covid-19 and prevent them from resuming “normal life”. For these people who have not developed a serious form, the occupational disease is not recognized. The testimonies are multiplying and have been reported to the Minister of Health, Olivier Véran. The latter knows the existence of these patients and says that research is underway.
A rather significant fatigue is felt, because the resuscitation is a test for the body of the patient who undergoes it. For any long-term sequelae, healthcare professionals do not yet have sufficient perspective. Studies have shown certain risks of complications, including failure of certain organs. For example, there may be a risk of kidney failure. All doctors know at the moment is that the road to full recovery from resuscitation is long and difficult, but possible. The health team always does its best to take care of the patient, and thus reduce the risk of sequelae. From one person to another, the risks are higher or lower. Moreover, a risk is never a certainty.