Pandemic – a group of accelerated seniors is formed. This is due to the COVID-19 long tail

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Long covid (or COVID-19 long tail) is a colloquial term for a set of symptoms that appear after infection with the coronavirus and last longer than three months after the end of the infection. Officially, it is not a disease entity, but – as predicted by Dr. Michał Chudzik, an internist and cardiologist, working with patients after the home course of COVID-19 under the “STOP-COVID” program – it will soon be, because the scale of the phenomenon is enormous. Just like the dramas of patients who struggle with ailments such as brain fog, chronic fatigue, and disorders of the sense of smell and taste. Some people have been unable to return to normal for over a year.

1. Dr. Michał Chudzik tells the stories of patients who struggle with long covid
2. Smell and taste disorders are one of the most serious complications of COVID-19, with which medicine, in most cases, cannot cope with it.
3. Many of Dr. Chudzika feels as if she has aged several years after COVID-19
4. Doctors are concerned that the pandemic will result in, inter alia, faster aging of the population
5. You can find more such stories on the TvoiLokony home page

Paulina Wójtowicz, MedTvoiLokony: During our first conversation, you said that after the reorganization, the “STOP-COVID” program would cover two thousand people. This is a huge group of patients. Can you name those who, for various reasons, stuck in your memory the most?

Dr. Michał Chudzik: These people actually show up every week of work. On the one hand, these are medically interesting cases, on the other – living people with serious problems that make everyday functioning difficult. For example, a young person who has not been ill before came to me recently, and now her heart is working at 50%. your possibilities. As if that were not enough, we detected sarcoidosis in her. It is not known what influence COVID-19 had on this diagnosis – whether the disease was activated as a result of an infection or whether there was any independent factor.

This week there was also a patient with me who has been suffering from smell and taste disorders for over a year. During this time, she lost almost 20 kilograms of body weight because she is almost unable to eat. We referred her to a psychologist and dietitian, because the situation is on the verge – she has huge nutritional deficiencies. We cannot allow anyone to starve to us.

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Such reluctance to eat results from the inability to taste and feel or is the problem more complex?

Much more complex. The patient wants to eat, but the food she sees in front of her smells so unpleasant that she cannot force herself to eat it. There are many patients who smell of burnt or human waste everywhere. These are terrible stories. There is practically no person who – struggling with such a disorder – smells pleasant. These are always negative feelings, and the smells are ugly, disturbing. I have a patient who constantly smells cigarette smoke and burns. She can’t function normally. When she falls asleep, she feels that something is on fire in the apartment. She doesn’t know if it’s really a fire or just her delusions – and it has been for many months.

How do you get out of such fear?

When symptoms persist for so long and no improvement is seen, consultation with specialists is necessary. At this stage, we referred this particular patient to a psychiatrist. This is not an ordinary infection or even the flu, during which we feel worse for some – shorter or longer, but usually finite – period. Some long covid patients have been struggling for over a year and are unable to return to normal on their own.

Two-thirds of patients who come to the clinic are women. It follows that the long tail of COVID-19 affects them more often than men.

Men, on the other hand, get sick more intensely and require hospitalization more often. The answer to why women suffer from long covid in large numbers is certainly partly in hormones and emotions, but also partly in the lifestyle they lead. Often they have to take care of their relatives and home first, and only then – if possible – give themselves permission to be ill and worry about their health. And then various symptoms appear, or maybe only then are they noticed, located and consulted with a doctor.

What ailments do they come with?

The biggest problem is hair loss. In the first three months after contracting COVID-19, 10 to 15% of people report this symptom. female patients. Some admit that they have already bought wigs because the loss of hair was so large and visible that they felt a great deal of discomfort when looking at themselves in the mirror or leaving the house.

How to help such patients?

We have a lot of support from dermatologists who work, among others, in the field of psychodermatology. This field of medicine focuses on the relationship between our psyche and what appears on our skin. Of course, we always check patients first for deficiencies, but usually we don’t find them. It often turns out that hair loss is associated with chronic stress. For many months, together with the Dermatology Clinic and professor Joanna Narbutt, with good results, we have been conducting phototherapy, the so-called blue light, which, apart from affecting our skin, has a beneficial anti-stress effect.

Chronic stress, but also chronic fatigue. How is it different from the usual exhaustion many of us experience?

If a patient feels tired despite more than three months after the COVID-19 infection, and we do not find cardiological disorders, the liver and kidneys are working properly, we are dealing with chronic fatigue syndrome. Its main symptom is reluctance to work and act, but patients also complain of headaches, intestinal disorders, recurrent rhinitis or other mild symptoms of a cold.

We define chronic fatigue syndrome today at the level of mitochondria – the structures in the cell that are responsible for energy production. The starting point is ischemia, which results from blood clots in the area of ​​microcirculation, i.e. the smallest vessels in our body. When cells become hypoxic, mitochondria are also damaged, and when they do not get oxygen, they produce less energy. In practice, this is manifested in the fact that our muscles do not have strength.

Is there a cure for it?

Here you need a very compact operation. We must skilfully rehabilitate the patient, and properly target the mitochondrial diet, which is rich in compounds that stimulate these important structures. Mitochondrial therapy, i.e. breathing air with a low oxygen content, also brings good results.

The effects of such therapy, and the treatment in general, appear over time. How do long covid patients deal with persistent ailments on a daily basis?

The most bothersome are the symptoms of brain fog, which affect the sphere of activity. This is perfectly understood by young people who, before the infection, had an active, even sports lifestyle, and today they are not even able to enter the first floor without being out of breath. Interestingly, while long covid generally affects overweight people more often, exceptionally patients with brain fog usually have a very low BMI. I cannot explain this phenomenon.

When it comes to the professional sphere, the situation is quite dramatic at the level of memory and concentration. Many people do not remember what they have learned so far. I have young patients who are in college and are unable to join the session because they do not remember what they have been learning all year long. Or people working in large companies, corporations, where they used the English language on a daily basis, and now they cannot return to work because their foreign language is only at a basic level. These are benign dementia syndromes – symptoms that appear 10-15 years before the symptoms of dementia, Alzheimer’s disease, develop.

While we are able to deal with chronic fatigue during therapy, when it comes to the work of the brain, memory, and sensory disorders, we do not know how to reverse this process and we cannot stop it.

Doctors and scientists from all over the world are wondering how to help these patients and they have great fear that it will not be possible to do it in time, that irreversible changes will occur. We are afraid that from all this we will be born a group of accelerated seniors. Many COVID-19 patients admit that they have the impression that they have aged 10, 15, even 20 years.

It is quite a burden to bear.

Yes, the more so as it mostly concerns people who have hardly ever used health care. Patients who have already been hospitalized or suffer from many different diseases are somewhat hardened. Whether they go to the doctor four or six times a year does not make as much difference to them as to people who have not seen specialists at all and now have to undergo all this diagnosis and treatment. It’s mentally traumatizing: I was healthy, and now I have to go to tests, consultations, take medications. There is also a surprise that such a simple disease, an ordinary infection – because, let me remind you – our patients underwent COVID-19 at home, it was usually a light course, at most moderate – it changed life so much, and its consequences are much worse than the disease itself. .

Is it easier to come to terms with them when we are seriously ill?

Please see how patients react after strokes, heart attacks and cancer. It’s hard, but these conditions are also generally considered severe, so it’s kind of normal that their effects are bothersome. But that after a viral infection, which in addition has been a little bit, you now have such problems? This is too much for many people.

Any positive news for these patients?

At some stage, they themselves undergo a kind of private-social reset. So far chased, busy, overworked, they suddenly notice that health is a priceless value, without it it is impossible to function normally, that it is worth slowing down and taking care of yourself. As for the treatment itself, we try to show these patients small successes, for example, when they manage to walk 300 meters without any problems at the beginning, and 400 meters after six weeks of therapy. We emphasize the 100 meters difference, we explain that it is a specific percentage value, it has a positive effect.

What about the rest who do not see these successes?

Here we are moving more towards psychology because we are afraid that these people will develop depression. In a social setting, long covid is a misfortune. And the problem it is can be seen, for example, in the more and more common use of the term.

Soon, it will enter the dictionary and will become a disease entity, because there are more and more patients with its symptoms. Currently, we are also contacted by patients who suffered from COVID-19, for example a year ago and only now feel its consequences, for example in the form of heart or circulation problems. Only today we had a patient here who had COVID-19 lightly in October last year, and in June, six months after the infection, we diagnosed her with a pneumothorax with emphysema. It was necessary to establish drainage, i.e. surgical expansion of the lung. Luckily, the GP remained vigilant, auscultated the patient and referred her for further examinations. Otherwise, her lung would eventually die.

This is not an isolated case – I know from my colleagues that they meet such patients more and more often. There are patients who have a pulmonary embolism a few months after COVID-19 – with no other disease to lead to it – with myositis and weakness so severe that it is impossible to walk 200 meters.

Even the “normal” hypertension that occurs after COVID-19 affects 10-15 percent. sick, untreated can lead to stroke! And we are talking about people aged 40–50 who have been completely healthy so far. Each new symptom up to a year after contracting COVID-19 should encourage us to consult. Some complications may be a threat to our health or life. So even if a few months have passed since the disease, and something bothers us – let’s see a doctor, let’s do some tests.

1. Have you been infected with COVID-19 and are worried about the side effects? Check your health by performing a comprehensive test package for convalescents.

About 10-20 percent. long covid patients fail to help. Why?

These are mainly patients with impaired smell and taste. Sometimes olfactory rehabilitation, when the patient somehow learns to recognize smells anew, brings results, but in some cases we fail. Almost a year passes, and these patients report that they have not actually noticed any major improvement. The brain is an extremely complex organ, made up of millions of cells. These people evidently developed serious disturbances, as if the nerve impulses were not traveling in the path they should. You have to put it all back on track, make the senses harmonize with what your brain tells you. Unfortunately, this cannot be done either surgically or pharmacologically. There are suggestions to treat patients with high-dose vitamins, but so far there is no medical evidence that this really helps. So at the moment we are helpless in the face of this type of ailments. COVID-19 continues to teach us humility.

Information about the «STOP-COVID» program can be found on the website www.stop-covid.pl.

This may interest you:

1. 12 symptoms of “COVID long tail”. You have? Go to the doctor
2. What do convalescents suffer from? The list of symptoms of “long covid” continues to grow
3. What tests should be done after contracting COVID-19?