Until now we knew, in general terms, that serious cases of covid-19 affected mainly older men with underlying conditions, and that younger patients generally did not require hospital admission. But what about patients with symptoms of covid-19 persisting for months? This group, which could be made up of a third of the mild or moderate patients, does not appear in the official records and has been struggling for some time to get answers and adequate care. That is why, a few days after the World Health Organisation (WHO) recognised its existence and demanded more studies on the subject, the survey published this Wednesday by the Spanish Society of General Practitioners and Family (SEMG) gains special significance. The results, drawn from the responses of 1,834 patients with persistent covid-19, indicate that 79% of those affected are women with an average age of 43. And the median duration of the symptoms they suffer is already 185 days, that is, more than half a year.
The survey, conducted among patients infected during the first wave of the pandemic, was carried out between 13 July and 14 October, now one month ago, so that in many cases the disease has already gone beyond six months. This is highlighted by the group of affected people in Catalonia -created as a result of an article in ARA and which already has more than a thousand members - and those in the rest of Spain, who have been the basis for the study. The survey, which reveals that most of those persistently affected are in both the Community of Madrid (35%) and Catalonia (30%) -the territories most affected by the virus-, indicates that 50% of the patients surveyed (917) are between 36 and 50 years old. Young people - there are also minors affected - would fit in with the fact that their pathologies are mild or moderate, but why most of them are women continues to be unknown.
"To answer this question we still have a lot to learn. There could be many circumstances," Dr. Pilar Rodriguez Ledo, head of research at the SEMG, answered at a telematic press conference, although she pointed out that it could have to do with the different immune or inflammatory response that women have with respect to men. Rodriguez Ledo has pointed out that the prolongation of the symptoms could be due to the fact that covid-19 persists in areas of the organism that have not yet been identified or to a strong inflammatory reaction to the virus, with an immunological reaction and multiorganic affectation. Also, 78% of the respondents were tested for the virus (73% of whom were positive) and, although many were not tested at all - at the beginning of the pandemic those who did not require hospital admission were not tested - SEMG sees no significant difference between the evolution of the two.
This was also confirmed by the taskforce that the Health Department set up a few months ago with the group of people affected by long covid-19, which identified around thirty possible symptoms of this type of patient. The survey published on Wednesday raises the figure to 200, and points out that each patient suffers an average of 36. The most common are tiredness (95.9%), general discomfort (95.5%), headache (86.5%) and low mood (86.2%), as well as muscle pain (82.8%), shortness of breath (79.3%), joint pain (79%) and difficulty concentrating or attention deficit (78.2%). These neurological symptoms are those that make the day-to-day life of those affected more difficult.
The general symptomatology affects 95% of patients - 50% have seven areas of the body affected - whilst the neurological alterations affect 86% of the total. Moreover, 72.52% have problems working outside the home, 74.65% find it difficult or impossible to spend time with friends and other people, 70.12% have problems taking care of daily family obligations and 30.43% even have to make an effort for personal hygiene. "We are faced every day with an unknown, unrecognised and very disabling illness," lamented Anna Kemp, a member of the groups of people affected in the State and who has been ill since 18 March, at the press conference. "It has a serious impact on our lives, which are totally shrinking, and we have a lot of difficulties in following our daily lives," she added.
The tip of the iceberg
The main demand of the patients, gathered by the SEMG, is that more studies are done on these cases to make a clear diagnosis and guarantee adequate treatment. "The symptoms do not improve and many of us feel even worse than when we started," warns Kemp, who makes it clear that they have felt "invisible" and "forgotten" by the institutions, which do not count them in the statistics. "Long covid is a big problem and could become the dregs of the pandemic... And it could become a serious state problem, since we are young people at the productive peak of our lives," she concluded. Dr Rodriguez Ledo, in fact, predicts that this type of illness could increase with the second wave of the pandemic. "Has anything changed so that there will be different results?" she asked rhetorically, adding that just as serious cases are increasing, the persistence of symptoms is also likely to grow.