Fatigue, pain, digestive disorders… the list of symptoms of long Covid, as long as it is varied, makes its detection and treatment difficult. Update on the situation with Dr Jérôme Larché, a long-term Covid referent at ARS Occitanie.
“This is the north face of the pandemic.” Long Covid has affected at least two million people in France in recent years. Four years after the start of the Covid-19 pandemic, French people suffering from post-Covid syndrome (PCS) represent around 10% of infected people, according to figures put forward by the Committee for Monitoring and Anticipation of Health Risks (Covars).
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Dr Jérôme Larché, one of the first doctors in France to take a close interest in long Covid, speaks of a global issue. “Several tens of millions of patients are affected throughout the world with prolonged symptoms,” confides the man who was for a time a referent on the subject with the ARS Occitanie. “We are still seeing people who were infected in the first months of the pandemic and who remain with prolonged, disabling, debilitating symptoms…”
Invasion of the body
Sars-Cov-2 “enters human cells by interacting with its receptor on the cell surface”, according to Covars. It is thus capable of affecting “the nasal cavity, the lungs, the gastrointestinal tract and the eye, as well as the cells lining the capillaries of the central nervous system, the heart, the pancreas and the adrenals”. An invasion of the body which brings together the necessary conditions for the occurrence of a post-infectious syndrome. The committee recalls that PCS is indeed an “organic reality” and not a somatoform disorder – a mental disorder characterized by increased attention to physical symptoms.
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Of the approximately 2 million French patients, “there are very probably several hundred thousand patients who have severe forms. That is to say who have developed some sort of chronic illness linked to post-covid”, explains Jérôme Larché. But quantifying the number of patients has become difficult as the list of symptoms is so long. According to the doctor, there are nearly 200 different ones counted. “Which allows us to say that long Covid is not an organ disease but a systemic disease.”
A countless number of symptoms
After contracting Covid, symptoms can occur even in people who have had mild forms. These symptoms are numerous, varied and can fluctuate over several weeks or months. It becomes extremely difficult in certain cases to establish a direct link with long Covid. “Most patients suffer from asthenia, that is to say extremely significant fatigue”, lists Dr Jérôme Larché, “there are respiratory or cardiological problems and neurological problems and often of a neurocognitive type”. Indeed, some patients have difficulty remembering, concentrating and finding words. In addition, there are also digestive, joint, muscular, skin symptoms… So many symptoms which make the diagnosis “extremely difficult” which becomes a “diagnosis of elimination”.
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For Dr Jérôme Larché, “the challenge was, beyond understanding the disease, to be able to take care of people, try to make diagnoses, try to reduce their symptoms and allow them to resume a minimum of normal life. As a reminder: a person likely to be affected by long Covid meets several criteria. She must have had Covid, documented by a PCR as well as symptoms persisting beyond four to eight weeks. In this case, consultation with the general practitioner should be a reflex.