Status: 02/26/2022 00:47 a.m
It was previously thought that long covid occurred primarily in older patients with pre-existing conditions. But younger women seem to be particularly affected. There are different explanations for the causes.
In fact, she was always very sporty. Almost every day she trained for several hours in the gym. Today she usually has to lie down as soon as she comes home from a short errand. “It accompanies me every day, I’m exhausted every day,” says Stephanie Rheinsberg from Hemmingen near Stuttgart. “My stress limit is much lower, my body no longer reacts as usual.” Stephanie Rheinsberg suffers from Long Covid. Her voice is weak and short of breath, the words sound like a breathy whisper.
Even in a relaxed situation, her heart rate is 120. She did not have a severe course of the Covid 19 infection. Only mild flu-like symptoms and shortness of breath. She did not have to go to the hospital, had no fever and no previous illnesses, reports the woman, who suffers from persistent symptoms despite her young age. “I came into this phase of my life completely unprepared,” she says. “I wasn’t expecting Long Covid, especially not at 23.”
Surprise for medical research
Case histories like this initially came as a surprise to medical research as well. “You would not expect patients who did not have to go to the hospital, who had a mild course and who survived the infection well, to get Long Covid,” explains Christine Falk, President of the German Society for Immunology.
So far, it has been assumed that older patients in particular with previous illnesses such as asthma have a high risk of long Covid – especially after severe corona courses. Reliable data on how often Long Covid occurs is not yet available. It is estimated that every tenth infected person will not get rid of the symptoms.
“This seems to be the case even more frequently in the 30s to mid-50s age group. And women are particularly affected,” reports Falk. This is based on previous experiences in the clinics. Symptoms such as exhaustion, shortness of breath, lack of concentration and anxiety are also typical of these young patients.
Cause not yet clarified
There are various explanations for the cause of Long Covid. Some patients have permanent organ damage as a result of their corona infection. Others may still have some virus or viral components in their body, which the body responds to by causing inflammation. Or there is a persistent inflammatory response even though the virus is no longer present, similar to autoimmune diseases.
Falk considers the latter explanation to be particularly likely in young long-Covid patients with a mild course of the infection. After all, in these cases it can be assumed that the viral load was not very high during the infection either.
Symptom treatment as the only way
However, since the actual cause is still unclear, the treatment of Long Covid is also difficult, says Jördis Frommhold, chief physician for respiratory diseases at the Median Clinic in Heiligendamm. “At the moment this is a chronic, incurable disease for us. But we can treat the symptoms,” she says. This applies to both young and older patients. She has treated around 3000 people with Long Covid since the outbreak of the pandemic. At the moment, almost all of the 120 beds are occupied by people who were previously infected with corona.
“In our experience, these are often the top performers in our society. Those who have particularly high expectations of themselves,” reports the doctor. It is particularly difficult for these patients to accept a lower stress threshold. That is why this is one of the elements of the therapy: mindfulness training and light physical activity without going to the new personal limits. They call this “pacing”. In addition, breathing training, because the respiratory muscles are often tense due to the disease.
Therapy with pure oxygen
Frommhold is testing a special treatment for patients with cognitive impairments. “One suspects that in such cases, small blood vessels in the brain could be inflamed and the oxygen supply impaired as a result,” she explains. In a hyperbaric chamber, these patients regularly breathe in pure oxygen. The hope behind this is that the oxygen can pass more easily into the nerve cells under higher pressure. How well this therapy actually helps is currently being investigated in a study.
Most of the long-Covid patients who are currently being treated were infected with the first virus variants and were not yet vaccinated. “It will now be interesting to see how high the proportion of long-Covid cases will be among those infected in the future, what changes the new virus variants and the vaccinations have brought about,” says immunologist Falk.
Finally back to the old life
Stephanie Rheinsberg was already infected in February 2021. And she wasn’t vaccinated at the time either. Because of Long Covid, she can no longer work in her job as a paint laboratory assistant. She couldn’t even stand the smoke of a blown out candle. “My greatest wish is to finally return to my old life,” she says. “And that at some point there will be a cure for us long-Covid patients.”