University of São Paulo: Half of people diagnosed with covid-19 suffer from sequelae

A study developed by the Oswaldo Cruz Foundation (Fiocruz) indicates that half of the people who had covid-19 were left with sequelae of the disease. In addition, the Hospital das Clínicas, Faculty of Medicine, USP monitors patients after treatment. Professor Carlos Roberto Carvalho, from the USP School of Medicine and director of the Pulmonology Division of the Instituto do Coração (Incor) at HC, talks about the long covid in an interview with Jornal da USP in Ar 1st Edition .

Hospital das Clínicas had 700 beds to treat the coronavirus in the first half of 2020, according to Carvalho: “The entire hospital was closed to only care for covid patients. We had 400 infirmary beds for slightly less severe cases and 300 ICU beds to assist the most serious patients. Between March and August we stayed with this hospital exclusively for this, more than 3,500 patients were treated during this period and those patients who recovered were invited to be followed up for up to four years”.

Seven hundred and fifty people agreed to participate in the study, which brings together a group of people who share a common experience or condition — the cohort study. “We did the first evaluation between six months and a year, now, we are doing the evaluation between 18 and 24 months of this same cohort of patients. It is very important for us to understand, as it is a new disease, what kind of repercussion it will have on the body. We learned how it attacks our body in the acute phase in the first few weeks and now we are following up to find out what happens in the chronic phase”, comments the professor.

Recurring implications
Carvalho reports the main implications found in the follow-up: “From a neurological and psychiatric point of view, we have seen a high frequency of situations characterized as anxiety, depression, sleep disorders — both drowsiness and insomnia — and cognition alterations. Many individuals cannot, for example, read a book or even read a newspaper, they start to read and disperse, they do not follow and do not fix what they have read previously. From a general point of view, the most frequent complaints can be summarized as weakness of the body, fatigue, tiredness and shortness of breath. These are the symptoms that people most often refer to when they are interviewed in these post-covid recovery periods.”

The professor points to the attempt to unite groups of patients to determine if there are clusters — groups of symptoms, groups of clinical situations — and to try to determine patterns that can guide treatments. “We have many millions of recoveries, unfortunately also many millions of deaths, and these many millions of recoveries are candidates to suffer from these more chronic problems. So, it is impossible to treat each of them individually, for a health system of a municipality, a state and a country, this is unfeasible”, he says.

Some symptoms are amenable to intervention. Carvalho says that some of these fatigues and weaknesses are muscle strength problems. “You have to guide a rehabilitation program, which involves not only exercising, but also dietary and nutritional guidance. Some of these situations are lung inflammations, which tend to become chronic; if you get it in a more inflammatory phase, you can still act, if the lung heals, evolves into fibrosis, then there is no more treatment. If the individual develops some kind of ‘beating’, tachycardia, cardiac arrhythmia, he needs to be diagnosed, so that intervention can be made to prevent this arrhythmia from interfering with the functioning of the heart, and so on.”