Descriptive and Narrative Study of Long Covid Cases in General Practice and Diagnostic Value of Single Photon Emission Computed Tomography (SPECT scan)

Abstract

The issue of Long Covid, its diagnosis and therapeutic approach are discussed here in detail. The Long Covid is described on the basis of a review of the literature and also on the basis of clinical experience in general practice. The main characteristics of thirty four cases (twenty five women) of Long Covid encountered in 2021 and early 2022 are outlined. The experience of six of them is reported on the basis of notes from their medical records. These six patients were interviewed and each was asked to reread and correct the texts concerning them. This is therefore a descriptive study based on clinical and narrative experience, verified by the patients. Long Covid, the first disease in the history of medicine to be described first by patients themselves on social networks, is not yet precisely defined and the multi-systemic symptoms may be non-specific or vary according to the organs affected. Diagnosis is based on careful listening to the patients history. Previously unknown irrepressible fatigue, brain fog, working memory disorders with possible anomia, anosmia, dysgeusia or other muli-systemic symptoms occurring after an acute Covid are varying characteristics of Long Covid. Biological evidence of Covid is missing in fourteen patients as PCRs may have been not done or came back negative in the acute phase of the disease. Anti-SARS-CoV-2 antibodies are not always present or are indistinguishable from post-vaccine antibodies. In fourteen severe cases presented, Single Photon Emission Computed Tomography (SPECT) after intravenous administration of Technetium-99m (Tc-99m HM-PAO) were able to demonstrate a disorder of cerebral perfusion. Two follow-up brain SPECT at three months showed significant improvement. Further genetic and immunologic study is ongoing for all patient with the help of the international consortium COVID Human Genetic Effort. A patient who presents after a Covid with medically unexplained symptoms may well be a Long Covid. Despite some interesting hypothesis, there is no known specific treatment. Neurocognitive revalidation and physiotherapy may help those patients who need long-term empathic support to cope with their condition.

Exploring Long Covid: An Unexpected Research Journey in Family Medicine Leading to Translational Research

“…The research pathway can be visualized in a poster online. By following the arrows on the poster, the reader can follow the development of the research step by step, and understand the central role of the bibliography when a field is unknown [6].…”

Follow-Up of a Cohort of Patients with Post-Acute COVID-19 Syndrome in a Belgian Family Practice

“…In May 2021, in a fee for service group practice of two family doctors, serving about 2500 patients in a deprived area in the city of Charleroi, Belgium, taking into account an increasing number of patients with unexplained symptoms after being sick with COVID-19, a data collection was initiated on thirty-two patients of the practice. After the publication of a first research report [39] and its dissemination on social networks, twenty-four patients from other treating physicians joined the cohort. In June 2022, a standardized follow-up form has been designed for patients with clinical signs of PACS met in the daily busy practice of the two practitioners (MJ & AZ).…”

“…Some of the characteristic features are underlined and highlighted here by relevant SPECT-CT images. Other cases are described in the clinical research report [39].…”

Reviewing fair subject selection considerations for the unique case of post sequelae COVID-19 translational studies

“…Studies use different terms for similar symptoms and cover very different timelines ranging from two weeks after onset of symptoms to more than 6 months [61]. Anti-SARS-CoV-2 antibodies are not always present or look identical to post-vaccination antibodies, leaving little evidence to be tested or clear diagnostic measures [62]. Although digital epidemiology methods seek common, long-lasting cytokine signatures that may facilitate diagnostic criteria [63], this novel approach is still at a preliminary stage.…”