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

Abstract

Fifty-five patients who suffered from COVID-19, who were still very ill after several months, with extreme fatigue, effort exhaustion, brain fog, anomia, memory disorder, anosmia, dysgeusia, and other multi-systemic health problems have been followed in a family practice setting between May 2021 and July 2022. Data extracted from the medical records of the 55 patients (40 women), mean age 42.4 (12 to 79 years), and a qualitative study of 6 of them using a semi-open-ended questionnaire allowed to highlight the clinical picture described by WHO as post-acute COVID-19 syndrome (PACS) also known as long COVID. We used brain single-photon emission computed tomography (SPECT-CT) in thirty-two patients with a high severity index and a highly impaired functional status, demonstrating vascular encephalopathy in twenty nine patients and supporting the hypothesis of a persistent cerebral vascular flow disorder in post COVID-19 condition. The patients will benefit from the consortium COVID Human Genetic Effort (covidhge.com) to explore the genetic and immunological basis of their problem, as 23/55 cases don’t have immunological certainty of a COVID-19 infection. There is no known verified treatment. Analyzing the data from the first 52 patients, three categories of patients emerged over time: 16 patients made a full recovery after 6–8 months, 15 patients were able to return to life and work after 12–18 months with some sequelae, both groups being considered cured. In the third group, 21 patients are still very ill and unable to resume their work and life after 18 months. The biopsychosocial consequences on patients’ lives are severe and family doctors are left out in the cold. It is necessary to test the reproducibility of this description, conducted on a small number of patients. Nevertheless, identifying, monitoring and supporting these patients is a necessity in family medicine.

Alzheimer's early detection in post-acute COVID-19 syndrome: a systematic review and expert consensus on preclinical assessments

“…Olfaction was impacted in all but two studies (Bertuccelli et al, 2022 ; Jamoulle et al, 2022 ). Direct involvement included a persistent dysosmia in 11–57.6% of PACS patients (Ahmad et al, 2021 ; Davis et al, 2021 ; Parker et al, 2021 ; Silva Andrade et al, 2021 ; Girón Pérez et al, 2022 ; Michelutti et al, 2022 ; Tan et al, 2022 ) related to an anosmia (Ahmad et al, 2021 ; Fernández-de-Las-Peñas et al, 2021 ; Malik et al, 2022 ; Mendes Paranhos et al, 2022 ; Michelutti et al, 2022 ; Premraj et al, 2022 ; Tan et al, 2022 ), explicitly reported in 12.8% (Deer et al, 2021 ), 19.3–21.4% (Ahmad et al, 2021 ), 32.2% (Michelutti et al, 2022 ), 44% (Ser et al, 2022 ), or 55.9% (Vandersteen et al, 2021 ) of cases or hyposmia (Mendes Paranhos et al, 2022 ; Michelutti et al, 2022 ) explicitly reported in 14.7% (Vandersteen et al, 2021 ), 15.3% (Deer et al, 2021 ), or 33.1% (Michelutti et al, 2022 )of cases.…”

“…When it was reported (90%; n = 18) population size ranged from 34 (Vandersteen et al, 2021 ) to 178 496 (Parker et al, 2021 ) people with an average of 24 031 ± 54,301 patients in reviews papers and 638 ± 1,379 in cohort observational studies papers. Patients' ethnic groups were reported to be from all over the world apart from five (38.5%) reviews (Deer et al, 2021 ; Bertuccelli et al, 2022 ; De Luca et al, 2022a ; Jamoulle et al, 2022 ; Premraj et al, 2022 ) and five (71.4%) observational studies (Vandersteen et al, 2021 ; Girón Pérez et al, 2022 ; Mendes Paranhos et al, 2022 ; Michelutti et al, 2022 ; Ser et al, 2022 ) where patients where reported to come from only one country depending on teams origins. When it was clearly reported in 50% of studies ( n = 10), the average patient ages were 40- and 50-years-old.…”

Physical Activity in Long COVID: A Comparative Study of Exercise Rehabilitation Benefits in Patients with Long COVID, Coronary Artery Disease and Fibromyalgia

“…Autonomic dysfunction is a major hypothesis of the symptom's persistency in long COVID [7,65,66]. A chronotropic incompetence or inadequate HR recovery were suggested to explain autonomic dysfunction throughout CPET values [17,67].…”

Blood transcriptomics reveal persistent SARS-CoV-2 RNA and candidate biomarkers in Long COVID patients

“…Long COVID patients were diagnosed according to WHO criteria and followed up for up to 39 months after acute COVID 2 . Complete clinical history was obtained using electronic health records and validated clinical scales (Duke Severity of Illness, Dartmouth Coop charts, see Supplementary Data) were used to quantify patient evolution 2 .…”

“…Long COVID patients were diagnosed according to WHO criteria and followed up for up to 39 months after acute COVID 2 . Complete clinical history was obtained using electronic health records and validated clinical scales (Duke Severity of Illness, Dartmouth Coop charts, see Supplementary Data) were used to quantify patient evolution 2 . Whole blood samples were obtained from 48 Long COVID patients and 12 controls from the same general practice, matched for age, sex, time since acute COVID-19 and severity (47/48 patients and 12/12 mild-moderate, non-hospitalized), vaccination status and comorbidities (Supplementary Table 1) and analyzed by digital transcriptomic analysis (nCounter, Nanostring), as previously established for critical COVID-19 3 .…”