October 2023 COVID-19 Chronicle

A-   The term « Long COVID Syndrome » has been used for a while, since the end of the year 2020 and it is not surprising to hear about it in public conversations anywhere in the country. Almost 6% of the actual adult population has sequalae from the pandemic with SARS-CoV-2 infection. It does not appear to be a public Health enigma but there has not been any significant progress on its causes, prevention, or treatment in the medical world. It is certainly a national health disaster in which politicians and scientists have played the game to advance their agenda interfering with science and patient care.

B-   The Congress of the United States provided money (1.15 billion over 4 years) to the NIH to lunch the Long COVID Research “RECOVER”. The CDC and Prevention Center promptly added a Registry program which extended through the Veteran’s Affairs. There is little to report to better the situation. Patients suffering from Long COVID feels hopeless while they are looking for help through the healthcare system.

C-   Long COVID treatment remain puzzling in the eyes of the one receiving care. Medical care spending and loss of income have affected all who suffered from the disease as well as from Long COVID. So many are experiencing functional impairment and disability. Its is now well understood that the best way to prevent Long COVID-19 is to avoid getting COVID-19. We are still all at risk for new or recurrent infections essentially when so little precautions are taken toward the disease.

D-    Long COvID-19 is not new. We may think about Myalgic encephalomyelitis, or a post infectious syndrome or chronic fatigue syndrome and think that the term may apply to the same conditions. Researchers have not been unable to find any persistence of the virus or any defects in the immune system, or any microvascular clotting problems due to the syndrome. There may have some obscure sigs like myocarditis or blood clotting, but scientists are still not sure of their significance. It remains difficult to know if the symptoms are due to the severity of the disease or the virus itself.

E-    Myalgic Encephalomyelitis was used to describe the syndrome in the 1950’s, and the World Health Organization (WHO) ten years later entered it in their vocabulary. Over the years the term chronic fatigue syndrome was preferred to any case related to a viral etiology. Many entities were included even Fibromyalgia, Postural Orthostatic tachycardia syndrome. In fact, many believe that the Lon Covid may not be a true entity but represent a spectrum of pathological and even psychological components that can explain the syndrome.

F-     Mayo Researchers found out that patients who were vaccinated prior to contacting the virus, were less likely to experience symptoms like abdominal pain, dizziness, chest pain and shortening of breast. It was published in the Journal of Invective Medicine. It is the first study showing a decrease in symptoms in relation to the vaccine itself in relation to the Long Covid.

G-   Post Acute Infection syndromes (PAIS) may develop after acute viral disease. Infection with SARS -CoV-2 can result in the development of a PAIS known as Long COVID. Individual report unremitting fatigue, post exertional malaise and cognitive dysfunctions.

H-   I just received a little word from Nadim Salomon MD, an AMHE specialist in infectious disease, reminding us about mosquitoes: “All mosquitoes are not the same. Surely. they are mosquitoes, and they go zzzz and fed on blood… Aside this, there are some differences… Anopheles mosquitoes (Malaria) feed on blood between 10 PM and 4 AM… A good net can prevent disease. Aedes mosquitoes (Dengue-Yellow Fever- Chikungunya) are mostly daytime feeders. Aedes mosquitoes feed approximately two hours after sunrise and several hours before sunset. They can also bite at night in specific areas especially when the area is well lit. For them, insect repellents are the best protection. Aedes are prevalent in the urban areas. Culex mosquitoes (West Nile Encephalitis – Japanese Encephalitis) feed during darkness. Anopheles, Aedes and Culex can transmit also the parasite “Wuchereria bancrofti” responsible for the lymphatic filariasis. It was just a reminder for the one who like to venture outside. Indeed, mosquitoes are more than bzzzzzz.

Related: ‘Underwhelming’: NIH trials fail to test meaningful long Covid treatments — after 2.5 years and $1 billion

Maxime Coles MD

Boca Raton FL



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