The expected tsunami in the health system

After five successive waves of COVID-19, a tsunami now awaits Quebec with the thousands of people who remain mortgaged by the tenacious symptoms of their infection.

Long COVID could become a new chronic disease. And several experts fear that these patients will become forgotten by the pandemic.

“This is the big problem that we will have to deal with, insists the D Alain Piché. Even if it is not fatal, these people suffer, and some for 24 months”.

Commonly referred to as long COVID, this disease occurs when symptoms, which cannot be explained by any other diagnosis, persist beyond three months after infection, according to the World Health Organization.

Dr. Piché, director of the post-COVID clinic in Sherbrooke, witnesses the ravages of the disease, while doctors are still powerless. To date, no recognized treatment has succeeded in curing patients.

“People are no longer functional at all, no longer able to work, to carry out their daily activities. It’s extremely demoralizing for them, because they see zero improvement and we don’t have much to offer them,” he explains.

Unknown patients

According to experts, 10 to 30% of people infected with COVID-19 are at risk of developing symptoms that persist for months, especially those affected in the first waves.

In Quebec, we still don’t know exactly how many suffer from it, because no one keeps track of it. Even more worrying, children are not spared either.

With three million Quebecers infected in recent months by the Omicron variant, the threat of seeing the number of long-term COVID cases explode is very real.

“[Les patients] of the Omicron wave, we begin to see them. There are fewer, but there are. It’s starting to come in,” says Dr. Thao Huynh, leading a study on long COVID at the Research Institute of the McGill University Health Center (MUHC).

Vaccination appears to reduce the risk of persistent symptoms, she says. Several patients have reported Newspaper having gone through an ‘uphill battle’ to obtain a diagnosis as well as a minimum of care.

“You have to run right and left to get access to specialists. Some do basic examinations and, not seeing the sequelae on the scansthey tell us it’s anxiety or in our head”, rages Geneviève Dubé, 40 years old.

The ex-marathoner has been suffering from symptoms for more than 22 months after contracting the virus while working in a CHSLD.

“It’s difficult to organize health services when you don’t know the extent of the situation. But we will have to take an interest in it at some point, ”drops Dr. Alain Piché. Moreover, Quebec is slow to announce its plan.

Because other countries already have a head start. In Finland, a minister has recognized long COVID as the next chronic disease of the century. In the UK, a quarter of employers say it is already a leading cause of absenteeism at work.

Dr. Huynh worries about the patients she sees.

“I don’t like to say it, but it’s like an accelerated aging process,” she remarks. They look older, physically and mentally.”

Accelerated aging

Because other countries already have a head start. In Finland, a minister has recognized long COVID as the next chronic disease of the century. In the UK, a quarter of employers say it is already a leading cause of absenteeism at work.

Leading a study at the McGill University Health Center (MUHC), Dr. Thao Huynh worries about the patients she follows. “I don’t like to say it, but it’s like an accelerated aging process,” she remarks. They look older, physically and mentally. »

50 symptoms

Suffering from just one of the 50 most common persistent symptoms after a COVID-19 infection can quickly become very disabling for a patient, says Spanish researcher Sonia Villapol, based in Houston, Texas.

She co-authored in the scientific journal Nature an analysis of 15 studies involving nearly 50,000 patients around the world still presenting with symptoms related to COVID-19.

“It is very debilitating and serious. Imagine, some have 20 symptoms at the same time”, she says, illustrating the extent of the weight of this disease.

Symptoms that persist

A review of studies conducted around the world on patients who have contracted COVID-19 has enabled researchers to count around fifty of the most common symptoms that persist in patients for months after infection. Here is the count published by the scientific journal Nature.

Children seem to be affected by long-term COVID in smaller numbers and would have fewer permanent sequelae, according to a pediatrician at Sainte-Justine hospital.

“We do not know the percentage of children who have contracted the virus who will then develop long COVID, but it would be lower than in adults”, reports Dr. Thanh Diem Nguyen, pulmonologist at the post-COVID clinic of CHU Sainte- Justine.

A British study published in February revealed that 1% of children aged 5 to 11 suffered from symptoms 12 weeks after infection and 2.7% of adolescents, aged 11 and 18.

Fatigue, shortness of breath, memory and concentration problems, mental fog: the symptoms that persist are essentially the same as in adults, specifies Dr. Nguyen.

“Virtually everyone we see at the clinic had never had any health problems before contracting COVID,” she notes.

They recover better

The good news is that children seem to recover faster: “In the majority, we see a marked improvement in a few months. But there is still a minority who have had symptoms for more than 18 months,” says the pediatrician.

And the pulmonary function tests of children show less post-COVID damage, unlike adults in whom we more often find visible sequelae on the pulmonary tissues, indicates the doctor.

“We observe rather a deconditioning, that is to say that their muscles are not in the right conditions to exercise”, explains Thanh Diem Nguyen.

Experts are working tirelessly to understand the causes.

Axiety and sadness

Long COVID in young people can be just as debilitating as in adults, writes in an editorial published last month in the scientific journal Nature.

We ask that studies focus more on the case of children.

For this reason, Dr. Thanh Diem Nguyen also suggests psychological follow-up to toddlers who end up in her office at Sainte-Justine Hospital, as many develop anxiety, sadness and worries about their situation. .