At the beginning of the pandemic, the pulmonary symptoms caused by Covid-19 were the main focus of concern for the disease. But almost two years after the arrival of the new coronavirus in Brazil, science has already determined that the damage goes far beyond that: Sars-CoV-2 causes a systemic disease that can affect different areas of the body simultaneously.
“After the initial phase of the virus cycle, some symptoms remain for certain patients, especially neuropsychiatric patients”, points out Evaldo Stanislau, an infectious disease specialist at Hospital das Clínicas and a member of the board of SPI (Sociedade Paulista de Infectologia).
Among them, explains the doctor, chronic fatigue, accompanied by slow thinking, memory failures and a feeling of inability to move the body due to extreme tiredness has been one of the ailments that accompany those affected by the disease — and it seems to be even more frequent with the wave caused by the omicron variant.
Why do some feel post-Covid fatigue?
Nobody knows for sure. As with many aspects of Covid-19, the exact reason is still a mystery, but there are theories that indicate possibilities.
“Some lines of research point out that neurological symptoms are caused by the body’s own reaction in response to Covid-19, creating a trigger to trigger reactive inflammatory processes”, says Stanislau.
This overreaction of the immune system, called a cytokine storm (the emission of signals between cells during the triggering of immune responses) occurs when the individual’s own body creates a disproportionate defense mechanism to fight the various cells already infected by Sars- CoV-2. The systemic inflammation caused in this process is indicated as one of the possible reasons for sequelae such as fatigue, memory loss and lack of smell and taste.
Another hypothesis, says Stanislau, is that this process of chronic inflammation is caused by very small amounts of residual virus.
Silent hypoxia (lack of oxygen to the brain that does not cause strong signals at first) is also thought to be a likely cause of serious damage. In addition, there is the possibility – still being studied – that brain cells are directly harmed by the virus.
Can the fatigue caused by Covid be reversed?
The infectologist explains that there may be different stages of the same phenomenon. “From what we have observed of the action of other viruses and infectious diseases that trigger similar conditions, when it lasts less than eight weeks, the problem is usually reversed naturally.”
For a smaller number, the symptom of lack of energy can last from six months to a year – and it is not yet known how the damage caused by the disease will affect in the long term.
“This has a very large impact on the production chain, both for those who work with intellectual activities and for those who use physical skills, since tiredness does not allow the person to carry out their activities in the same way as before”, says Stanislau.
Who can suffer from post-Covid fatigue?
“There is no evidence that post-Covid extreme fatigue or other symptoms associated with long-term Covid are associated with other patient comorbidities, viral load or DNA markers”, says the infectologist.
“That’s why we have to work with the possibility that everyone has the potential to suffer from these sequelae — and to intentionally get infected or fail to protect yourself is irresponsible.”
A group that is more likely to suffer sequelae, however, is patients who have been hospitalized for a long time. In these cases, there are usually changes in the joints, skin and respiratory system, caused by, in addition to the effect of the disease, the lack of direct feeding (for intubated people, tubes are used), and long periods without movement.
Treatment
“As the exact cause is not known, the recommendation is non-specific, only for the management of symptoms, which can include, for example, a cough syrup and even the prescription of an antibiotic, if the disease caused a secondary infection such as sinusitis”, indicates Jordana Machado Araujo, an infectious disease specialist at Hospital Japonês Santa Cruz, in São Paulo.
Physiotherapy, rest and psychological support can also be complementary treatments.
“In general, patients expect that after ten days of isolation, life will return to normal and this does not happen for everyone. Araujo.
The most important thing, in the opinion of experts, is that the person informs himself, knows that this exists and that he is not the only one affected.
“People shouldn’t feel guilty about their symptoms and they need to know they’re not the only ones going through it. There’s a certain shame in admitting a symptom like tiredness, people want to show they’re okay. But it’s okay not to be okay. message is: ‘Be calm and seek help'”, recommends the SPI doctor.
Other common symptoms of long covid
In addition to extreme tiredness, doctors explain that the symptoms below can also indicate that someone is suffering from “Long Covid”:
- Insomnia
- Dizziness
- Changes in smell and taste
- Mood changes
- depression and anxiety
- Insomnia
- Muscle and joint pain
- residual cough
- Forgetfulness
- “Soft body” feeling
If the signs persist for an extended period, it is worth investigating with a general practitioner — or specialist, depending on whether it is a specific problem — if there are other causes.
“It is interesting to look for someone who has experience in the area to know what is important to investigate, and what is common post-Covid, so as not to alarm the patient unnecessarily”, says doctor Jordana Araújo.
Read more about Covid Long:
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