Study says ‘Long Covid’ is psychological and controversial in France

Is persistent Covid mainly psychological? The suggestion made by a recent study in a Paris hospital angered patients and received numerous scientific criticisms for the methodology used, highlighting the numerous mysteries that still surround this disease.

The study published in the Journal of the American Medical Association (JAMA), one of the world’s leading medical journals, says that these symptoms “can often be associated with a belief of being infected” with the virus. In other words, persistent Covid would be a psychological problem, not a physical aftermath of contagion.

The study, coordinated by Cédric Lemogne, head of the psychiatric service at the Hôtel-Dieu hospital in Paris, focused on nearly 27,000 people being treated for months by French public health to study the multiple effects of Covid.

The patients answered questionnaires in which they explained if they had already been ill and if they still perceived the symptoms. To find out if they had really become ill, these people were subjected to serological tests that make it possible to later confirm whether the person has transmitted the virus.

Most of those investigated did not have Covid-19 antibodies and said they had not been ill. Of about 1,000 who tested positive, only 450 believed they had contracted the virus. But about 460 people with a negative serological test result believed they had transmitted the disease. And by comparing the responses of all these groups, the study found that people who believed they had the disease, regardless of the test result, were more likely to report long-lasting symptoms.

“A medical evaluation of these patients may be needed to ensure that symptoms of another disease are not being misattributed to persistent Covid,” the authors write.

The French associations of patients with the disease accused the researchers of denying the reality of their problem by giving an exclusively psychological explanation, and some even called for the study’s removal from the file.

The report leaves room for interpretations “stigmatizing, dangerous and harmful” for patients, said the French association AprèsJ20 on Thursday (11). Criticism also came from the scientific field, with several researchers being skeptical of the methodology used in the study at the Hôtel-Dieu hospital.

“A serological test is not reliable as a marker of previous infection,” said British virologist Jeremy Rossman, cited by the Science Media Center. This is the main objection to this study. A serologic test is more likely to miss a real infection than to find one by mistake, which distorts the results.

The authors of the scientific text, quoted in the journal Le Monde, said their study showed an association between a real infection and a long-lasting symptom: loss of smell.

According to them, this is proof that the method allows distinguishing which symptoms of persistent Covid are actually associated with an infection. This disease continues to be vaguely defined and the controversy shows the difficulties of research on the subject.

The controversial study includes more than a dozen symptoms, ranging from fatigue and dizziness to muscle pain or attention deficit disorder.

“We have to recognize that vague symptoms lead to vague diagnoses,” says American physician Perry Wilson, a professor at Yale. “Without stricter criteria, many people are at risk of being labeled ‘Persistent Covid’ when that’s not what they suffer,” he insists.

Even so, the doctor warns of the danger that this study will be “used to argue that this [sintomas persistentes] don’t be a real problem”.

_{With information from AFP}