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Covid-19: persistent symptoms post Covid-19

After hearing from specialists and patient cohort coordinators and a thorough review of the literature, the HCSP lists the persistent symptoms that can be observed at a distance from a documented SARS-CoV-2 infection.

The most frequently identified symptoms are general symptoms (asthenia in particular), but also cardio-respiratory, ENT, neurological and psychological symptoms. While the HCSP is aware of the impact of the occurrence of a Covid-19, it stresses that there is still insufficient knowledge to answer the many questions raised by the persistence of these symptoms.

There are many retrospective studies but few prospective cohorts, and even fewer comparative prospective cohorts with sufficient hindsight to be able to integrate these symptoms into a precise nosological framework, as the pathophysiology may explain their occurrence. These large-scale studies are pending.

The HCSP recommends the following for the management of patients presenting persistent symptoms after a Covid-19:

  • the identification of multidisciplinary structures for the management and integration of these people into research procedures. Access to these structures in conjunction with the practitioners treating these patients must be facilitated;
  • that multidisciplinary consultations include, as required, an appropriate assessment to look for dysautonomia, maladjustment to exercise, respiratory and cardiac complications, sarcopenia, neuropsychological disorders and nutritional status, particularly for the eldest populations and/or those in post-resuscitation;
  • the implementation of cardio-respiratory rehabilitation programmes, re-education aimed at strengthening muscles, olfactory re-education, correction of nutritional disorders, cognitive-behavioural therapy (CBT), etc.
  • Psychological care for any Covid-19 patient who requires it, and possibly for his or her family;
  • the reinforcement of the coordination of research programmes, the coordinated continuation of national prospective cohorts, possibly linked to European cohorts, which have systematically and prospectively included patients followed up after a Covid-19 and the collection and sharing of data by the ANRS - MIE in a centralised national database.

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