what consequences for survivors of severe forms?

Patients with Covid-19, who have gone into intensive care or who have severe forms, present major complications to the disease, which can affect all functions of the body. Are these sometimes impressive after-effects reversible? What hope for a return to normal for these patients who have been intubated, sometimes for several weeks?

Wednesday April 8, 30,375 people were hospitalized in France for an infection with coronavirus, including 7,148 serious cases in intensive care. Fortunately, the vast majority of these patients will wake up, sometimes after several weeks of coma artificial. For these, as well as for all patients affected by severe forms of Covid-19, the return to normal will however prove to be long and difficult. It is still far too early to know exactly what sequelae long-term caused by the disease, but several studies have recently highlighted worrying signs.

Intubation and artificial coma: major risks of complications

First of all, a long period spent under intubation itself causes complications. " Being intubated, ventilated, sedated, causes the body to hyper-metabolize, which means that we consume too much calories, so the muscles melt, details David Mispelaere, pneumo-oncologist at the private hospital of Cesson-Sévigné (Ille-et-Vilaine), at the site France info. We can therefore have difficulty returning to walking " There is also a risk ofrenal failure and of thrombosis vascular due to immobilization.

A deviant immune response that leads to general inflammation

Most of the sequelae caused by the disease are not due to virus himself but at iinflammation caused by immune response too strong, which can damage lungs, but also the heart, kidneys, the liver where the brain. The syndrome acute respiratory distress (ARDS), one of the symptoms the most serious of the Covid-19, can therefore cause fibrosis pulmonary, bad healing connective tissue of the lungs which leads to a decrease in breathing capacity. This would affect approximately 10% of patients with ARDS.

Others organs risk toast. A study published in April in the journal JAMA thus evokes an infiltration of the myocardium by inflammatory cells that can cause myocarditis. Another study suggests the virus may affect the central nervous system, with neurological manifestations such as loss of consciousness and acute cerebrovascular disorders. " We have noticed that many patients suffer from delusions during their resuscitation "Confirms Wesley Ely, a pulmonologist at the Vanderbilt University Medical Center (United States) which is expressed in Science. Disorders may, however, arise from the sedatives administered or from the lack of oxygenation of the brain which results in the death of neurons.

A long rehabilitation, but a hope of total remission

Finally, there are the psychological consequences, which are much more difficult to assess. A study conducted with patients with SARS in 2003 shows that more than one in three patients show signs of depression, anxiety or symptoms post-traumatic more than a year after the illness. Are all these after-effects only transient or are they final?

" What we know about the influenza, in the most severe cases, it takes 6 to 9 months to have normal breathing tests "Explains on BFMTV Jean-Paul Mira, head of the intensive care unit at Cochin hospital. But the doctor is optimistic: " Whatever severity of lung damage we see today in our patients when they go out, they really have an extremely high probability of returning to a normal life " Even if it involves a long period of walking and breathing rehabilitation.

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