During a visit by a post-Covid patient in the pneumology department of Prof. Alain Didier, at the Toulouse University Hospital.

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Tristan Reynaud / SIPA

  • While the second wave of Covid-19 is hitting France hard, patients from the first wave still have sequelae.

  • A Toulouse team from the pneumology department of the Toulouse University Hospital observed the presence of sequelae four months later in 30 to 40% of patients severely affected during the first wave.

  • Sequelae that are reminiscent of the symptoms of interstitial lung diseases, mostly due to environmental and genetic factors.

At the Larrey hospital in Toulouse, usually at this time of year, the pneumology service is preparing to receive victims of the seasonal flu.

In the corridors, when the doors open, we can hear the patients coughing, but the majority of them are infected with Covid-19.

Today, of the sixty beds in this Toulouse CHU department, nearly half are occupied by victims of the coronavirus.

But beyond the patients now hospitalized, doctors and nurses continue to receive those who were affected during the first wave.

Because some of them, several months later, continue to have consequences according to Professor Alain Didier, head of department.

80 patients followed over four months

He was able to follow 80 patients who had suffered from a severe form in March and April, to the point of being treated either by intensive care or by intensive care for severe pneumonia.

“Four months later, they describe persistent asthenia [severe fatigue], they still have cough or chest pressure.

In 30 to 40% of cases, we could observe an anomaly on the scanner, with the persistence of an opacity, a fibrosing aspect without knowing if this is reversible or not for the moment, once in three we have objective things ”, indicates the doctor, whose study is to appear on the subject.

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- Toulouse University Hospital (@CHUdeToulouse) October 3, 2020

All these "long Covid" have been the subject of extensive tests, breath measurements, some patients sometimes having difficulty breathing without this giving rise to tangible results on the radios.

For those who have visible physical sequelae of Covid-19, "it looks like the interstitial lung diseases that we know, such as fibrosis, which are rather rare diseases, which are not due to a virus but to the environment. or genetics, ”explains Alain Didier.

Relapse of some patients

For the latter, further studies are needed to see if these “long Covid” patients have genes that predispose them to more serious forms.

In the meantime, its service receives daily calls from general practitioners confronted with patients who still feel the symptoms of Covid many weeks after the appearance of their clinical signs of SARS-CoV-2.

“Sometimes the tests show that there is nothing abnormal, it is akin to post-traumatic stress, so you have to work on the mind and the anxiety.

In some cases, patients imagined they were going to die.

They must be taken out of this spiral and put back into activity without rushing them, the psychological aspect is important ”, explains the pulmonologist.

Among the patients, this doctor saw many elderly people or people with a risk situation pass through his department.

“But we have also had high-level sports people with fairly severe forms.

What struck us is that there are relapses, we have had patients who left with a negative test and came back eight to ten days later while shedding a positive virus ”, relates Alain Didier.

The latter does not believe in recontamination but in reactivation of the disease.

For now, his teams are facing this second wave.

But like many officials, he fears that its management will be at the expense of other patients, sometimes suffering from progressive pathology such as cancer and for whom delaying treatment for a month means fewer chances of survival.

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