In the case of the new coronavirus, the wearing of masks has already become an individual decision, and in May, it was decided to shift to the same "Class 5" as seasonal influenza.
However, even if it becomes a "normal infection", what remains is the problem of "sequelae" such as fatigue and shortness of breath.
What are the symptoms of "sequelae" and how long will they last? Is there a cure?
In addition, there are people who feel anxious every time they feel unwell, "It may be an aftereffect."
A reporter who was actually suffering from this anxiety interviewed what he now knows.
(Faculty of Science and Culture, Tetsutaro Soe)
【Corona sequelae, its symptoms】
WHO = World Health Organization defines the aftereffects of the new coronavirus as follows.
It usually comes out within three months of the onset of the novel coronavirus.
Lasts at least two months.
Symptoms of other diseases cannot be explained.
If all three of these conditions apply, it is considered to be the "after-effects of the new corona".
The main specific symptoms are malaise, shortness of breath, memory problems, difficulty concentrating, and impaired sense of smell and taste.
However, some studies have shown that patients complain of more than 3 types of symptoms. The frequency of onset is not yet well understood.
This is because, even if some symptoms appear after the new corona infection, it is very difficult to determine whether they are related to the infection or another cause, and it is difficult to investigate and research.
"Let's see if it's really an aftereffect and deal with it."
Dr. Shinichiro Morioka National Center for Global Health and Medicine
"At this stage, the mechanism and mechanism of why long-lasting symptoms appear after infection with the new corona are not clearly understood. It is distinguished as it is. I think we need to find out if the symptoms that patients complain of are really related to the new coronavirus infection and think about how to deal with them."
【Frequency of sequelae】 Overseas
In May 2021, a large-scale survey of approximately 5,10 people in the United Kingdom, ranging from mild illness to hospitalized, found that out of approximately 1,3000 infected people, approximately 2800,21, or 6.12%, continued to experience symptoms such as malaise, muscle pain, insomnia, and headache more than <> weeks after the onset of the disease.
According to a survey released by the Brookings Institution in August 2022, approximately 8 million people in the U.S. working population aged 18 to 65 are affected by the effects of the new coronavirus, and up to 1600 million people are at risk of being unable to work.
If you calculate the economic loss, it is said that the maximum annual loss is 400 billion dollars, or more than 2300 trillion yen in Japan yen, and the impact on the economy has been pointed out.
【Frequency of sequelae】 In Japan
So, how much sequelae are there in Japan new corona patients? Several investigations have been conducted.
Dr. Morioka's research group at the National Center for Global Health and Medicine conducted a survey to interview patients who visited medical institutions between February 2020 and November 2 about their symptoms after recovery. The survey was surveyed by 2021 people in their 11s to 20s.
The
percentage of people who complained of having any symptoms after recovery was 70.502% after six months, 32.3% after one year,
and 1.30% after one and
a half years. This is about 5 in 1 people.
The frequency for each symptom is
So, what kind of symptoms were they experiencing? One year later, the results were as follows:
Memory impairment 11.7%, concentration loss 11.4%, olfactory abnormalities 10.3%, "brain fog" that makes you feel like you have a haze in your head and impaired thinking ability is 9.1%, depressed 7.5%, and taste abnormalities are 5.9%,
Shortness of breath was 5.6%, malaise was 3.8%, hair loss was 3.5%,
women
tended to have persistent olfactory abnormalities, hair
loss, and difficulty concentrating, and those who were moderately or severely ill due to COVID tended to have continued shortness of breath, cough, and malaise.
【Analyze risks from medical examination records】
A research group led by Professor Akimasa Hirata of the Nagoya Institute of Technology is analyzing the risk of sequelae in another way.
Professor Hirata and his colleagues used the "receipt = medical fee statement" created when visiting a medical institution. The name of the diagnosis and the treatment received are listed here.
To protect their personal information, we will use anonymized data from 125.10 million people to see if there is any difference between those who are infected with the new coronavirus and those who are not.
We picked up and compared 20 symptoms such as malaise, headache, and breathing difficulty, which are often reported as aftereffects of the new corona.
The target was people who had annual medical expenses of less than 2021,1 yen, that is, people who were considered to have no serious chronic illnesses, for one year until the spring of 1. During this period, the country was generally experiencing a wave of epidemics from the first to the third wave.
"Experienced infection" has a five-fold rate of hospital visits
The percentage of people who visited a medical institution for these 10 symptoms is as follows.
About 3% of people who have never been infected with the new corona and about 16% of those who have been infected. People infected with the new corona were about five times more likely to go to the hospital with 10 symptoms such as malaise and headache.
In addition, during the fourth and fifth waves, it was up to six times higher.
However, according to Professor Hirata, data on the period of the "sixth wave" (January to March) when the Omicron variant expanded has not yet been collected, but according to the analysis as of March 5, it is three times lower than before.
"Experienced infection" is often examined for symptoms of "sequelae"
Professor
Hirata: "Since it is only receipt data, it is not possible to understand the causal relationship with corona infection, but the data showed that infected people often visit the hospital with so-called sequelae. The decline in risk in the sixth wave, when the Omicron variant was the mainstream, may be due to the effectiveness of vaccines and the decline in the pathogenicity of the virus. However, as the absolute number of patients is increasing, it is likely that the number of people who are being examined with these symptoms is increasing."
[There are also differences in the frequency of symptoms over time]
Some studies have shown that there are differences in the frequency of symptoms that are considered to be sequelae over time after recovery.
Professor Kenji Kushina of Osaka University, in collaboration with Toyonaka City, Osaka Prefecture, conducted a questionnaire survey of approximately 2022,3 people infected with the new coronavirus by the end of March 2 by mail and smartphone app.
More than 6000,4000 people responded.
Those who
answered that they had some symptoms were 10.47%, nearly half at the end of the 7-day medical treatment period after infection.
One month after onset, 1.5%. That's about 2 in 20 people.
Two months after onset, it was 1.2%.
In addition, the analysis of the questionnaire showed that those who had a higher severity when infected tended to complain of subsequent symptoms, and those who were vaccinated tended to have fewer symptoms.
Professor
Kushina: "It is thought that people suffering from sequelae are more likely to respond to surveys, so it is necessary to interpret the survey results, but the same trend as similar studies conducted overseas is generally observed, such as more sequelae in people who become severely ill, or fewer sequelae in vaccinated people. Some people last a long time."
【Unexplained mechanism at the hypothesis stage】
The aftereffects of the new coronavirus.
The mechanism by which this is happening has not yet been clarified.
Professor Akiko Iwasaki of Yale University, USA, who specializes in immunology and is conducting research on the aftereffects of the new coronavirus, introduced the following hypotheses regarding the mechanism of sequelae that are currently being considered.
"Even if the initial symptoms such as cough and fever subside, the remaining viruses and their fragments are inflamed for a long time." "The immune system, which is supposed to protect the body, attacks your body in the wake of infection" ▽ "
The repair of organs damaged by infection is prolonged."
"Viruses that have been in the body for a long time, such as the herpes virus, are being reactivated in the wake of the new coronavirus infection."
岩崎教授
「感染してから数か月後でも体内のいろんなところにウイルスの抗原（ウイルスの一部）やRNA（新型コロナウイルスの遺伝子）があるということが分かってきて、ウイルス感染の感染が長く持続しているという仮説が特に注目を浴びています。その可能性があるんじゃないかということで、私たちの研究室では新型コロナの治療薬を使って後遺症を治療する研究を行うことにしています」
後遺症の判別研究 “「コルチゾール」の濃度に差”
岩崎教授たちは検査で後遺症かどうかを判別できるようにする研究も進めています。
新型コロナの後遺症の患者に特徴的な血液の成分がないかや、後遺症がある人では特定のホルモンの数値が上がっていないかなどを調べ、血液検査などで診断を支援できるようにする研究です。
いま注目しているのは、「コルチゾール」の濃度です。炎症や免疫の働きを抑えるのに関係するホルモンです。
通常、コルチゾールは、朝、目が覚めたときに血中の濃度が大きく上昇し、血糖値や血圧を上げることで活発に行動できるようにする役割があるとされています。
岩崎教授たちの研究では、「新型コロナ後遺症」とされる人は、目覚めた際の「コルチゾール」の濃度が健康な人に比べて大幅に低いことが分かってきたということです。
ただ、まだまだ後遺症のメカニズムについては完全には解明されておらず、謎が多く残されています。
【治療法の現在地は】
では、新型コロナ後遺症の治療法はどこまで進んでいるのでしょうか。
忽那教授
「いまのところ後遺症に対して効果が証明された有効な治療法がないことが問題です。後遺症のリスクを避けようと思うのであれば、ワクチン接種や感染予防がより重要です」
森岡医師
「いくつか治療法の臨床試験が進められていて、中には神経症状に対する高圧酸素療法やファイザーの飲み薬『パキロビッド』に効果がありそうだという結果が出ています」アメリカ退役軍人病院がおよそ5万6000人を対象に行った研究では、パキロビッドで治療を受けた患者は新型コロナ後遺症とされる症状の多くで発症リスクが低下したと報告されています。
「ゾコーバ」の効果は 研究進む
In addition, Japan Shionogi & Co., Ltd. is conducting research on whether the drug "Zocova" for the new coronavirus is effective in alleviating the sequelae.
This is because 14.14% of patients who took Zocova in clinical trials of this drug complained of any of the 5 sequelae such as cough, sore throat, malaise, and taste disturbance six months later, while 26.3% of those who took the fake drug showed a high rate.
According to Shionogi & Co., Ltd., "The risk of developing symptoms that appear to be sequelae was reduced by 45% in people who took Zocova."
They also reduced their risk of developing neurological symptoms such as difficulty concentrating and thinking, as well as forgetfulness and insomnia, by 33%.
Results that also indicate the possibility of treatment
There have been several other reports from Japan that "nasopharyngeal abrasion therapy," which strongly rubs the back of the nose, improved various symptoms that are considered to be the aftereffects of corona.
This therapy itself was originally covered by insurance as a treatment for chronic inflammation at the back of the nose, and the effect on the aftereffects of the new corona is still in the process of being scientifically verified, but some medical institutions provide this treatment for patients with corona sequelae.
Although nothing has been established and it is still in the research stage, the results are gradually emerging that indicate the possibility of future treatment.
【The site of medical treatment】
The frequency and mechanism are unknown, and no treatment has yet been established.
Under such circumstances, what is the state of treatment for patients who complain of the aftereffects of the new coronavirus?
The Medical Research Institute Kitano Hospital in Osaka City is one of the medical institutions with outpatient clinics specializing in sequelae.
In this outpatient clinic, it is difficult for people who wish to see a doctor to make an appointment.
Among them, a man who had made an appointment more than 10 months ago and was finally able to see a doctor was suffering from insomnia and difficulty concentrating after becoming infected.
Male
: "It took a long time until the first visit, but I was relieved to have a place where I could consult" At
the outpatient clinic, we interview the symptoms in detail to determine whether it is related to the new coronavirus or another disease.
If necessary, we connect them to specialized departments such as psychiatry and neurology.
Dr. Satoshi Maruge, Department
of Respiratory Medicine: "It is possible that chronic diseases have worsened due to the new coronavirus, for example, rheumatoid arthritis may worsen due to the new coronavirus, and depression and anxiety disorders may worsen in some people. Sleep apnea syndrome may worsen and lead to malaise. It is important to first distinguish whether it is a direct aftereffect of corona or another disease. If you know the specific symptoms, you can find a treatment in a specialized department."
[Some people become depressed]
In addition, some people who complain of sequelae become depressed due to continued poor health, which makes them more anxious that they may have sequelae or that they will not be able to continue working.
Dr.
Maruge: There is no doubt that there are many patients who suffer from sequelae, but there is a pattern in which the word "sequelae" precedes the disease, and the anxiety that it is not the case causes the symptoms on the contrary. Even at this hospital, about 40% of people in their 50s and 6s are in their prime of work who have been infected with the new corona and cannot return to work immediately. Some people get even worse because they are worried that it will be like this because of the after-effects if they look it up on the Internet and look it up on the Internet."
【Some clinics are reluctant to receive medical examinations】
The Ministry of Health, Labour and Welfare has also published a manual saying that if you have symptoms that suspect the aftereffects of the new coronavirus, please consult a local medical institution or family doctor, but some local clinics are reluctant to examine the aftereffects, or they may be asked if it is because of their mind.
Dr. Morioka of the National Center for Global Health and Medicine Hospital points out that it is important to establish a system that allows patients who complain of sequelae to receive medical care.
Dr. Morioka: Based on our research, which shows that about one in four people have some kind of symptom even one and a half years after infection, I think we need more patients to receive patients.
For patients who complain of the aftereffects of the new coronavirus, the consultation time per person may be a little longer in order to hear about the symptoms and history in detail, so depending on the medical institution, the number of patients who can be seen will decrease, so I think it is necessary to work on the aspect of medical fees."
The Ministry of Health, Labour and Welfare has requested prefectural governments nationwide to prepare and publish a list of medical institutions that can respond to the aftereffects of the new coronavirus by April 1, 4.
[After-effects anxiety that reporters also feel]
In January 2022, I (Tetsutaro Soe), who was working at NHK's American Bureau in New York, USA, at the time, was infected with the new coronavirus.
I had no fever, a sore throat, sluggishness, and loss of taste and smell for about three days, and I was able to return to work one week later.
However, more than 1 days after I recovered, I started to feel unwell, such as getting tired easily and not being able to concentrate. I can't concentrate when I try to read a scientific paper at work.
Often, during a press conference or interview, I suddenly feel light-headed and lose track of the connection.
I often had sudden severe palpitations, or woke up with severe anxiety even when I slept at night.
Even after one month, the situation did not improve, and I was worried that I would not return to my original state.
I don't know if it's the after-effects of the new corona.
I am also over 40 years old, and it may be due to stress or aging. Moreover, my weight is well above the standard of health. Obesity may also be one of the causes.
Is it the after-effects of the new coronavirus or is it another cause? I really feel that this anxiety is one of the major problems of the aftereffects of the new coronavirus.
After that, I returned to Japan in Japan, but I have not yet been examined at the corona after-effects outpatient clinic. Because I can't get a reservation.
Fortunately, symptoms such as insomnia and palpitations are improving, but they are not completely gone. The same goes for anxiety.
Dr. Maruge's words "anxiety worsens symptoms" resonate heavily.