Les formes prolongées de la COVID-19 ou COVID long : formes cliniques et prise en charge

As a result of an acute symptomatic COVID-19 episode, more than 30% of adult patients still have symptoms at 1-2 months and 10-15% at 6-8 months. These may be persistent symptoms or new symptoms. If the most common are severe fatigue, dyspnea and neurocognitive signs, many other organs may be affected. These symptoms generally evolve in a fluctuating manner and are often aggravated by physical or intellectual effort. Over time they evolve slowly towards improvement. The lack of virological documentation (PCR could not be made at the initial episode and/or serology is negative) does not exclude this diagnosis. The origin of these symptoms is not yet clear: a viral persistence has been demonstrated in some cases, an inflammatory response including excessive mastocyte activation, a defect of innate or adaptive immunity are hypotheses being explored. Genetic and hormonal factors may be associated. Patient management must be initiated at the first point of care. Based on a thorough analysis of the symptoms, diagnoses will be made which leads to a multidisciplinary management where symptomatic treatments and rehabilitation are important. While hospitalization is rare, these protracted forms, now known as” long COVID”, will have a major societal impact requiring the implementation of appropriate public policies.