The manifestations of “Covid long” are not necessarily linked to infection with SARS-CoV-2

Chronic fatigue, shortness of breath, chest, muscle or joint pain, problems with immediate memory or concentration, headaches, anxiety … More than a month after contracting Covid-19, some people continue to experience a variety of persistent symptoms , sometimes very disabling. A new terminology, known as “Covid long”, forged by patients, has gradually imposed itself to describe this new pathological entity. But is this really due to infection with the new coronavirus?

An explosive and meticulous epidemiological study, published Monday, November 8 by the journal JAMA Internal Medicine, questions the possibility of such a causal link. It does not invalidate the fact that some people may suffer from post-infectious syndrome but suggests that, from a statistical point of view, it is the belief that they have been infected with SARS-CoV-2 that is linked to the symptoms of the “long Covid”, more than the fact of having been indeed infected.

In a context where many patients suffering from a “long Covid” believe that they are not taken seriously by the medical community, this work is fueling a lively debate. “We must be careful: our results do not in any way say that the disorders reported by patients are imaginary or necessarily psychosomatic, immediately warns Cédric Lemogne (AP-HP, Inserm, University of Paris), head of the adult psychiatry service at Hôtel-Dieu, and study coordinator. Our analysis is limited to suggesting that the presence of prolonged symptoms is not specifically associated with having been infected with the new coronavirus, and not that these symptoms do not exist. Since these patients experience them, these symptoms exist by definition. “

One or more persistent symptoms

The researchers used data from the Constances cohort, the largest French epidemiological cohort. About 30,000 of its members responded to a questionnaire asking them in particular if they thought they had contracted Covid-19, if a firm diagnosis had been made, and if they were suffering from one or more persistent symptoms, several weeks later. the onset of the disease.

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The researchers then crossed these responses with the HIV status of each of the participants. During the period studied by the researchers – between March and November 2020 – PCR tests were difficult to access: many participants enrolled in the study were diagnosed with Covid-19 without solid validation. Thus some are convinced to have contracted the disease but their serology is negative, suggesting that they have not been infected by the coronavirus. Conversely, some have not felt symptoms of Covid-19 but their HIV status suggests that they have indeed been infected. More trivially, some think they have been infected and their serology is indeed positive, others are convinced that they never have been, in accordance with their seronegativity.

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The manifestations of “Covid long” are not necessarily linked to infection with SARS-CoV-2