Long-Covid: The late effects of corona infection

27. August 2021

The Corona virus continues to keep the world on tenterhooks. The highly contagious delta variant and the still insufficient vaccination rate are causing the number of infections to skyrocket once again. As the number of infected people increases, so does the number of patients who suffer from late effects after the acute phase has subsided. The late effects of Corona infection manifest themselves in physical and psychological symptoms and are referred to as Long-Covid. Long-Covid requires individualized and holistic treatment. LIMES Castle Clinics specialize in this psychosomatic therapy of Long-Covid, which means taking into account body and psyche.

What is Long-Covid?

Long-Covid is an umbrella term for a variety of symptoms associated with a past corona infection. Based on current data, it matters little how severe the acute phase of the infection was. Long-Covid symptoms can always occur, even if the disease itself was very mild or even unnoticed. This makes Long-Covid an underestimated danger for many. Scientists are working at full speed to further investigate Long-Covid in order to identify possible risk factors and risk groups. At present, however, research is still in its infancy.

Importantly, scientific estimates suggest that 10% of infected individuals are likely to experience persistent symptoms, or Long-Covid (NICE guideline, 2020).

Symptoms of Long-Covid

Even though Long-Covid is not well researched – the level of suffering and the need for treatment are high! Affected persons are massively impaired in their everyday life and in their quality of life by the late effects. The complaints are highly diverse. Roughly, they can be divided into physical and psychological complaints, although these can of course also be interrelated.

Long-Covid: Physical symptoms

  • Breathing problems, such as shortness of breath
  • Heart palpitations or arrhythmias
  • Diminished exercise tolerance
  • Chronic fatigue (also called fatigue syndrome)
  • Long-term loss of sense of smell and taste
  • Pain

Long-term fatigue: psychological symptoms

  • Anxiety
  • Depressive moods
  • Disturbances of memory
  • Concentration difficulties

Quite figuratively, some sufferers describe their condition as a feeling of “brain fog”, or “fog in the brain.” Many are extremely frustrated, feeling that they are helpless in the face of Long Covid symptoms. Recovery requires a lot of patience, rest and a sound therapy concept.

Causes of Long-Covid

The causes of long-covid are not yet clear. So far, scientists have three guesses as to why corona infection can lead to severe late effects. First, it is conceivable that individual virus particles can persist in the body and lead to complications again from time to time by damaging cells again. This is also known from measles or herpes viruses. On the other hand, Long-Covid may be based on a misdirected immune response. The immune system does not shut down after the acute infection and starts attacking other body structures.

Thus, Long-Covid can become a multi-organ disease, which then brings a variety of different symptoms. Another possibility is that the coronaviruses attack cellular structures in the body. The resulting damage is called “microlesions” and can also trigger inflammatory processes.

Psychosomatic treatment of Long-Covid

Depending on the type and severity of symptoms, the treatment of Long-Covid may have different emphases. In order to increase the physical resilience step by step, dosed breathing and sport exercises are necessary, but without overstraining the body. Breathing training helps to improve shortness of breath or coughing. For this purpose, the respiratory musculature is strengthened with special exercises and new, helpful breathing patterns are practiced. The sports program is aimed primarily at improving endurance.

For example, patients undergo individually adapted ergometer training, during which pulse and breathing are constantly monitored to keep the load at an optimal level. The training should be accompanied by experienced sports scientists and physiotherapists to prevent overloading. In addition to the load, the relief is also of particular importance. Relaxation, rest and recuperation are essential to allow the body and mind to recover from the stresses and strains of the infection.

Excursus: Treatment methods are precisely tailored to the respective symptoms. Sensory disturbances, olfactory and gustatory disturbances can also be treated. In the repertoire are also physical measures such as lymphatic drainage, reflexology or acupuncture.

Neuropsychological training and psychotherapy for Long-Covid

Neuropsychological training can be used to improve affected cognitive functions in a very targeted manner. For example, attention or memory exercises are performed. Here, there are special computer programs that can be finely adapted to the respective performance. In addition, there is conversational psychotherapy in individual settings and in groups. Important topics are:

  • Disease management: Already the acute corona infection is a shock for many affected persons. The first relief after the acute phase subsides then often does not last long: affected people gradually realize how much the infection with the Corona virus has affected them and have to deal with the Long Covid symptoms. In the process, they often experience a lack of understanding and knowledge, whether from medical professionals or from their environment. In conversation, these experiences can be worked through.
  • Coping strategies: In psychotherapy, those affected learn how to deal with the new situation. For example, everyday life must be restructured, since the reduction in resilience does not allow the usual workload. This requires a large portion of acceptance and self-care, not only in the affected persons themselves, but also in their environment.
  • Stress management: In Long-Covid, it can be assumed that the symptoms persist longer. The fact alone can trigger stress. In addition, there are external stressors, such as financial pressure, the job or the family, as well as internal stressors, such as beliefs and behavior patterns. In therapy, those affected learn how important it is for recovery to cushion these stressors and learn a new way of dealing with them.
  • Exchanging experiences with other sufferers: In groups, sufferers can meet and share their stories. So it becomes clear that no one is alone with this symptom picture. In addition, helpful tips can be discussed.

Further therapy measures for Long-Covid

In general, the rehabilitation treatment of Long-Covid should lead to the fact that the affected person can participate in everyday life again. This, of course, includes returning to work. The return to work is prepared in ergotherapy. The occupational therapy measures used here train concentration, endurance and resilience. It is clear that a condition as complex as Long-Covid calls for complex treatment. This treatment must include both the physical and psychological complaints. In psychosomatic medicine, this is part of the basic philosophy, which is why psychosomatic clinics, such as the LIMES Schlosskliniken, are particularly suitable for the effective treatment of Long-Covid.

References

(1) Funke-Chambour, M., Feldmeyer, L., Hoepner, R., Huynh-Do, U., Maurer, B., Rexhaj, E., & Geiser, T. (2021). Long-COVID syndrome-a new clinical picture after COVID-19 infection. Practice

(2) Mahase, E. (2020). Covid-19: what do we know about “long covid”?. bmj, 370

(3) Müller, T. (2021). Mystery solved about cause of long covid?. CME (Berlin, Germany), 18(6), 20

(4) NICE. Covid-19 rapid guideline: managing the long-term effects of covid-19. https://www.nice.org.uk/guidance/ng188/chapter/4-Planning-care (5) Venkatesan, P. (2021). NICE guideline on long COVID. The Lancet Respiratory Medicine, 9(2), 129.

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Categories: Long-Covid

Friederike Reuver
Autor:in Friederike Reuver
"Die LIMES Schlosskliniken haben sich auf die Behandlung von psychischen und psychosomatischen Erkrankungen spezialisiert. Mit Hilfe des Blogs möchten wir als Klinikgruppe die verschiedenen psychischen Erkrankungen näher beleuchten und verschiedene Therapien sowie aktuelle Themen vorstellen."

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