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Résumé: Dans la plupart des cas les signes de la Covid disparaissent complètement en 2 à 3 semaines, mais certains malades, qu'ils aient été hospitalisés ou non, peuvent ressentir des symptômes bien au-delà, sans qu'ils soient expliqués par une autre maladie. Les données probantes dont on dispose actuellement laissent entendre qu'environ 10 % à 20 % de ces personnes éprouvent par la suite divers effets à moyen et à long terme. On parle alors pour ces effets à moyen et à long terme d'affection post-Covid-19 ou de « Covid-19 de longue durée ». Mais que sait-on sur ces symptômes prolongés du Covid-19 et de quoi parle-t-on ? In most cases the signs of Covid disappear completely in 2 to 3 weeks, but some patients, whether they have been hospitalized or not, can experience symptoms well beyond that, without being explained by another disease. Current evidence suggests that approximately 10% to 20 % of these individuals subsequently experience various medium- and long-term effects. These medium and long-term effects are then referred to as post-COVID-19 illness or "long-term COVID-19". But what do we know about these prolonged symptoms of COVID-19 and what are we talking about? [ABSTRACT FROM AUTHOR]

The long COVID includes non-specific symptoms affecting patients of all ages., Methods: Monocentric, prospective, quantitative and descriptive study interested in comparing the knowledge of general practitioners in Alsace (France) with the positioning and recommendations of the World Health Organisation (WHO) on long COVID in the period November 2022-February 2023. A multiple-choice questionnaire was elaborated based on the WHO positioning and recommendations on the long COVID., Results: 126 questionnaires were received, 65 (51.6 %) women, 42 % aged between 25-35 years. 84.9 % had knowledge about long COVID. The need for an impact on daily life, unexplained symptomatology and symptoms persisting at two months were criteria retained (84.9 %, 91.3 % and 82.5 %, respectively). A history of anxiety disorders (86.5 %) and severe acute forms of COVID-19 (57.9 %) were considered as risk factors. Fatigue, dyspnea, joint pain, headache and cough were associated with long COVID in 65.9 % of responders. About 74,6 % performed a complete blood test, 96.03 % recommended rehabilitation, 76.2 % referred to the pulmonologist and 71.4 % were in favour of a consensus document., Conclusions: General practitioners are aware of the existence of long COVID as a pathology and agree with the recommendations of scientific societies, among which those of WHO. However, this study has some limitations so that this topic deserves further dedicated investigations.

Introduction: Long COVID refers to persistent symptoms, lasting more than 4 weeks after acute SARS-CoV-2 infection, even though the infection itself has been successfully controlled and remedied. Patient complaints are diverse, and the underlying physiopathological mechanisms are not well understood. Dyspnea and muscle fatigue are among the most commonly reported symptoms., State of the Art: Cardiopulmonary exercise test (CPET) has been recognized as a useful tool in investigation of unexplained dyspnea. In patients with chronic lung disease, pulmonary rehabilitation is a program designed to counteract dyspnea, to increase exercise capacity and to improve quality of life., Perspectives: Publications on CPET and pulmonary rehabilitation are needed in order to deepen comprehension and enhance management of long-COVID-19., Conclusions: CPET reports have shown that symptoms persisting in the aftermath of acute SARS-CoV-2 infection may be related to deconditioning, a common occurrence after ICU stay, to cardiac dysautonomia subsequent to critical infections and, finally, to dysfunctional breathing subsequent to mild infections. These findings justify pulmonary rehabilitation, which has proven to be effective regardless of the severity of the initial infection, not only immediately after hospital discharge, but also at later points in time., (Copyright © 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Long COVID, frequently associated to neuropsychiatric manifestations, impacts the ability of patients to return to work and often requires adjustments of the previous workstation. Due to the duration of the symptoms and the professional consequences, disability insurance (DI) procedures may be necessary. Because the persistent symptoms of Long COVID are often subjective and unspecific, the medical report to the DI should include a detailed description of the functional impact of these manifestations., Competing Interests: les auteurs n’ont déclaré aucun conflit d’intérêt en relation avec cet article.

The study of post-COVID-19 symptomatology revealed a first wave of post-acute (persistence of symptoms less than 3 months) neurocognitive symptoms. However, some of these symptoms worsened, while others improved. To our knowledge, these symptoms may persist for up to 1 to 2 years after infection. The intensity, variability and persistence of neurocognitive symptoms may rise the hypotheses of accelerated neurodegenerative processes, as well as neuropsychiatric and/or genetic vulnerabilities that are still poorly understood. Moreover, the multi-organ manifestations of post-COVID-19 symptoms remind us of the importance of promoting an interdisciplinary perspective at both clinical and fundamental levels. Finally, many social and economic issues parallel to the neuropathological consequences remain to be investigated., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Some individuals who have been infected with SARS-CoV-2 can experience long-term effects from their infection, known as post-COVID conditions, post-acute sequelae of COVID-19 or long COVID. Different underlying mechanisms can lead to long COVID, none of which are mutually exclusive. Lingering symptoms can persist years after SARS-CoV-2 infection, including fatigue, muscle weakness, tachycardia, dyspnea and various neurological symptoms. The symptomatology is partly similar to that reported by people with chronic fatigue syndrome and other unwell studied long-lasting diseases that may occur after other infections. People who have experienced more severe COVID-19 illness are at higher risk of developing long COVID, although anyone who was infected can experience post-COVID conditions. Importantly, unvaccinated individuals are more likely to develop long COVID. Here we review the current knowledge and discuss key findings regarding the epidemiology and physiopathology of long COVID. We briefly review current diagnostic and treatment options that remain so far largely insufficient.

Recent observations suggest the persistence of neurological and neuropsychological symptoms in the long-term following SARS-CoV-2 infection. Currently described within the post-COVID-19 syndrome. The objective of this article is to discuss recent epidemiological data and data from neuroimaging studies. Finally, a discussion is proposed regarding recent suggestions regarding the existence of distinct phenotypes of post-COVID-19 syndrome., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Competing Interests: Intérêts concurrents: Kieran Quinn a été directeur scientifique adjoint de l’Ontario COVID-19 Science Advisory Table du 8 août au 30 septembre 2022. Il est actuellement le directeur scientifique adjoint du Comité consultatif scientifique ontarien des urgences de santé publique. Il a reçu des bourses des Instituts de recherche en santé du Canada (IRSC) par l’entremise de son institution pour étudier les effets à long terme de la COVID-19. Il a été conseiller pour le Groupe de travail sur la condition post-COVID-19 de la Conseillère scientifique en chef du Canada. Fahad Razak détient une bourse salariale comme lauréat de la bourse Graham Farquharson en application des connaissances de la PSI Foundation. Il est à l’emploi de Santé Ontario et était employé par Santé publique Ontario pendant la rédaction de ce manuscrit. Des bourses pour étudier la COVID-19 (non liées au présent article) lui ont été accordées par les IRSC, le Réseau canadien des soins aux personnes fragilisées, l’Université de Toronto (Département de médecine, Hôpital St. Michael et Centre des sciences de la santé Sunnybrook), l’Alliance de recherche numérique du Canada (projet pilote Champion de données) et le Collège royal des médecins et chirurgiens du Canada. Angela Cheung a reçu des bourses des IRSC (versées à son institution) pour CANCOV (étude observationnelle plateforme de la COVID-19 au Canada) et RECLAIM (essais cliniques multi-centriques à répartition aléatoire sur une plateforme adaptative pour les interventions en COVID-19 de longue durée au Canada), dont le médicament à l’étude et le placebo sont fournis par MediciNova. Angela Cheung a conseillé l’Ontario COVID-19 Science Advisory Table, l’Agence de la santé publique du Canada, l’Agence canadienne des médicaments et des technologies de la santé, le Groupe de travail sur l’immunité face à la COVID-19 et le Groupe de travail sur la condition post-COVID-19 du Canada de la Conseillère scientifique en chef. Aucun autre intérêt concurrent n’a été déclaré.

Competing Interests: Intérêts concurrents: Kieran Quinn a été directeur scientifique adjoint de l’Ontario COVID-19 Science Advisory Table du 8 août au 30 septembre 2022. Il est actuellement le directeur scientifique adjoint du Comité consultatif scientifique ontarien des urgences de santé publique. Il a reçu des bourses des Instituts de recherche en santé du Canada (IRSC) par l’entremise de son institution pour étudier les effets à long terme de la COVID-19. Il a été conseiller pour le Groupe de travail sur la condition post-COVID-19 de la Conseillère scientifique en chef du Canada. Fahad Razak détient une bourse salariale comme lauréat de la bourse Graham Farquharson en application des connaissances de la PSI Foundation. Il est à l’emploi de Santé Ontario et était employé par Santé publique Ontario pendant la rédaction de ce manuscrit. Des bourses pour étudier la COVID-19 (non liées au présent article) lui ont été accordées par les IRSC, le Réseau canadien des soins aux personnes fragilisées, l’Université de Toronto (Département de médecine, Hôpital St. Michael et Centre des sciences de la santé Sunnybrook), l’Alliance de recherche numérique du Canada (projet pilote Champion de données) et le Collège royal des médecins et chirurgiens du Canada. Angela Cheung a reçu des bourses des IRSC (versées à son institution) pour CANCOV (étude observationnelle plateforme de la COVID-19 au Canada) et RECLAIM (essais cliniques multicentriques à répartition aléatoire sur une plateforme adaptative pour les interventions en COVID-19 de longue durée au Canada), dont le médicament à l’étude et le placebo sont fournis par MediciNova. Angela Cheung a conseillé l’Ontario COVID-19 Science Advisory Table, l’Agence de la santé publique du Canada, l’Agence canadienne des médicaments et des technologies de la santé, le Groupe de travail sur l’immunité face à la COVID-19 et le Groupe de travail sur la condition post-COVID-19 du Canada de la Conseillère scientifique en chef. Aucun autre intérêt concurrent n’a été déclaré.

Covid long affects each patient differently. This disorder can occur in people with both severe and mild forms of the disease. It is often a series of symptoms that disrupt different areas of life in a very variable way. These symptoms can change rapidly. Moreover, several symptoms are associated and fluctuate (between aggravation and recovery) during very variable periods, which leads to a mosaic diagnosis and engages the need for multidisciplinary management., (Copyright © 2022. Publié par Elsevier Masson SAS.)

As we enter the eighth wave of pandemic Covid-19 infection, the disabling persistence of certain symptoms after this viral infection, often trivial with the latest variants, is still a concern. The most effective treatment of these prolonged symptoms after Covid remains a rapid diagnosis, even if it is primarily of elimination, followed by comprehensive, multidisciplinary, specialized management and early but individualized self-help exercises., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Covid-19 is a polymorphic disease, characterized in some patients by persistent symptoms several weeks or even months after the initial manifestations of SARS-CoV-2 infection. This is referred to as "long Covid" or post-Covid-19 disease. The polysymptomatic and fluctuating nature of these clinical manifestations generates questions and concerns for patients. To meet their care needs, the regional health agencies have worked with local health care providers to develop appropriate care pathways., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

In the front line, from the beginning of the pandemic, to take care of patients hospitalized for severe forms of Covid-19, health professionals have not failed, despite the precautions taken, to contract the virus and develop the disease, sometimes with severe forms. Two hospital caregivers testify about their respective experiences and the repercussions on their daily life due to a long Covid., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Post-COVID syndrome (or long COVID) is a set of persistent symptoms occurring after a documented SARS-CoV-2 infection. Children and adolescents are also affected, with similar symptoms than adults. To date there is no clinical or biological parameter allowing to confirm the diagnosis, which relies on the presence of typical symptoms associated with a suggestive temporality, in the absence of any other explanation. These persistent symptoms can have a strong impact on the quality of life and schooling. In our specialized consultation for pediatric post-COVID syndrome, we offer a global and multidisciplinary follow-up to patients and their families, supporting them progressively resuming physical and mental activity, and pursuing school attendance to avoid dropout., Competing Interests: Les auteures n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

The SARS-CoV-2 pandemic has caused an unprecedented global public health crisis. The term long Covid is used to describe diverse and heterogeneous symptoms that persist more than 4 weeks after infection with an estimated incidence of 10-40%, which varies between studies. The principal characteristics of long Covid are fluctuating symptoms of prolonged duration affecting multiple organs, such as fatigue, dyspnea, cough, anosmia, dysgeusia, chest pain, palpitations, headache, myalgia, cognitive and gastrointestinal disorders. Contributing factors, possible pathophysiological explanations and international recommendations can help in the management of the disease in the outpatient setting. Biopsychosocial and multidisciplinary management in primary care medicine is essential., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Since February 2020, hundreds of thousands of patients have been left with persistant symptoms after their infection. Along with their clinicians, these patients are exposed to a high degree of uncertainty and the urgent need to produce conceptual frameworks aimed at recognising, treating and validating their experience as patients suffering from new and protracted symptoms and witnessing debates as to how these symptoms should be qualified. In this respect, long covid illustrates the need to combine the collective experiential knowledge of patients and scientific knowledge for the benefit of the patients, clinicians and research., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

In this work, we address the issue of prolonged symptoms following an infection by SARS-CoV-2, labeled "long COVID". This clinically unspecific syndrome must be put in perspective with the post-infectious syndromes known for a long time but ultimately poorly understood and little studied, qualified, for lack of convincing arguments for a unambiguous pathophysiology and better terms, as functional somatic syndromes. The clinical implications for clinical care ("holistic" work-up and care of patients), for research (need for truly "bio-psycho-social" investigations), and the social implications of "long COVID" (social construction of the syndrome through the experiences of patients exposed on social networks, inequalities in the face of the disease and its socioeconomic consequences) are considered. "Long COVID" must be view, because of its expected prevalence, as an opportunity to address the complexity of post-infectious (functional) syndromes, their risk factors, and the biological, psychological and social mechanisms underlying them., (Copyright © 2021 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)