A saúde depois da Covid-19: médicos alertam sobre danos prolongados da doença

Health after Covid-19: Doctors warn of prolonged damage from the disease

Among the most common complaints are memory loss, headache and dizziness. Photo: reproduction

Even after vaccination, a drop in deaths, a decrease in serious cases of hospitalizations, and the false sense of control, Covid-19 continues to bring disorders, many of them with prolonged and permanent potential. The great concern now is the increase in reports of young patients, without comorbidities, who took two or three doses of the vaccine, with complaints of problems with memory, reasoning, vertigo and dizziness. Characteristics that don’t kill, but that can cause great sequels and problems in everyday life.

Despite being a disease that mainly affects the airways, studies have shown that Covid-19 can also damage other systems, causing damage that can last for long periods. Among the most worrisome complaints are neurological and vestibular auditory disorders, which affect balance, memory and hearing.

The neurologist, head of the Neurology and Neurosurgery Unit at HC-UFG, Délson Silva, explains that at a neurological level, the most common sequelae are “headache, dizziness, vertigo, tinnitus, memory loss, attention disorder , stroke (stroke), cerebral venous thrombosis, neuropathy (inflammation of the peripheral nerves) and myelopathy (inflammation of the spinal cord)”.

Also according to the otolaryngologist, specialist in otoneurology, an area that deals with balance disorders, Eduarley Belle, about “14.8% of patients have tinnitus, 7.6% hearing loss and 7.2% vertigo”. Recent research has shown that 7% to 12% of patients also report dizziness.

Dizziness and Vertigo

Fashion designer Tainara Maia, 27, fits this statistic, had complaints of headache, memory loss and developed labyrinthitis. The designer reports that the symptoms appeared a week after the infection and that she still suffers from bouts of dizziness. “I still have the memory failures and the labyrinthitis, which has been under treatment for over a month.” Tainara mentions that the sequels affected common everyday things. “The sequels get in the way of performing simple day-to-day tasks. In crises of labyrinthitis, even bending down to pick up objects requires more effort”.

Biologist Ludimila Pereira, 30, says that she had “very strong bouts of dizziness and vertigo”, but that the memory loss was even worse. “I can’t keep anything with quality. It gets in my way a lot in my work with the doctorate, I always have to work hard to get things done”, says the doctoral student in biology.

According to the otolaryngologist, balance disorders, hearing loss and tinnitus can appear at different stages of the disease, and also persist for longer periods. “The sequelae can be permanent, but if the otoneurological manifestations are detected and treated early, there are chances of being partially or totally reversed”, points out Eduarley.

The doctor warns against the use of vestibulo-toxic drugs, that is, those containing substances capable of causing damage and injury to the balance system. Some of these remedies were recommended by doctors in the “covid kit” and used by many patients in a preventive way. “Usually, vestibulotoxic compounds cause damage to both labyrinths and central vestibular neurological pathways. Many drugs are potentially toxic vestibule, even those classically used for the treatment of Covid-19, such as: Chloroquine and Hydroxychloroquine, Azithromycin, Lopinavir, Ritonavir, Interferon, Ribavirin, Ivermectin”, says the otolaryngologist.

Memory and Reasoning

In addition to problems related to dizziness, vertigo and attention deficit, other common symptoms are memory and reasoning complaints. The biomedical esthete Luana Campelo, 30, reports that thirty days after positive, she began to notice changes in her memory, which persisted for a while. “When I went back to work, two months after the infection, I no longer remembered some important things, such as the amount of saline to reconstitute the botulinum toxin. It’s as if I’ve never even worked with it”, says Luana.

Délson says that one of the explanations for this variation in the appearance of complaints and persistence of symptoms is related to the immunological reaction of each patient. “One of the hypotheses is an exacerbated immune reaction with attack by antibodies, cytokines and chemokines, with consequent damage to organ tissues”, says the neurologist. According to the doctor, the elderly, immunocompromised and those with comorbidities are more likely to develop this type of reaction.

In relation to young patients and without comorbidities, the reactions may be related to the immunological alteration caused by the vaccine against covid. “Vaccines, in general, cause changes in the immune system. Sometimes, with a decrease in immunity, momentarily, due to the deviation of the system’s attention to that vaccine, causing the activation of interleukins and inflammatory mediators”, describes the otorhinolaryngologist.

Even having taken both doses of the vaccine against covid-19 at the time he had the infection, civil engineer Gustavo Japiassú, 32, says he noticed problems with memory and reasoning 14 days after testing positive. “I feel like it detracted from any task that involves math. The issue of speed of reasoning, I feel, is still impaired today. I did a lot of math with relative ease, after the covid it has been more difficult”, explains the engineer.

Mental confusion, called “brain fog,” is also very common, according to the neurologist. “In Brain fog, the patient reports as if the mind or thought is blurry is a very common symptom, which most of the time disappears with time”. It was like that with the civil engineer, “the loss of recent memory, when someone told me something and I couldn’t remember, over time it returned to normal”, says Gustavo.

The theory that explains the action of the virus in the neurological system is that there is a tendency for it to enter the neuronal tissue through the bloodstream and bind to nerve receptors. Covid infection causes an inflammatory action in the nervous system, characterized by the immune response. “The nervous system is more susceptible to infection and there is tropism of the virus for the nervous tissue, in addition to which there are immunological reactions that attack this tissue and also lesions of the walls of the cerebral vessels that provide thrombosis (blood clotting in the veins and arteries)” , says Delson.

Treatment

According to experts, there is no treatment with drugs, but medical follow-up, from different specialties, is important. “In the cases that most interfere in the patient’s life, cognitive rehabilitation, physical activity and mental occupational therapy can help overcome. There is no drug treatment for it, however neurological follow-up is recommended”, concludes the neurologist.

For Eduarley, the sooner the patient seeks medical help and treatment, the better. “It is important that auditory and vestibular rehabilitation be started as early as possible, with a multidisciplinary team made up of doctors, physiotherapists, speech therapists, dentists, psychologists and nutritionists”, says the otoneurologist.

Journalism Intern at the agreement between UFG and Diário de Goiás.

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