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A sports medicine specialist on the long-term effects of Covid-19

The corona pandemic has had a major impact on us and our lives. Many who were infected with the virus have now recovered and not every course has been difficult. Nevertheless, the disease can still have an impact on the state of health even after weeks and months. The term “Post-Covid” summarizes all those complaints that affect people who have survived Covid 19 disease. Which are they? Do you have to worry as a person affected?

Dr. Karin Nentwich. She is a specialist in internal medicine, cardiology and sports medicine at the Clinic for Cardiology II on the RHÖN-KLINIKUM Campus Bad Neustadt.

As an expert in cardiac arrhythmias and sports medicine diagnostics, among other things, she is currently working with patients whose bodies have battled the coronavirus and who sometimes still feel symptoms weeks afterwards.

In an interview with the RHÖN health blog, the expert talks about the scientific status of things and the often difficult search for a clear diagnosis. And she gives tips on how to behave as a victim.

Miss Dr. Nentwich, are there any reliable findings regarding long-term damage that Covid-19 can cause?

Indeed, there is still a great deal unexplained. However, it is known that there can be long-term lung damage. We can also prove this on the basis of appropriate examinations – and treat affected patients accordingly. There are also other long-term effects, such as the so-called fatigue syndrome, which, however, is very difficult to grasp.

What are the characteristics of this fatigue syndrome?

Those affected often suffer from chronic fatigue, weakness and a lack of resilience, so that in some cases they can no longer even climb stairs. Loss of appetite and the resulting weight loss can also sometimes be detected.

Do these symptoms help you make a diagnosis?

Barely. In such cases it is difficult or even impossible to objectify the clinical picture using imaging examinations such as X-rays or EKGs. Here it is very problematic for us doctors to simply assign symptoms to a certain disease. Also because there are a number of other clinical pictures besides Covid-19 that are associated with such states of exhaustion. Just think of mental illnesses, or those related to the heart. The internal medicine department also deals with symptoms of this kind. In short: research into the cause is very difficult here. One interesting theory is that it assumes that the virus remains in the body even after the Covid 19 disease, but can no longer be detected by a smear. The affected person seems to be healthy again, and the blood values ​​are also okay. Unfortunately, there are currently no reliable scientific findings in this area, only reports on individual cases.

Who is currently turning to you as a sports medicine specialist regarding Covid-19?

Of course, we mainly get inquiries about the sports medicine ambulance. They often come from amateur athletes, including marathon runners, who were sick with Covid-19 and now want to be examined to find out whether they can exercise again. In addition, people come with cardiological issues, i.e. those that affect the heart. Here we have made the experience that the examinations do not reveal anything obvious.

When should one come to you as a patient if one thinks that one can discover post-Covid symptoms in oneself?

I think that nobody should be frightened if they still have certain symptoms around the first few weeks after the Covid 19 illness. However, if the symptoms persist for many weeks or even months, it certainly makes sense to have the issue medically clarified. As a rule, we then approach the matter in a multidisciplinary manner. This means that we ask several medical departments for their respective assessments. The aim is to get a holistic assessment.

Who is involved in such an investigation?

There are, for example, somatics, heart specialists, lung specialists, internists and psychosomatics who, among other things, deal with the clinical picture of depression. It is therefore important to “check out” what are known as differential diagnoses in order, at best, to rule out other clinical pictures that have nothing to do with Covid-19.

Is it possible to use numbers to determine how many people actually still suffer from long-term effects after their corona disease?

As a sports medicine specialist, I can give you a number that is based on my experience with athletes: Here there are around 20 percent who still have symptoms after three months after recovering from Covid 19 disease. The number could be higher among the general population simply because athletes tend to live healthier lives and may “deal with” such a disease more quickly.

Do you think that the athletes come to you because they are afraid of long-term damage? Or do you just want to be briefly “checked through”?

I think that the athletes simply want to have a kind of “free pass” so that they can train intensively again.

Are there people who are at particular risk of long-term damage?

What we now know is that people who lead an unhealthy lifestyle, for example overweight, are more at risk of long-term damage. The same goes for diabetics or people with high blood pressure. Since athletes usually live healthier lives, post-Covid symptoms are probably less common in them.

So it comes as no surprise that you recommend as much exercise as possible in everyday life …

I would advise all people to think about their lifestyle. It is important to have a look at your own weight and to be active. And by that I don’t mean running a marathon, but rather intensive walking or walking three times a week. Leave the car behind and ride a bike instead! With such actions, which are quite easy to implement, the risk of suffering from long-term consequences can be noticeably reduced. For anyone who worked intensively physically before contracting Covid 19, it makes sense to have a quick check-up. With exercise and cardiac ultrasound tests, and with an EKG. And if everything fits, you can and should get going again.

Your expert for sports medicine, cardiology and internal medicine:

Dr. med. Karin Nentwich
Specialist in internal medicine, cardiology and sports medicine, special rhythmology (DGK / EHRA)
at RHÖN-KLINIKUM Campus Bad Neustadt, Clinic for Cardiology II

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