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Thursday, December 01, 2022

“Clinical suspicion of infection”, the only need to study LongCovid

Antony Serrano Blanco, co-author of Phase I of CyberPostCovid.

The first phase of the study, commissioned by the Carlos III Institute of Health to continuously study COVID, has caused a stir due to its general definition and Demand gang up laboratory tests or previous diagnosis of acute covid infection. is a necessity, as explained by one of the main authors of the essay medical writing, “Leaving no one out” does not mean, Since the doctor-patient relationship may consider the result valid when conducting a self-test.

“Many people have commented on this and it is a mistake. Testing is not mandatorybut yes there should be clinical suspicion that the person has passed it. What is needed is a clinical diagnosis, because especially in the first waves, the availability of tests was non-existent as well as they were being hospitalized due to covid,” said Antoni Serrano Blanco, Co-Vicky Serra —Sutton, lead author of the study.

For a psychiatrist, the best thing to do is to do a diagnostic test, but he or she understands that if you have a history that you have been admitted or treated for symptoms conducive to covid.” It can be diagnosed that you have had it.” “what We can’t diagnose without testing confirmatory and only on suspicion and set of symptoms. should be Eliminate other diseases first which can explain the symptoms. It should be kept in mind that they are very systemic symptoms and they can occur in many other diseases,” explains Serrano Blanco.

In this sense, the expert remembers that first you have to discard certainties and then stick to the symptoms. “So, you have to help that person and you can try persistent covid treatments like physical therapy. You are still not 100 percent sure, but you have a high suspicion and you can improving the quality of life of the individual, which we are after”, claims the expert.

What about who took the antigen test at home?

The need to present this ‘evidence’ has led doctors to brand the study as “foreign to reality”, due to the fact that most infected people in previous large waves self-examined and health The system did not record the results.

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However, for Serrano Blanco “Cannot guess” that the results of this study are leaving these people behind, “It doesn’t, what we are sure of is that people who have it and present these symptoms” We can identify with a clinical picture That we have consistently said Covid”, assured the psychiatrist.

In this sense, the doctor reminds that there is Same percentage of diagnoses as overdiagnosis. “It is the same risk as the diagnosis of persistent Covid and it is another pathology. It does this by discarding that hypothesis and others, so that you don’t stick with it. Absolute certainty in medicine is very complex”, recalls Serrano Blanco.

Importance of doctor-patient relationship

In these cases of absence of laboratory tests or clinical history, the doctor-patient relationship is particularly relevant. “You have to take this into account to see if you believe what the patient tells you. If you did the test at home, The doctor may or may not trust you, depending on whether he trusts you or not.”

To the expert, we all have to rely on the national health system, because it has “great quality” and moreover, remember that Helping Relationships Are Based “On Trust”, “Doctors don’t want to do harm by instigating action based on little information. If the doctor knows you and knows he’s telling the truth, he’ll do everything he can to help you and possibly get a good diagnosis of covid consistently.” Kind of will do,” explains Serrano Blanco.

On the other hand, if the doctor doesn’t know the patient, it’s going to get more complicated. “If you go to the ER and say: “I took a test, but I don’t have it here”, the doctor will have a low degree of confidence. First, he or she will search to see if it’s another pathology and from there it will work, no one is forbidden here But we should try to get maximum certainty on the basis of present knowledge. This will evolve and some concepts may be changed in the future”, details one of the main authors.

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A general definition, but with new concepts

Regarding the definition of persistent COVID, the study’s co-authors understand the criticism: “Some have told us that we are similar to the World Health Organization’s (WHO) definition and This is normal because we have reviewed your documents Along with guides from the Spanish Society of General Practitioners (SEMG) of NICE (United Kingdom National Institute of Health and Excellence in Care), and other articles have been published on how they defined or used a perceived definition of persistent covid. analysis in patients. In addition, we have conducted focus groups and Delphi panels to reach a consensus.”

A systematic review that, according to Serrano Blanco, provides scientific strength. However, it also highlights that there “Different Shades”, “For example, Time What we have determined is higher than NICE or WHO. We do not see that there is evidence and we have not included the interval of persistence of symptoms or waiting after the passing of Covid”, details Serrano Blanco.

One of these nuances is that in addition to the set of symptoms, Need to assess the impact on quality of life and functionality, “In other definitions it does not appear. You may have a set of symptoms, but if there is no effect, it cannot be considered a clinical condition to study. For this type of evaluation, Standardized tools have to be used to measure the impact”, claims the expert.

While it may include statements, data or notes from health institutions or professionals, the information contained in medical writing is edited and prepared by journalists. We advise the reader to consult a health professional on any health-related questions.

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