Lung Covid patients are prescribed painkillers, nerve blockers and sleeping pills, while the impact of the condition on the brain receives insufficient attention, infectious disease consultant Prof. Jack Lambert warned yesterday.
rof Lambert, of the Mater Hospital in Dublin, said the experience of long-term Covid patients can resemble someone who has had a closed head injury.
About 1pc-5pc a year later is still very badly affected, to the point where they can’t function, work or “get out of bed”.
However, the effect on the brain is underestimated and the HSE‘s draft treatment plan needs to be updated to reflect this growing evidence, he told the Oireachtas Health Committee.
In 2021, a questionnaire of long-term Covid patients at Prof. Lambert’s clinic – who has seen more than 1,000 patients – found that a year later, many had persistent brain fog, cognitive problems, exhaustion, sleep disturbances and psychological problems that they did not. had used to have.
A study of patients at his clinic found that a third had significant neurocognitive deficits after one year. And 15-20pc had unexplained anxiety, depression, PTSD and alcohol dependence to cope with.
He said by the time the HSE’s long-Covid guidelines were drafted a year ago, the “goal posts” had shifted.
“It focuses on early post-Covid-19 follow-up with a group of eight lung specialists and a cadre of dieticians and podiatrists with no mention of psychologists.
“However, for those of us treating patients in the hospital, the mounting evidence at the time was that the lungs were healing, the heart was healing, but the brain was not,” said Prof. Lambert.
He said he was surprised to see that Mater’s infectious diseases department had not been included as a site for follow-up despite generating most of the scientific data in Ireland on the subject and also “I suspect managing more patients.” with prolonged Covid than any other location in Ireland”.
He requested a meeting with the HSE’s national clinic leader to discuss the findings of his investigation in April, but it wasn’t until last Friday when he received a phone call – prior to his appearance before the committee – requesting a meeting in the coming weeks.
Prof Lambert said he proposes that the Mater be the neurorehabilitation center with a national network to support GPs as there are so many patients across the country with long-term Covid and many are unable to travel because they are so sick.
He said it would focus on brain rehabilitation as patients with long-term Covid behave very much like patients who have had closed head injuries.
The team would consist of neurologists, psychologists and psychiatrists, as well as neurophysiotherapists.
He told the committee that his team will help rewrite guidelines in the HSE’s long-term Covid treatment plan.
Prof Lambert said he knows of patients who have been discharged from post-Covid clinics as there appears to be nothing wrong with them.
Some have “bounced from one specialist to another and many thousands of euros worth of tests have been carried out.
“I was recently contacted by a psychiatric nurse who has Covid for a year and has an overwhelming fear of not being able to go to work.
“She has been privately referred to a psychiatrist with the first appointment available in February 2023.”
Many Covid patients who have been Covid for a long time are still being told that they are all right and that they should be “vigilant” and exercise, but the reality is that he is treating health personnel that he knows are still never missed a working day before.
As for treatment, Prof. Lambert said the low dose of Naltrexone appeared to improve the condition of patients who had been unwell for about a year on average.
There is no strong data to show that Covid-19 vaccination prevents Covid for a long time and some people are predisposed to it, he added. It can affect people who get a mild dose of infection.
Most people who develop Covid for a long time recover within a year.
Prof Lambert, who said he still wears a face mask, said: “Covid-19 is an ever-mutating and changing virus, and it’s not going away.
“We’ve known for 18 months, based on the collection of scientific data, that brain damage is the problem with long-term Covid.
“We need a new plan and new resources and staff to help these patients recover and return as contributing members of society.”