No, the long Covid cannot necessarily be considered psychosomatic

Last week, Covars (Committee for the monitoring and anticipation of health risks) published its first opinion. In it, the experts specifically explained that the health situation was under control, but expressed concern over the rapid growth of the Omicron sub-variant BQ.1.1. However, that is not why the Committee’s report caused a stir.

On social networks it is a very specific passage that was widely taken up later. On page 12, a paragraph explains: “Scientific debate also exists as to whether symptoms are attributable to SARS-CoV-2 or another triggering agent. The research work on “long Covid” should make it possible to better address the complexity of post-infectious syndromes in general, to improve the management of these little-known and little-studied so-called “functional” disorders. “For many Internet users, describe the disease as a “functional disorder” would be equivalent to designating it as psychosomatic. But can we really consider that the long Covid is “done” only in the head?

FALSE

By definition, functional disorders are diseases that have no injury support. With the affected patients, doctors will not find so-called organic disorders and will therefore refer to psychosomatic disorders. Except that the long Covid is much more complex than saying “it’s all in the head”.

Santé Publique France estimates that 2 million people have long-term symptoms after the first Covid-19 infection. Disturbances in concentration, memory, digestion or even respiratory problems … it is now known that the long Covid takes many forms.

On October 26, after the publication of the opinion by Covars, the AprèsJ20 association – which brings together patients with long-term Covid – reacted directly to the use of the term “functional disorder”, which is not scientifically founded. “For more than a year and a half these prolonged symptoms have been called“ post-acute sequelae of Covid ”. They are described with the acronym PaSC in English (Post-acute Sequelae of COVID-19), or indifferently “Long Covid”, in several thousand studies ”, the statement reads. Contacted by 20 minutesthe spokesman of the association Matthieu Lestage regrets a great “minimization” of symptoms by the scientific experts during this first opinion.

“Complex and misunderstood”

On the part of Covars, the missing little brother of the Scientific Council, we regret the clumsiness of the comments used. In an e-mail sent to the association of the sick, the Prime Minister Brigitte Autran made a point of explaining her point: “It does not mean at all that we consider these disorders as ‘functional’, but that on the contrary we consider them complex and little known. . We recommend research and better management of these disorders sometimes called “functional”, but which remain little known and little studied. “

Close 20 minutesBrigitte Autran also specifies: “The term ‘functional’ generally designates in medicine a set of ill-defined disorders whose cause is not known, but which may include, among others, the so-called psychosomatic disorders”. Understand: it can be in the head, but it can also be something else.

France back in research

According to the Covar, research on the long Covid is still lacking. “We obviously analyzed the works already published on the subject, but these do not yet allow us to give a scientific and medical basis to these disorders, nor to open therapeutic perspectives. The work needs to continue in France and around the world. There is an international consensus on this point ”, the Prime Minister explains.

For its part, the association ensures that many studies have been carried out abroad, where the psychosomatic character has not been highlighted as much. “It is a French exception”, regrets Bertrand, the head of the association’s Science division, charged with supervising scientific studies on the subject. According to our interlocutor, this thesis of the long psychosomatic Covid remains marginal in the literature. “This represents only 0.5% of the review I do and it is still the same team of French researchers. “

The same team is the one that published a study in the medical journal “JAMA Internal Medicine” in early November. Their hypothesis? The symptoms of the long Covid would be more related to the belief that they have been infected by the disease, rather than having actually been. But the study was quickly criticized by healthcare professionals, especially for its sampling. “We realized that there was a methodological and ethical bias. The tests were not integrated into the study, but were actually carried out on the participants, “says Bertrand of the AprèsJ20 association. A few weeks ago, ANRS in turn launched its long-running Covid research program and work is ongoing. .

More patient interviews

Following the publication of Covars, patients with Covid have also long regretted that they were no longer involved in discussions with the Scientific Committee. In the future they hope to be included again in the debates, as during the health crisis. “When the Health Council still existed, we took part in the discussions. We were able to give our ideas and we got feedback. We expect the same from Covars: listening and that we are not left alone ”, Matthieu Lestage hopes.

For the AprèsJ20 association, the argument of “functional disorder” is no longer admissible and even tends to add a problem to the problem. “The sentence is not false: we really have functional disorders. Today there are 203 symptoms listed, it affects the mind. But it is in no way a psychosomatic illness, it is psychopathological ”, says Matthieu Lestage, who assures that the long Covid necessarily plays on his mental health today. “My life stopped twenty-four months ago and it stopped,” he says. He imagines everything that suddenly happens to us with the corner of the face. I ask anyone not to lose morale. “

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