Since the start of the program, 454 referrals have been received for long-covid treatment. Women were more likely to develop the pathology (65%), while the average age of patients was 47, Staub announced. Only 20% of cases had been hospitalised due to the infection, which suggests, according to Schütz, that a stay at the ICU does not necessarily have an impact on chances of developing post-covid symptoms. However, stronger symptoms were more likely to result in aftereffects, he added.
Schütz also explained how the acceptation process is undertaken. Patients whose symptoms last long after the initial infection have to first be assessed by their GP, who refers them to the service. Following this, a case manager remotely conducts an interview, to know more about the patient’s history (severity of illness, hospitalisation…) and symptoms. After the initial interview, the patient is assessed by a doctor and sent to one of the centres dealing with long covid patients. This variety of steps has so far resulted in a 26-day waiting time for referrals.
The pilot project had initially received a dedicated budget of €1m, with the clear aim of addressing the physical and psychological aftereffects of a covid-19 infection. At the end of January, it had exceeded the budget, with €1.2m spent on the equipment to take care of long-covid patients, but also the creation of 12 additional positions to aid patients in their rehabilitation.
A long and frustrating therapy
Long-covid symptoms--there are up to 200 identified different symptoms at the moment--include fatigue; neurological, cardiac, and psychiatric disorders; and dyspnoea (difficulty breathing). The symptoms vary in presentation, intensity and duration and are managed as they come, though rehabilitation remains at the heart of the treatment. Due to their diversity, a multidisciplinary management--in a hospital setting--is necessary, according to Schütz.
Once a patient has been diagnosed with the illness, they are redirected to either Mondorf--which also works on smell and taste rehabilitation, and now has both cures and ambulatory treatments--, the Rehazenter--for more severe cases--, or the CHNP for issues pertaining to psychological or psychosomatic symptoms.
The project has also introduced group therapy sessions--after assuring they are safe, Schütz says--which improve the treatment progress of patients as “they feel understood, by being with others who went through the same thing,” reveals Schütz. The issue, however, is that treatment remains focused on the symptoms, as too little is still understood about the illness. The length of the therapy is also hard to define as it depends on each patient, but is usually a few months long. At the moment, less than 30 patients have been discharged, Schütz noted.
While mobility and breathing difficulties represented the biggest issue at first, this has now been replaced with chronic fatigue, not only physically but also mentally. Long-covid suffers are not as resilient anymore, explained Schütz. One third of patients present psychological or psychosomatic symptoms. Others suffer from physical aftereffects that are invisible to the eye, but have a strong impact on their quality of life as a person.
Omicron, boosters, and the future of the project
The arrival of the omicron variant has, however, given the project leaders some hope. As the variant seems to cause less severe symptoms, there is hope that there will be less cases of long covid, said Schütz. Asked in the conference whether the impact of the booster on long covid numbers was already known, Staub answered that it was far too soon to determine this.
Current sufferers of long covid have also mostly been suffering since before the introduction of the vaccine.
Despite expecting fewer cases as new, and so far less virulent variants take over, Jean-Paul Freichel announced that the program is likely to continue, with government support. A similar project could be conducted in Luxembourg’s paediatric clinic, to determine the impacts of the virus on children.
While some patients are still on the waiting list to get treatment, they are likely to be referred within the next month, as Staub reassured.
Health minister Paulette Lenert reminded that, while the omicron variant seems less harmful, “vaccination works,” and that it protected against potentially developing severe forms of the infection, too.
On 4 February, the government will advise more about the current restrictions.