A year ago I had to close my Rheumatology outpatient practice to go to the call for help at the Hospital. Faced with an unprecedented health crisis, in my life as a physician I had the professional duty to help as much as possible in the face of the collapse of the system and the suffering of the people. For two full months of my life, my exclusive activity was focused on helping as many patients as I could in the Covid19 contingency team 1 of the Teknon Medical Center.
During those two months I already noticed a very remarkable fact: the patients we stabilized and returned home were exhausted, fatigued and had to continue resting. Their immune system had fought against the virus, had managed to defeat it, but their batteries had been discharged. In the same way that happens with cell phones when they are out of battery, unable to send a photo, make a video call or upload a message, the battery system of these patients had gone into reserve and was discharged.
Fatigue and tiredness, the main after-effects postcovida
When after two months I was able to reopen my office and once again attend my patients in person, I began to realize that not only the patients who had been hospitalized had run out of batteries, but that the same thing was happening to those who had spent the Covid19 in their homes confined to their own homes.
I began to research the scientific literature and to share my clinical observations with fellow rheumatologists in various hospitals, and they all observed the same fact: Covid19 sensitized the pain perception system, both peripherally and centrally, and caused a wide range of symptoms beyond the pulmonary. I am mainly referring to tiredness, extreme fatigue, muscle pain and joint pain. Many patients still describe it to me today as: “a steamroller has run over me”, “I’m exhausted, everything hurts and I can’t even get out of bed”.
Similarities between rheumatologic diseases and postcovid syndrome
Faced with this clinical reality, over the last 6 months I have seen many more patients and I have noticed that they do not really experience anything new that I had not seen before in other diseases. Specifically in central sensitization syndromes such as fibromyalgia and chronic fatigue.
My perception and opinion as a specialist in Rheumatology and PhD in Internal Medicine, specifically in the study of inflammatory and autoimmune diseases, is that Covid19 acts as a trigger, a trigger, it generates stress in the immune system of the infected person. In those people whose system is not able to adapt correctly and defend itself, what happens is that it discharges its vital endorphin system, its battery and, in addition, it becomes sensitized to pain and other stimuli, as if suffering from a fibromyalgia crisis or chronic fatigue syndrome.
Our effort and work is based on helping these patients to recharge their batteries and desensitize their nervous system until we have a definitive curative treatment. Today we use all the tools, with a multidisciplinary approach, that are within our reach: a good nutritional plan, an individualized schedule of progressive physical activity, personalized physiotherapy, psychological support, neuromodulation techniques and acupuncture treatments.