The story of Francisco, the first Portuguese teenager to suffer a sequel to Covid-19, a “scar” on the heart, had a happy ending but there is still great uncertainty about the chronic effects of the virus that stopped the world Has.
The pandemic is now a year old, but the marks the virus leaves on the adults and children it infects can last longer and even become chronic. Some are already visible on X-rays, but little is known about long-term effects.
Statistics show that around 50% of the population suffer from consequences. The disease is less common in children and adolescents, and the consequences are also less common, but still leave a mark.
Maria João Brito, head of the Infectious Diseases Department at Dona Estefânia Hospital, explained to Lusa that changes in the body only stabilize “six, nine or 12 months after the onset of the disease”. “Only then can we evaluate,” he said.
In an interview with the Lusa agency, the specialist explained that in the almost 800 children and adolescents Estefânia received with Covid-19 – around 240 had to be hospitalized – there are two types of consequences: organic such as respiratory or cardiac Circulatory problems and inorganic ones such as anxiety, depression, and even obesity.
As an example, Maria João Brito points to the case of children who have been hospitalized with complicated pneumonia and who will all “do respiratory function tests”. But even for that you have to wait: “These tests are only valid six to nine months after the illness.”
Maria João Brito, Director of the Infectious Diseases Department at Dona Estefânia Miguel Manso Hospital
In addition to respiratory diseases, the specialist also pointed out those that have to do with the heart part, for example in children with inflammation in the heart muscle. About 20 are followed through a protocol with pediatric cardiology at the Hospital de Santa Marta.
Echocardiograms and cardiac resonances done at a later time are some of the tests that will help identify traces of SARS-CoV-2. And they are repeated three, six, or nine months later, depending on the case.
“Some children who have had myocarditis have scars in their hearts and can no longer do normal physical activities such as running or playing football,” he said.
Conceição Trigo, of Pediatric Cardiology at Hospital de Santa Marta, told Lusa that the effects of the heart part are still being investigated, but recalled that “most children have relatively benign disease”.
“Indeed, during the acute phase of Covid-19, there can be direct damage to the heart cells,” said the pediatric cardiologist, who is in the colorful corridor by the students of the Institute of Arts and Crafts of the Ricardo Espírito Santo Silva Foundation With the support of the Foundation do Gil was also referred to as an “inflammatory condition that can occur after infection”, although the patients had no symptoms in the acute phase of the disease.
It’s known as multisystem inflammatory syndrome, “it affects multiple organs,” and when it reaches the heart it also leads to “myocardial inflammation,” he explains.
The doctor said that the evolution of these cases is very different and that it all depends on the initial severity of the disease. In the case of Francisco, the first teenager in Portugal to develop this multisystem inflammatory syndrome, the result was happy, but the shock for the parents and sister was enormous.
To Lusa, Francisco’s mother Madalena said she was surprised by the illness of her son, who had always been a healthy child: “I didn’t even remember the last time he got sick.”
In April 2020, almost a month after his mother was infected, Francisco woke up with a high fever. Since he failed, his mother took him to Dona Estefânia hospital, where he was tested several times. During the blood tests, they found that “there was a large source of infection”.
On April 23, he was immediately hospitalized and the doctors “tried to understand what he had,” said the mother. The five tests with Covid-19 were negative. Only later did the serological test identify the new coronavirus through antibodies in the child’s body.
“On April 25th – I will never forget that date – he was very listless,” reported Madalena, explaining that the exams only showed worrying values after Francisco complained about an “impression on the chest” and revealed bilateral ones Lung infection.
From then on, he “started inflaming everything”, developed myocarditis, pancreatitis and went to intensive care.
“It was horrible inside. I could see in their eyes, all masked, that they were clueless. It was very scary, ”he said. Only after three days of induced comas did Francisco, then 13, begin to improve.
He was hospitalized for about 20 days, lost ten pounds, and unable to exercise with impact or cardiac exertion – a ban that still exists today – Francisco did Pilates to recover.
Madalena said that the lack of knowledge frightened her most in the case of her son, who is still persecuted in Estefânia to this day.
In addition to the consequences of the hospital’s imaging tests, there are others that are not seen but felt, such as anxiety and depression.
“We have found that people with this disease may become anxious or depressed. This never happens with the youngest children (…), but with the teenagers we found that even after the illness there was great fear and some were depressed, ”says Maria João Brito.
Some young people are supported by child psychiatry, others receive medical care. How long will the sequels last? Nobody knows.
“It’s too early. There are patients who haven’t had the six months to assess the consequences. We still have a lot to do at this point,” he said.