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Symptoms of long covid can be confused with those of other serious diseases

Doctors warn that the symptoms of long-term covid can be confused with those of other serious health conditions, opening the possibility of several misdiagnoses – which can have serious consequences for patients. An emblematic case is that of an American re-diagnosed with Hodgkin’s Lymphoma after months of believing she only had symptoms of long-term covid.



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With dozens of possible symptoms, long-term covid can easily be confused with other conditions, especially since infection with covid-19 can make pre-existing health conditions worse. Making what is called differential diagnosis, defined by the analysis of all the possibilities that could be causing the symptoms, is laborious and takes time, making the process difficult.




Numerous symptoms of long covid can actually be from other conditions: it is important not to use the term as an umbrella for any diagnosis after infection (Image: Reproduction / Freepik)

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Differential diagnoses and the long covid

Making accurate differential diagnoses is not only important to allow adequate patient care, but also to improve the understanding of the long covid, still obscure in the medical literature. Specialists warn that the condition does not become a “scapegoat” that aggregates all types of symptoms and ends up falling into the evaluation of any patient.

The diagnosis of long covid, in the absence of tests, is made by exclusion, that is, after ideally exhausting all other possibilities, the condition is considered. Recent studies indicate that many patients end up leaving the process with a diagnosis of other diseases.

A July article published in the journal Nature noted that of over 2 million British patients, 5.4% of those infected with Covid-19 had at least one long-term Covid symptom, while 4.5% had no evidence at all. of the virus infection also had at least one symptom of long covid.

If there are a considerable number of people with symptoms considered to have long-term covid without having contracted the virus, then many previously infected may be having persistent symptoms for unrelated reasons. The British numbers, even, may be underreported, as many doctors describe symptoms in free text fields of the patient record, which is not included in the analysis of the article.



Even patients who did not have symptoms or signs of infection with covid can have symptoms, which has worried doctors and generated alerts (Image: Reproduction / AnnaStills / Envato Elements)

Even patients who did not have symptoms or signs of infection with covid can have symptoms, which has worried doctors and generated alerts (Image: Reproduction / AnnaStills / Envato Elements)

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In August, another article, this time published in the Lancet, noted that 21% of recent Covid patients in the Netherlands reported at least one symptom that worsened after their infection, but 9% with no evidence of infection had similar symptoms. Many patients who come to specialists in long covid have already been tested elsewhere, but leave the clinics of these doctors with diagnosis of other diseases in place of long covid.

Conditions confused with long covid can be very serious: shortness of breath can be caused by blood clots in the lungs, or abdominal pain can be the result of a heart attack. Differential diagnosis can be a long and disheartening process, with each additional symptom leaving the pathological possibilities exponential, but it is still essential for effective treatment — and this is the wake-up call for clinicians around the world.

Source: The Lancet, Nature Medicine

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The article is in Portuguese

Tags: Symptoms long covid confused diseases

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