Why are you involved in Altea's Expert Board?
Due to my specialization in lung tissue diseases, I came into contact with COVID-19 patients relatively early on. As most were severe cases, and many patients had to be ventilated, this brought up the question of whether those affected would recover quickly or have to deal with shortness of breath for a lengthy period of time. At the same time, we were hearing about people who had experienced less severe symptoms, but were more and more frequently suffering from Long COVID. I think Altea’s project is very meaningful, and I was on board from the very beginning.
What is your professional relationship to Long COVID?
As a pulmonologist, I’m interested in whether there is long-term damage to the lungs, to the lung tissue, that is, in people who have had COVID-19.
To find out, the interest group Swiss Society for Pulmonology created a study protocol and recruited from different centers. We examined the patients four and twelve months after their illness. The first part of the study has already been published, the second part was recently submitted for publication. The group has also published Guidelines on Pulmonary Long COVID.
We can already say that a considerable improvement could be observed in the majority of those affected who suffered a severe case. Most of these patients from the first wave are no longer receiving treatment. There were, however, individual cases where the lungs, unfortunately, did not recover and even required a lung transplant.
At the beginning, my work and therefore my experience with Long COVID was very centered around the lungs, and on patients who had severe symptoms. Over time, due to the wide variety of symptoms – even in patients who experienced mild cases – we started working more often with other specialists, such as ear, nose, and throat (ENT) physicians and neurologists. And as more hospital employees were affected, it brought the topic more into focus.
Including therapists is also essential. For example, we developed a program for Pacing, and “Energy management training”, in which physiotherapists, occupational therapists and psychologists are involved. As much still remains to be confirmed in research, it’s all about building knowledge and sharing experiences.
The gaps in knowledge that still remain are not just frustrating for patients, but are also frustrating for physicians, because they are not able to offer the patients much other than attempting to treat certain symptoms.
“The gaps in knowledge that still remain can be frustrating for both patients and physicians.”
How do you see the future with regards to Long COVID?
I hope that the vaccine reduces the number of severe cases and the amount of organ damage as much as possible. That would protect so many patients. Furthermore, I hope that research will find ways to have a positive impact on the course of the disease, so patients don’t have to suffer from fatigue, for example. Medication-based approaches could also be possible. The clock is ticking for this illness, as there is a lot happening in the field of international research. It’s important that we are ready to accept what’s in store.
It has been observed that there isn’t just one type of Long COVID. I’m convinced that patients can be categorized into subgroups. So I’m optimistic that most people can be helped. However, the problem is much more complex than previously indicated by the collective term Long COVID. And I’d say that there will continue to be symptoms that cannot be biologically explained.
“The clock is ticking for this illness, as there is a lot happening in the field of international research.”
What are you enthusiastic about as a private person?
At the moment, I’m very much looking forward to my skiing trip in Davos. I’m originally from Germany, and I love exploring Switzerland with my family. I’m most at home in places where there is wind and water, which is why I really enjoy going to Lake Silvaplana and to the North and Baltic Seas.
Christian Clarenbach is a chief physician for the Department of Pulmonology at the University Hospital Zurich. He specializes in lung diseases and breathing problems.
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