Itinerários terapêuticos e perspectivas na saúde pública para casos de “Covid-longa”

Abstract

This qualitative study analyzes the therapeutic itineraries of patients with long-term COVID-19 in northern Rio Grande do Sul, seeking to understand the care pathways and challenges faced by individuals with persistent sequelae of COVID-19. Ten semi structured interviews were conducted in Marau and Passo Fundo, between 2023 and 2024, linked to projects on the psychosocial effects of the pandemic. The reports show diverse experiences, from diagnosis and use of the “COVID kit” to hospitalizations and search for specialized treatments. Most participants resorted to the SUS, although some used private services. Persistent symptoms included fatigue, dyspnea, muscle pain, and cognitive problems, aggravated by difficulties in access, lack of specific policies, and lack of medical credibility. The itineraries highlighted the role of faith, family, and trust in health professionals, but also highlighted gaps in care networks, especially in post-acute monitoring and rehabilitation. Severe cases generated lasting physical disabilities, impacting daily life and professional life. The data reinforce the importance of institutional recognition of long-COVID and of valuing patients' knowledge for more effective responses. The analysis of itineraries is a powerful tool for understanding inequalities in care and the limits faced by users with chronic conditions that are little recognized in the health system.