[Breathless, without strength, forgetful: Long Covid, the pandemic within the pandemic.] / Senza fiato, senza forza, smemorati: Long Covid, la pandemia nella pandemia.

Following the Covid-19 pandemic, a new disease has emerged: Long Covid syndrome, about which we know little and on which too little research is being done. It is a chronic disease, which is diagnosed when Covid symptoms last more than 12 weeks. To date, there is no pharmacological or other approach to Long Covid. The main symptoms of Long Covid are pain similar to those of rheumatic and autoimmune diseases, headaches, concentration and memory disorders, sometimes also perceived as brain fog and fatigue. Research and education and sensible, bipartisan social policy, away from all ideologies, are needed to address this additional aspect of the SARS-CoV-2 pandemic.

[The choices in CoViD-19's time.] / Le scelte al tempo di CoViD-19.

In these times of insufficient resources for all there can be no shared decision-making, that is, a shared plan of care. Without attempting to subtly induce the patient to believe that it is the best decision for him. In the case of CoViD-19, we must rely on professionals: it is not the time for the anticipated treatment plan, for self-determination. Of course, we can always say "no"; but we hope that as soon as possible we will be able to take back all the freedoms that has just been conquered: that of end-of-life choices, after a process of sharing with the carers. But in this difficult moment someone can also feel a relief - that of the old paternalistic choices - that someone else decides for us.

End-of-life decision making in respiratory failure. The therapeutic choices in chronic respiratory failure in a 7-item questionnaire.

INTRODUCTION: The transition from paternalistic medicine to a healthcare culture centred on the patient's decision making autonomy presents problems of communication and understanding. Chronic respiratory failure challenges patients, their families and caregivers with important choices, such as invasive and non-invasive mechanical ventilation and tracheostomy, which, especially in the case of neuromuscular diseases, can significantly postpone the end of life. MATERIAL AND METHODS: A 7-item questionnaire was administered to 100 patients with advanced COPD, neuromuscular diseases and pulmonary fibrosis, all of them on oxygen therapy and receiving day-hospital treatment for respiratory failure. The objective was to find out whether or not patients, if faced with a deterioration of their health condition, would want to take part in the decision making process and, if so, how and with whom. RESULTS: Results showed that: 90% of patients wanted to be interviewed, 10% preferred not to be interviewed, 82% wanted to be regularly updated on their clinical situation, 75% wanted to be intubated, if necessary, and 56% would also agree to have a tracheostomy. These choices have been confirmed one year later, with 93% of respondents accepting the questionnaire and considering it useful. CONCLUSIONS: It is possible to conclude that a simple questionnaire can be a useful tool contributing to therapeutic decision making in respiratory failure.