JonathanLong COVID thread 🧵
(Long COVID thread: https://mastodon.social/@jmcrookston/110972597032676290
Long SARS thread: https://mastodon.social/@jmcrookston/111561915474041941)
https://www.washingtonpost.com/health/2023/08/21/long-covid-lingering-effects-two-years-later/
Effects two years later ...
Postacute sequelae of COVID-19 at 2 years - Nature Medicine
Analysis of data from the US Department of Veterans Affairs showed that 2 years after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, risk for most postacute sequelae remained elevated in people who were hospitalized with COVID-19 but was attenuated in nonhospitalized individuals.
Long term effects after SARS-CoV-1 :
https://mastodon.social/@jmcrookston/110959646224585827
Also, thread here
https://mastodon.social/@jmcrookston/111561915474041941
We are very confused why a very strong virus would lead to long-term effects.
Who would have thunk it?
https://time.com/6309054/long-covid-recovery-rare/
Perm link https://web.archive.org/web/20230830000904/https://time.com/6309054/long-covid-recovery-rare/
"Living with long Covid, I’m terrified of being reinfected with one of the new variants"
Kathryn Bromwich
"After 1,284 days, I’m only just recovering from the coronavirus but there’s no vaccine for the likes of me"
Ah, here we go:
People develop long flu at the same rate as long COVID. Symptoms vary though, and long COVID is worse. (April 2023)
In other words: exactly as you would think if you didn't subscribe to foolish notions that infection ends for everyone after the acute phase. (Protip: your body is FLOODED with virus during infection.)
Prevalence and characteristics of long COVID in elderly patients: An observational cohort study of over 2 million adults in the US
Incidence of long COVID in the elderly is difficult to estimate and can be underreported. While long COVID is sometimes considered a novel disease, many viral or bacterial infections have been known to cause prolonged illnesses. We postulate that some ...
Here is another one, although I have not had a chance to look through it.
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00428-5/fulltext
“Persistent symptoms were more common after reinfection than following a first infection.”
“The burden of post-acute COVID-19 symptoms in a multinational network cohort analysis” - Nature Communications
Post-acute COVID-19 condition is difficult to quantify because it includes a range of symptoms that may have other causes. In this study, the authors use primary care data from England and Catalonia, Spain, to estimate the incidence of the condition and identify symptoms that occur more frequently following infection than in uninfected controls.
Ex-Senator Jim Inhofe Retired Due to Long Covid, Says at Least Five Other Congress Members Also Have It
"Five or six others have (long Covid), but I’m the only one who admits it,” Inhofe told Tulsa World in a recent interview."
Looks like he was born wealthy and connected no surprise there.
"in 1942. His father, Perry Inhofe, was an owner of insurance companies and his mother, Blanche Inhofe (née Mountain), was a Tulsa socialite. "
Virus that is stronger than influenza turns out to be stronger than influenza.
Who would have thunk it.
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2823%2900684-9/fulltext
--- Long COVID rates/prevalence around the world
--- Long flu?
In summary, long-term lung disability and psychological impairment in H7N9 survivors persisted at 2 years after discharge from the hospital. Pulmonary function and imaging findings improved during the first 6 months especially for those with ARDS. Most survivors returned to work, but at the 2-year follow-up, more than half of survivors still had ventilation and blood-gas diffusion dysfunction. ...
The H7N9 survivors had impaired HRQoL scores that were lower than those of a sex- and age-matched control population, and ARDS substantially influenced these scores
Chen, Jiajia, Jie Wu, Shaorui Hao, Meifang Yang, Xiaoqing Lu, Xiaoxiao Chen, and Lanjuan Li. ‘Long Term Outcomes in Survivors of Epidemic Influenza A (H7N9) Virus Infection’. Scientific Reports 7, no. 1 (8 December 2017): 17275. https://doi.org/10.1038/s41598-017-17497-6.
https://www.youtube.com/watch?v=W7tpe0evm5A
1:20 or so - 16 trillion in costs.
1:30 - you do not have to show you were infected at work.
NYSIF Panel on Long Covid's Impact on the Workforce
"No one knew there was such a thing as long COVID ..." post
In a sample of people hospitalized with COVID, a follow-up survey 2 or 3 years later showed about a 10 IQ point drop.
"Two to three years after being infected with COVID-19, participants scored on average significantly lower in cognitive tests (test of attention and memory) than expected. The average deficit was equivalent to 10 IQ points. Additionally, a substantial proportion reported severe symptoms of depression (about 1 in 5 people), anxiety (1 in 8), fatigue (1 in 4), and subjective memory problems (1 in 4), with these symptoms worsening over time."
Of the people who changed their job, most of them did so because they actually couldn't perform their duties any more.
Yes, they were brain damaged enough that they could no longer
Do
Their
Job.
Can I get an apology out of the people who said that this was not neurotropic?
Long COVID website, with questions and answers about common questions.
https://www.medpagetoday.com/neurology/longcovid/111401?trw=no
"At 2 to 3 years, most participants reported at least mild anxiety (74.5%), fatigue (53.5%), or subjective cognitive decline (52.1%). More than a fifth said these symptoms were severe. Symptoms at 2 to 3 years were not predicted by the severity of acute COVID-19, but by the degree of recovery at 6 months."
I believe these are unvaccinated. I have to confirm and I have to find the number of people.
Why do I have to hunt for this stuff? MedPage, do better.
kb@jmcrookston This kind of thing is absolutely why I think the primary focus should be on measures that prevent every airborne disease - we had been complacent about these problems far too long.
How much damage has been done, that we thought was just normal for humans?
Yup.
It's very obvious we had a baseline of disease much higher than it needed to be because we did nothing about these things.
I think when they put air purifiers in hospitals stuff like this the high risk locations you're going to see hospital acquired infection plummet.
As in, PLUMMET.
And everyone who got an infection in hospital should just sue their hospital.
@jmcrookston Schools as well need to be a *massive* focus - clean air in public schools might just be one of the more important things anyone can do right now.
@donkeyblam yes absolutely schools.
Actually, schools should be above hospitals even. I agree with you not me.
J.H.NoyesThere's a push on to conflate Long Covid with 'long' flu and 'long' cold right now. Influenza and common human coronaviruses. Put it to rest with pathology.
Watch from minute 32 for clarity, then go watch from the beginning if so inclined.
SARS-CoV-2 Infection and Persistence Throughout the Human Body and Brain
This will be an NIH–FDA COVID-19 SIG lecture concerning findings from the NIH COVID-19 Autopsy Consortium. Daniel Chertow is a tenure-track investigator in the Critical Care Medicine Department at the NIH Clinical Center and in the Laboratory of Immunoregulation at the National Institute of Allergy and Infectious Diseases.<br><br>For more information go to <a href="https://www.niaid.nih.gov/research/covid-19-sig-lecture-series">https://www.niaid.nih.gov/research/covid-19-sig-lecture-series</a>
They are suggesting it is mild by analogy to those others, you mean?
@jmcrookston
Yes, they're building a straw man. If you watch the video I posted with it from Minute 32 the pathologist talks about how different persistence of infection is with SARS-COV-2. The immune system wasn't even reacting to it--it gets to do what it wants.
He only had six subjects. All had similar patterns of persistence and died of causes—ostensibly—unrelated to Covid. He stresses how unique to covid this is.
Well perhaps they can do Ebola and long ebola next so that we can all rest happily knowing Ebola is no more than a cold. 🤡
I suspect persistence is far more common than we think across many viruses, but most are not so powerful so we do not see it or look for it. So this is not a surprise to me other than we again think COVID is unique. By this I mean I doubt it has a set of molecular tools other viruses do not have Rather I suspect it is simply very powerful.
In terms ...
... of effects on us it is unique, as it is extremely powerful, and damaging, and no sterilizing (hate that word) vax, as we see. I can't think of such a virus that has circulated before.
@jmcrookston
1)It's a philosophical matter, but I think the reason SARS-CoV-2 doesn't behave like other viruses is because it isn't a true virus. Without a Complement Control Strategy it will eventually lose its ability to transit the extracellular fluid. It only does so now because it has been subject to husbandry, but without a CCS, it's going to keep on evolving in ways that help it avoid the ECF. If it does that enough, it'll be much harder for it to jump from host to host. I could even see
1)It's a philosophical matter, but I think the reason SARS-CoV-2 doesn't behave like other viruses is because it isn't a true virus. Without a Complement Control Strategy it will eventually lose its ability to transit the extracellular fluid. It only does so now because it has been subject to husbandry, but without a CCS, it's going to keep on evolving in ways that help it avoid the ECF. If it does that enough, it'll be much harder for it to jump from host to host. I could even see
@jmcrookston
2)it getting to a point where it could only transmit with the help of other viruses capable of secreting proteins that make the ECF less hostile.
2)it getting to a point where it could only transmit with the help of other viruses capable of secreting proteins that make the ECF less hostile.
@jmcrookston
3)See those pom-poms on that S-protein? Collectively, that's the glycocalyx. Among other things, it allows the virus to hide from the earliest immune interactions by displaying a surface that doesn't trigger Complement. At least not initially. BA.1's pompoms were so densely packed that some had to catch it twice before mustering a protective humoral response.
3)See those pom-poms on that S-protein? Collectively, that's the glycocalyx. Among other things, it allows the virus to hide from the earliest immune interactions by displaying a surface that doesn't trigger Complement. At least not initially. BA.1's pompoms were so densely packed that some had to catch it twice before mustering a protective humoral response.
@jmcrookston
4)Those are useless once the host serocoverts. Antibodies push them out of the way to get at the epitopes beneath. Selection will favor subvariants that apply the resources involved along more productive axes, like cell to cell transmission.
4)Those are useless once the host serocoverts. Antibodies push them out of the way to get at the epitopes beneath. Selection will favor subvariants that apply the resources involved along more productive axes, like cell to cell transmission.
@jmcrookston
5)Eventually the carrier acquires a new variant. The new variant finds its way into cells occupied by the progeny of the old variant and they pool genes to produce new variants that aren't quite as durable in the ECF, but are just that much better at cell-to-cell transmission. The virus is more visible, but it also does more damage. Eventually it becomes something like MERS which
5)Eventually the carrier acquires a new variant. The new variant finds its way into cells occupied by the progeny of the old variant and they pool genes to produce new variants that aren't quite as durable in the ECF, but are just that much better at cell-to-cell transmission. The virus is more visible, but it also does more damage. Eventually it becomes something like MERS which
@jmcrookston
6)pokes it's head up every now and again as it escapes from a cryptic host, causes some chaos, and then disappears as fast as it came.
6)pokes it's head up every now and again as it escapes from a cryptic host, causes some chaos, and then disappears as fast as it came.
1)They're trying to imply that Long Covid is nothing out of the ordinary, that the same thing happens with other respiratory viruses(Covid is not dependent on respiratory tissue for its replication cycle, unlike cold or flu; another conflation).
Covid is much more like HIV, another syncytial virus known for undergoing changes in tropism and behavior based upon humoral pressures. In carriers with perturbed Complement, the virus ends up being subject to lysis. This ensuing
@jmcrookston
2)lysis-dependent immune activity increases the rate at which the virus is opsonized. The extra opsonins encourage cells to take up the HIV virus where they normally wouldn't. The gain in infectivity for a thus opsonized HIV virion is along the order of 60 to 300 times more infectious. Carriers subject to C'ADE decline rapidly, progressing to full blown AIDS in as little as 4 years post infection.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065417/
So yeah, Long Covid reminds me of a of C'ADE ME CFS mashup.
Extensive complement-dependent enhancement of HIV-1 by autologous non-neutralising antibodies at early stages of infection
Non-neutralising antibodies to the envelope glycoprotein are elicited during acute HIV-1 infection and are abundant throughout the course of disease progression. Although these antibodies appear to have negligible effects on HIV-1 infection when assayed ...
except they have found flu in the brain and cold coronas in the brain. So it's not strictly speaking that they are limited to respiratory tissue that's just a talking point. How much the tropism varies differs tho I'm sure.
I don't know about the other points to comment
I don't read the studies as necessarily down playing COVID. One of then expressly pointed out the COVID symptoms are more serious
That said, how the media reports these studies (or anything) is a separate issue tho...
@jmcrookston
I looked into this a bit last night, though my review is by no means comprehensive, even highly neuroinvasive flu strains are fully resolved by 130 days.
Lack of resolution is the issue with SARS-2 pathology—very little immune pressure is being applied to the infection. Almost no classical cytopathy in reservoirs—this is a huge part of why most carriers are asymptomatic.
My 2¢ on Long Covid is that they are the ones trying to fight the infection. Everyone else is just laying flat.
@noyes You're picking one virus though. My point is you have reactivation of chickenpox as shingles. You have EBV being connected to long-term issues. The idea that these things simply resolve when we're through the acute phase is probably just nonsense.
Now tissue tropism will probably limit some of them so they're not so dangerous etc., I agree with that.
I generally speaking dislike this idea that COVID is the first to have long-term effects is just nonsense. What it is is very powerful.
I haven't seen that the rates of asymptomatic COVID are much different from other viruses though in terms of transmission. (That is, not talking about Reservoirs.)
@noyes If I have time I'll poke around on these issues. Interesting. And I'm not disputing the covid might be better at immunovation by the way I just don't think the nature of these things is unique.
On the other hand, there's no way I would compare covid to flu in terms of severity. So If people like Isaac Bogoch are suggesting that flU also leads to persistent state, Therefore COVID is no big deal, he should just relinquish his medical license.