Covid Long Haulers

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  • Thread starter bhobba
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Hi All

An interesting article on Covid long-haulers appeared in our local newspaper - the Courier Mail in Brisbane. Unfortunately it is behind a paywall - but a precis follows.

Start of precis:

Gary Macpherson could pull a golf cart around 18 holes without effort. He’d climb the six flights of stairs to his rooftop garden in inner-Brisbane’s Newstead, no puffing required. He’d eat and drink what he liked.

That was before he keeled over in the emergency department of the Royal Brisbane Hospital on March 30 last year with Covid. He spent six weeks in intensive care, most of that in an induced coma.

He survived, and at 62, now a Long COVID sufferer. He went through the painful rehab for his wasted muscles. He slept for most of the day in the first months back home, returning to work in September, and even then only in the mornings.

It’s been almost a year now and exertion leaves him short of breath. His kidney function has not returned to its pre-COVID healthy condition. Macpherson’s kidney function test score used to be about 80 per cent (average for his age); today it’s at a concerning 40.

Some recover after a month; others have lived with their symptoms for more than a year. It’s feared permanent damage may be done. Scientists are growing increasingly alarmed about just what is going on – silently, often undetected – in the heart, brain, kidneys and lungs of former COVID-19 patients.

Doctors are warning that patients who have survived COVID-19 may be left with longer-term health problems. Post-viral illness is not new; people can take weeks to recover from influenza and many who suffer the once-maligned chronic fatigue syndrome report its onset after battling a virus. But the numbers of those afflicted by Long COVID are huge. Some doctors think it could be “the pandemic on the pandemic”.

Dr Fauci, estimates more than 10% of COVID patients will develop what is also called post-acute COVID syndrome, while Professor Danny Altmann, from Imperial College London, says it could be as high as 20 per cent. The number of COVID cases globally is 110 million, so at 10 per cent, that’s 11 million people. Already, post-COVID clinics are being established in hard-hit cities.

It’s not only those who were severely ill, like Macpherson, who suffer this ongoing syndrome. Some hospitals and clinics report the majority of those unable to fully recover from their brush with the SARS-CoV-2 virus had mild symptoms that did not require hospitalisation.

It’s not only older people who battle to recover. Many young people are reporting far worse ongoing symptoms than the sniffle and headache they had with the virus. Social media pages set up by long haulers are filled with the stories of once active, fit, young people now laid up in bed or unable to work because they can’t think clearly. A study of young, low-risk patients in the UK found that 66 per cent had impairments in one or more organs four months after their initial infection. About 15% of Ohio State University’s college athletes who had COVID-19 now have myocarditis, an inflammation of the heart muscle.

Answers are being sought. But, as we all know, COVID-19 threw the medical world into “uncharted territory”. Long COVID, with its multifaceted, hard-to-define nature, could prove even more difficult for science to navigate.

End Precis.

Statistics from Scotland show the Oxford vaccine, even after one shot, is after 35 days 75% effective in preventing Covid, but 95% in preventing hospitalizations. If that extra 20% that get it, but do not go to hospital, have the same percentage of long-haulers as those not vaccinated, even with the vaccine, we could be in for a serious long term health issue. I think more research is required.

Thanks
Bill
 
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  • #2
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Wow! This is reminiscent of the theme behind a Robin Williams movie where he's a doctor in a ward of patients that are catatonic due to encephalitis lethargica.

https://en.wikipedia.org/wiki/Awakenings


I fear that Covid-19 may have other surprises in store for humanity.
 
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  • #3
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The symptoms are similar to chronic fatigue syndrome or myalgic encephalomyelitis or ME:

These symptoms, sometimes called “post-viral fatigue syndrome”, have been reported by sufferers of many viral diseases including influenza, glandular fever, SARS, and now COVID-19.

Post-viral fatigue syndrome

"There may well be a post-viral syndrome associated with COVID-19," Dr. Anthony Fauci, the nation's top infectious disease doctor, said

Possible link between covid and ME
 
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Ygggdrasil
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An opinion piece published in STAT News questions some of the claims of long Covid in people with who had mild or asymptomatic disease:

First, consider that at least some people who identify themselves as having long Covid appear never to have been infected with the SARS-CoV-2 virus. In Yong’s influential article, he cites a survey of Covid long-haulers in which some two-thirds of them had negative coronavirus antibody tests — blood tests that reveal prior SARS-CoV-2 infection. Meanwhile, a survey organized by a group of self-identified long Covid patients that recruited participants from online support groups reported in late December 2020 that around two-thirds of those surveyed who had undergone blood testing reported negative results.

Admittedly, while blood tests are reported as highly sensitive and specific, they are imperfect and can yield both false positives and false negatives. And there is some evidence that antibodies can wane over time. But only to an extent: study after study has found that antibodies remain positive in a majority of people with confirmed infections for many months. So it’s highly probable that some or many long-haulers who were never diagnosed using PCR testing in the acute phase and who also have negative antibody tests are “true negatives.”

Why does this matter? For one thing, if some proportion of long Covid patients were never infected with SARS-COV-2, it shows that it’s possible for anyone to misattribute chronic symptoms to this virus. That’s not particularly surprising, since the symptoms of acute SARS-CoV-2 are often not unique, and can be caused by other respiratory infections. But what’s more notable is that the late-December survey also found virtually no difference in the long-haul symptom burden between those with and without antibody evidence of prior SARS-CoV-2 infection (or any positive test), which undercuts the likelihood of a causative role for SARS-CoV-2 as the predominant driver of chronic symptoms in that cohort.
https://www.statnews.com/2021/03/22...re-critically-speaking-cautiously-long-covid/
 
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  • #7
Astronuc
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I was talking with a pediatrician (and family doctor) today who mentioned that they are treating children (pre-teens and teenagers) who had Covid-19. They are finding cardiac problems (e.g., arrythmia), inflammation of the blood vessels, and in one case, so far, stroke. It appears that some children and adults develop an ongoing inflammation rather than an infection, and the concern is that this segment of the population could develop comorbidities with respect to various diseases and chronic illnesses.
 
  • #8
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It appears that some children and adults develop an ongoing inflammation rather than an infection, and the concern is that this segment of the population could develop comorbidities with respect to various diseases and chronic illnesses.
I, too, have heard similar stories in the press and interviews with doctors. It seems more prevalent with the newer strains. It is one of those things that makes me both mad and sad - sad for the people it happened to and mad at people that think this is just a bad strain of the flu.

Thanks
Bill
 
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I believe I had covid in late March 2020, and ever since then I've had wierd throat/lung pain. I've also felt fatigued constantly, but I assumed that was from mental health/stress or just laziness.

Recently, I've also had symptoms consistent with mycarditis, but I thought that could be from the vaccine since it has been reported to be a rare side effect.

I'm a little worried covid has permanently damaged me, and my case was only moderate and I'm fairly young.
 
  • #10
Ygggdrasil
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Studies that have attempted to look systematically for cardiovascular problems after mild or asymptomatic COVID-19 have not found elevated levels of cardiovascular problems. For example:

Prospective Case-Control Study of Cardiovascular Abnormalities 6 Months Following Mild COVID-19 in Healthcare Workers
https://www.sciencedirect.com/science/article/pii/S1936878X21003569

Abstract:
Objectives
The purpose of this study was to detect cardiovascular changes after mild severe acute respiratory syndrome coronavirus 2 infection.

Background
Concern exists that mild coronavirus disease 2019 may cause myocardial and vascular disease.

Methods
Participants were recruited from COVIDsortium, a 3-hospital prospective study of 731 health care workers who underwent first-wave weekly symptom, polymerase chain reaction, and serology assessment over 4 months, with seroconversion in 21.5% (n = 157). At 6 months post-infection, 74 seropositive and 75 age-, sex-, and ethnicity-matched seronegative control subjects were recruited for cardiovascular phenotyping (comprehensive phantom-calibrated cardiovascular magnetic resonance and blood biomarkers). Analysis was blinded, using objective artificial intelligence analytics where available.

Results
A total of 149 subjects (mean age 37 years, range 18 to 63 years, 58% women) were recruited. Seropositive infections had been mild with case definition, noncase definition, and asymptomatic disease in 45 (61%), 18 (24%), and 11 (15%), respectively, with 1 person hospitalized (for 2 days). Between seropositive and seronegative groups, there were no differences in cardiac structure (left ventricular volumes, mass, atrial area), function (ejection fraction, global longitudinal shortening, aortic distensibility), tissue characterization (T1, T2, extracellular volume fraction mapping, late gadolinium enhancement) or biomarkers (troponin, N-terminal pro–B-type natriuretic peptide). With abnormal defined by the 75 seronegatives (2 SDs from mean, e.g., ejection fraction <54%, septal T1 >1,072 ms, septal T2 >52.4 ms), individuals had abnormalities including reduced ejection fraction (n = 2, minimum 50%), T1 elevation (n = 6), T2 elevation (n = 9), late gadolinium enhancement (n = 13, median 1%, max 5% of myocardium), biomarker elevation (borderline troponin elevation in 4; all N-terminal pro–B-type natriuretic peptide normal). These were distributed equally between seropositive and seronegative individuals.

Conclusions
Cardiovascular abnormalities are no more common in seropositive versus seronegative otherwise healthy, workforce representative individuals 6 months post–mild severe acute respiratory syndrome coronavirus 2 infection.

See also:
https://www.statnews.com/2021/05/14/setting-the-record-straight-there-is-no-covid-heart/
https://www.physicsforums.com/threa...ptomatic-covid-19-in-college-athletes.994340/
 
  • #11
I found something interesting about long covid:
Long COVID and severe COVID-19 infections associated with Epstein-Barr virus reactivation
...
"We ran Epstein-Barr virus serological tests on COVID-19 patients at least 90 days after testing positive for SARS-CoV-2 infection, comparing EBV reactivation rates of those with long COVID symptoms to those who never experienced long COVID symptoms," said lead study author Jeffrey E. Gold of World Organization. "We found over 73% of COVID-19 patients who were experiencing long Covid symptoms were also positive for EBV reactivation."
...
"If a direct role for EBV reactivation in long COVID is supported by further studies, this would provide opportunities to improve the rational diagnosis of this condition and to consider the therapeutic value of anti-herpesvirus agents such as ganciclovir."
Source:
https://www.eurekalert.org/news-releases/612727
 
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  • #12
Astronuc
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I wonder if the numbers are correct.

They are not sure of the numbers. It could be as high as 1/3 of cases are long covid. It is something I think more research is very much needed. It could prove to be the most dangerous issue with covid. Current vaccines are very efficient at preventing hospitalisation and death - but perhaps not long covid. As we open up more, most may get covid, and we could have a vast number who get the sniffles but are left with long covid. A very depressing thought.

Thanks
Bill
 
  • #14
Astronuc
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Michelle De La Isla describes herself as one of the healthiest people she knows. She is a biker and runner, so when she caught the coronavirus in January, the Topeka, Kan., mayor said she expected a speedy recovery.

Eight months and three hospitalizations later, the 45-year-old mom of three — who ran for Congress in 2020 — says she will have a pacemaker implanted next week to fix heart damage inflicted by the virus. De La Isla is one of millions thought to be suffering from long-haul covid, a lingering condition that leaves some facing heart palpitations, shortness of breath, fatigue, joint pain and other health problems months after their initial illness.
https://www.msn.com/en-us/news/us/a...t-i-thought-i-was-going-to-beat-it/ar-AANeg4Y

The Washington Post has reported that "research in England released in June found as many as 2 million people living there were experiencing long-haul symptoms."
 
  • #15
jim mcnamara
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Another study from Ireland found abnormal blood clotting markers in 50 recovered long haul patients. It seems all of the patients studied had the markers, and (I think) due to small sample size, they found a weak association to severity of Covid to the levels of the biomarkers - more intense disease-> higher levels.

If we assume this series of tests does associate with root causes it would be useful if for no other reason than weeding out some "not-long haulers" from future studies.

Anyway, a larger study should be undertaken. It would be more feasible in countries that keep records and sera on patients, like the UK. Otherwise, the cost of a well designed RCT on existing patients would likely be larger.
See:
https://onlinelibrary.wiley.com/doi/10.1111/jth.15490
Or popular press
https://scitechdaily.com/researchers-may-have-discovered-the-root-cause-of-long-covid-syndrome/
 
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