Solving the puzzle of Long Covid

[zaax]

Published 22 Feb 2024. Long COVID is finally getting some attention. Not pay-walled.

science.org/doi/10.1126/sci...

[neurodervish]

Written by ZIYAD AL-ALY AND ERIC TOPOL, two of the best! Thanks for sharing 😍

[AussieNeil Administrator]

Thanks for posting this excellent Long COVID research update

With respect to the article statement: "Studies have consistently shown that vaccines reduce the risk of Long Covid by 15 to 75%, with a mean of ~40% reduction in risk. "

COVID brain fog drains 3-6 IQ points for more than a year

(Findings from the UK REACT (Real-Time Assessment of Community Transmission) project)

newatlas.com/health-wellbei...

Even mild cases of COVID cause significant, measurable cognitive deficits compared to those never infected with the virus, according to one of the largest studies of its type. COVID brain fog is real, and it can sap up to six IQ points for at least a year.

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The research comes out of one of the world’s largest and longest running COVID studies, dubbed REACT (Real-Time Assessment of Community Transmission). The project, which kicked off in April 2020, follows nearly three million people in England. The goal is to better understand who is suffering from long-term symptoms with COVID and what those symptoms actually are.

nejm.org/doi/full/10.1056/N...

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In a commentary on the study published in the New England Journal of Medicine nejm.org/doi/full/10.1056/N... , long-COVID experts Ziyad Al-Aly and Clifford Rosen called the findings concerning. They noted that the pandemic has impacted millions around the world and even small cognitive deficits from the virus could have larger long-term implications.

COVID-19 Tied to Increased Risk for Rheumatic Disease

— Maybe not a form of long COVID, but a concern just the same

medpagetoday.com/rheumatolo...

Rates of new-onset autoimmune inflammatory rheumatic disease (AIRD) such as rheumatoid arthritis and systemic lupus erythematosus were significantly increased following bouts of COVID-19 in South Korea and Japan, researchers found.

With data from large repositories in the two countries, AIRD rates were 25% higher in South Korea (95% CI 18-31) and 79% greater in Japan (95% CI 77-82) among COVID-19 patients versus uninfected controls from the general population, according to Dong Keon Yon, MD, PhD, of Kyung Hee University in Seoul, and colleagues.

Absolute rates after COVID were 1.15% in Korea and 3.87% in Japan.

and, similarly to what is seen with flu boosters;

Covid-19 vaccines seem to cut the risk of heart attacks and strokes (Paid subscription needed for full article access)

Many covid-19 vaccines occasionally cause side effects such as blood clots or heart inflammation, but, overall, they appear to be beneficial in preventing heart and circulatory conditions

newscientist.com/article/24...

It may be that many respiratory viruses can cause myocarditis.

Vaccine Effectiveness Against Long COVID in Children, MARCH 08 2024

publications.aap.org/pediat...

The incidence of probable long COVID was 4.5% among patients with COVID-19, whereas diagnosed long COVID was 0.8%. Adjusted vaccine effectiveness within 12 months was 35.4% (95 CI 24.5–44.7) against probable long COVID and 41.7% (15.0–60.0) against diagnosed long COVID.

CONCLUSIONS:

This large retrospective study shows moderate protective effect of severe acute respiratory coronavirus 2 vaccination against long COVID. The effect is stronger in adolescents, who have higher risk of long COVID, and wanes over time.

Myocarditis game-changer: We've blamed the wrong culprit

newatlas.com/medical/viral-...

Inflammation resulting from a viral infection has traditionally been thought to cause acute myocarditis, which can lead to fatal heart arrhythmias in otherwise healthy young adults. Now, a new study has shown for the first time that the virus itself damages heart cells before inflammation sets in, challenging traditional assumptions.

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Using a mouse model of the adenovirus to replicate the human infection process, the researchers studied the virus’ effects on the heart. They found that early in the infection, the virus disrupted critical components of the heart’s electrical and communication systems: ion channels and gap junctions.

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“Our data demonstrate that acutely infected hearts harbor dangerous electrophysiological alterations at the molecular level and reveal, for the first time, how adenoviral infection can precipitate such pathological subcellular remodeling before cardiomyopathy and development of inflammatory myocarditis,” the researchers concluded.

Referenced study published in Circulation Research ahajournals.org/doi/10.1161...

That's on top of the more immediate benefit from boosters;

Latest COVID Shots Protect Against Serious Outcomes

— Effectiveness against COVID-related hospitalization ranged from 43% to 52%

medpagetoday.com/infectious... (Need to register for free account)

From September 2023 to January 2024, vaccine effectiveness (VE) against COVID-related emergency department or urgent care encounters landed at 47% (95% CI 44-50), while protection against hospitalizations associated with the coronavirus ranged from 43% (95% CI 27-56) to 52% (95% CI 47-57), reported Jennifer DeCuir, MD, PhD, of CDC's National Center for Immunization and Respiratory Diseases, and colleagues.

"The comparison group included both unvaccinated persons and persons who had received original monovalent or bivalent doses only," the researchers wrote in the Morbidity and Mortality Weekly Report cdc.gov/mmwr/volumes/73/wr/.... "Thus, these results support current CDC recommendations for updated COVID-19 vaccination, including among persons who have previously received original monovalent or bivalent COVID-19 vaccines and those who have never been vaccinated, irrespective of previous infection history."

Neil

[bennevisplace]

Thanks for posting, zaax. This article gives an important characterisation of Long Covid, a relatively new syndrome there's still lots to learn about.

What struck me most forcibly was that "the prototypical (classic) form of Long Covid (with brain fog, fatigue, dysautonomia, and postexertional malaise)... more common in younger adults and in females", with several potential pathological pathways, is a perfect description of myalgic encephalitis (ME, aka chronic fatigue syndrome).

As the article notes, we don't yet know how long Long Covid can be, but we do know that similar syndromes afflicted some survivors of the 1918-20 flu pandemic for multiple decades.