Interesting findings from one study.
A page about immune response, B-cells, T-cells, vaccines, and how durable immunity may be.
More disturbing āLong COVIDā impacts: Long-term cardiovascular outcomes of COVID-19 | Nature Medicine
The study followed a cohort of US veterans for 12 months (meaning that the data skews white and male ā but on the other hand, itās a LOT of data).
We show that, beyond the first 30 d after infection, individuals with COVID-19 are at increased risk of incident cardiovascular disease spanning several categoriesā¦ These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection and increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care). Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial.
(This study was challenging for me to read with my background. Someone please correct me if Iām wrong with any of this commentary.) Figure 4 was particularly interesting (even though I HATE the way they scaled the x-axis) because it shows the increased cardiovascular risk over baseline for various subgroups. For example, it shows that if you are male, you have a higher increased risk for cerebrovascular disorders post-COVID than if you are female. In a lot of categories such as āobesityā, your risk increase is higher if you are in the āgoodā category. For example, you have a higher increased risk for dysrhythmia post-COVID if you were not obese. I would guess this is because your baseline risk starts out lower, so any increase in risk is magnified.
Figure 5 looks more like one would expect - the sicker you were with COVID, the more your risk for these events is increased. Some of the excess burden numbers in this figure are really sad.
Iām seeing things SLOWLY turn back to normal, if there is a normal anymore. Weāre finally moving into the endemic stage. Toilet paper supply is growing too.
I donāt have time to look at the study right now beyond what you put on the thread, but I know having issues like that after Covid is relatively common from what Iāve heard via the medical people I know IRL. Not just cardiovascular, but stroke and kidney too. Granted, they only see those who have problems so I wouldnāt know odds, but they feel itās disturbing with how many they are seeing. Covid is gone. Issues were created and remain.
Obviously, US veterans skew male. VHA users tend to skew older, so their demographics will otherwise resemble older cohorts than younger cohorts. The actual demographic information is given in the supplementary tables. Highlights of demographics (not weighted):
| Baseline Characteristics | COVID-19 | Contemporary control | Historical control |
|---|---|---|---|
| Age, mean (std) | 61.42 | 63.46 | 62.90 |
| White % | 70.88 | 76.78 | 77.35 |
| Black % | 24.14 | 18.49 | 17.95 |
| Other (race) % | 4.99 | 4.73 | 4.70 |
| Male % | 89.04 | 90.31 | 90.60 |
| Female % | 10.96 | 9.69 | 9.40 |
Note that it covers those who first tested positive between 1 March 2020 and 15 January 2021 ā i.e. largely before vaccines became available. Some other studies suggest that long COVID is much less common in breakthrough infections than in unvaccinated infections, but long COVID was defined differently from the effects in this study.
And before delta and omicron. I hope they do a similar study to see if the same cardiac issues can result from those variants.
Yes, thatās why I put it in quotes. Iām not sure what to call this. Actually I posted it because someone on another thread was talking about an increase in deaths not attributed to COVID (though, I never went back and mentioned that in the other thread). In light of these increased issues, Iām wondering if some of those extra deaths really are directly caused by COVID effects.
It would also be good to know what impact vaccination status has on issues like this. I guess weāll find out in 2022, one way or the other.
A potential avenue for those suffering with ālong covidā.
Final analysis of J&J vaccine trial: one dose was 53% effective against moderate or greater disease, 75% effective against severe or greater disease. This analysis does not cover additional doses or boosters.
As I have mentioned in the past, I am in a Johns Hopkins study for immunocompromised or chronically ill people, measuring COVID antibodies (semi-quantitative test) before booster, testing 2 weeks, 1 month, 3 months, 6 months, and 12 months after the booster.
Prior to the booster my score was 1078. At 2 weeks, 1 month and last week at 3 months, my score was >2500. Semi- quantitative does not give specific scores when over 2500.
I wish I was testing at 4-5 months when experts are now saying antibodies are waning. Iāll come back at the 6 month mark with results here on CC.
For those who are highly vulnerable to covid, there is a very useful article in todayās NYT on ways to protect yourself. Besides the use of N95 masks, the article suggests locating a pharmacy with Paxlovid and Euvshield in stock ( and discussing preventitive use of the latter), offering rapid tests to anyone prior to their entering your home, and the importance of using rapid tests oneself very frequently.
I believe that this daily rundown of the news of the day is not behind the paywall.
Perhaps a clue in the process of figuring some of it out:
Unfortunately both those medications are in short supply right now. I am immunocompromised but cannot get Evusheld because thereās insufficient supply so Iām still waiting. Itās super restricted to only the most severely immunocompromised, will be many more months before I can get it unfortunately.
Paxlovid is contraindicated in many people who are on medications that also put them at risk for Covid complications. This is because of the drug-drug interaction. Some medications can be held but others, such as anticoagulants or antiarrhythmics, canāt. The full list is on pages 9-15 here. https://www.fda.gov/media/155050/download
Preprint compares vaccine effectiveness over time.
Converting the odds ratios and month 1 vaccine effectiveness (figure 2 and caption) into vaccine effectiveness over later months:
| Vaccine | Versus | Month 1 | Month 3 | Month 5 | Month 6 |
|---|---|---|---|---|---|
| J&J x1 | Infection | 74% | 74% | 66% | |
| J&J x1 | Hospitalization | 81% | 78% | 76% | |
| Pfizer x2 | Infection | 88% | 80% | 72% | 65% |
| Pfizer x2 | Hospitalization | 89% | 80% | 61% | 56% |
| Moderna x2 | Infection | 92% | 88% | 83% | 78% |
| Moderna x2 | Hospitalization | 94% | 93% | 90% | 90% |
That suggests that waning immunity over a relatively short time is most likely to be a concern with the Pfizer vaccine, so a booster may be of more interest for recipients of that vaccine. While the J&J vaccine does not seem to wane much, protection from one dose is not as high level, so another dose could help. The Moderna vaccine seems to have high initial effectiveness and relatively good durability over six months.
Well Iām thinking eventually a fourth shot will be recommended at 65+ age group. We got Pfizer all three shots. Thinking maybe Moderna next go around. Any thoughts? Any studies about crossing over?
I opted for a Moderna booster last fall after initial Pfizer shots. I believe there were articles posted in this thread showing the effectiveness of mixing & matching, and if I recall correctly, a Moderna booster provided slightly more protection than a Pfizer booster.
I opted for a heterologous boost (PFx2, MX1). That said, the studies that showed the Moderna boost was better were done on a higher dose than what was eventually released. I havenāt kept up since.