Inside Medicine. What Are You Seeing? [COVID-19 medical news]

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5660

That links to the research paper at COVID-19 infection and transmission includes complex sequence diversity .

Going to the flu vaccine model is mostly dependent on deciding to make vaccines for the newest variants before full human trials, since new variants can show up faster than full human trials take. The bivalent vaccine with BA.5 is the result of deciding to offer a BA.5 vaccine before full human trials on that variant vaccine (there have been BA.1 and Beta variant vaccine human trials, but those variants became irrelevant before the trials finished).

5661

Sadly, I donā€™t think we know long term effects of Covid and long Covid yet, nor who will get long Covid and with what issues for how long. This is what is very frightening, especially for those of us who are medically vulnerable.

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5662

Research paper on the effect on immune response against different variants due to infection by different variants on thrice Pfizer-vaccinated people:
https://www.science.org/doi/10.1126/science.abq1841

3230Ɨ4583 1.34 MB

Some interesting findings:

  • Omicron infection in those without prior infection noticeably boosted antibody response compared to no infection or infection with the ancestral virus.
  • This boosted antibody response was seen against the ancestral virus, Alpha, Beta, Gamma, Delta, and itself.
  • However, the antibody response against itself was weaker than against other variants.
  • Omicron infection in those who previously had infection with the ancestral virus did not boost antibody response significantly. ā€œOriginal antigenic sinā€ perhaps?
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5663

COVID-19 is associated with a higher rate of Alzheimerā€™s disease.

Along with previous findings of higher rate of new type 2 diabetes after COVID-19, this could be another type of ā€œstealth long COVIDā€ that could result in increased medical and quality of life burden across the population, even though individual cases of Alzheimerā€™s disease or type 2 diabetes cannot be definitely known to be (or not to be) the result of COVID-19.

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I mentioned that back in my post #5102 in March
ā€œhearing Dr. Appel talking about how Alzheimerā€™s and ALS are a result of abnormal immune reactionsā€
He gave a great lecture about his research in these conditions concerning the inflammatory contribution and all I could think about was the similarities with Covid. Thatā€™s why I mentioned it in my post. Sounded like it was comingā€¦ā€¦ā€¦

ETA canā€™t find the link to the lecture to post but it may be similar to one I see thatā€™s on YouTube

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I saw new research about Alzheimerā€™s as an autoimmune disease. Hereā€™s an article written by one of the authorā€™s of the latest paper. @TexasTiger2

Covid dysregulates the immune system so could that help explain the connection between covid and Alzheimerā€™s disease?

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5666

Survey results on long COVID:

The tables start on page 17.

7.3% of the total surveyed population (including those with and without a COVID-19 infection) had long COVID.

25.3% of those who said that they had COVID-19 at least a month ago and knew when had long COVID.

5.3% of those who were boosted (including those with and without a COVID-19 infection) had long COVID, while 10.4% of vaccinated but not boosted did, and 9.1% of those not vaccinated did.

25.3% of those with long COVID reported a lot of reduction in capability to do daily activities, while 49.6% reported a little reduction. However, the percentage of those reporting a lot of reduction in capability declined for infections a longer time in the past (18.9% for >12 months ago, versus 30.2% 1-6 months ago). Reporting a lot of reduction in capability was also more common for White NH, age >50, and income <$60k people who had long COVID. Vaccination status did not affect the reported severity of long COVID (although being boosted reduced the likelihood to begin with).

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Thanks for the new data set. That data is definitely better some estimates (I have seen some estimates as high as 50% and generally seen the 10-30% estimate which I have not seen in my own ā€œvillageā€ of family and friends). It was in the range that I expected based on the question asked (ā€œWould you describe yourself as having long COVID, that is you experienced symptoms such as fatigue, difficulty concentrating, shortness of breath more than 4 weeks after you first had COVID-19 that are not explained by something else?ā€)

I saw the similar survey from the UK and it had both 4 week and 12 week findings and the number of people with Long Covid symptoms dropped significantly. It was also not surprising based on previous surveys that women, those with incomes under 60K, and those with comorbidities are at increased risk of Long Covid. The number that I have been most interested to see is the percentage of Long Covid sufferers who have a dramatic quality of life change due to continuous long term symptoms (25.3% of Long Covid respondents). The ability to find treatments for these people must be at the top of the list of action items.

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Agree. I donā€™t know anyone with what Iā€™d call ā€œLong long- Covid.ā€ Such that it persisted for more than a few months. These stats just make so much more sense to me than the ones that reported 30 percent with long Covid. That was just so contrary to my experience and the experience of anyone I knew.

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This study was just discussed at my monthly meeting on COVID issues which is through a consortium we belong to at work. Very interesting. Depression, anxiety may escalate chances of long COVID, says study ā€“ Harvard Gazette

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Great, now long COVID will continue to be viewed as psychological, along with other similar conditions.

5671

I read the posted link and I did not interpret nor conceive the premise that Long Covid is Psychological in nature. My own interpretation of the information provided is that the biochemical processes that manifest as anxiety and depression may be directly affected by Covid. Is it really such a large leap to infer that such Long Covid afflictions as ā€œbrain fogā€ could be a direct result of the virus affecting some biochemical processes in the brain more than others? Maybe, but scientists should continue looking down all paths that show such a significant variation from the control group.

Long Covid sufferers have measurable physical ailments (such as reduced lung capacity for example). I have yet to see one poster even imply that Long Covid is psychological in nature until you brought it up. I do see ā€œpushbackā€ on this thread and in my daily life on the actual percentage of the population suffering from Long Covid (and on the number of people who have possible permanent life altering changes due to Long Covid), because the original estimates did not match my personal experiences or those I know.

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5672

Have you read this study?

Not once do they mention biochemical processes of depression or anxiety. In fact, the science is moving away from a biochemical cause of depression, even before this analysis was published this summer: Scientists Find No Evidence That Depression Is Caused by ā€œChemical Imbalanceā€ or Low Serotonin Levels

There was no control group. These study findings do warrant further research.

I donā€™t have time to write a large analysis of this study. But itā€™s important to understand its objectives, conclusions, and shortcomings. The participants are primarily white female healthcare workersā€¦people who have been under incredible pressures during covid.

No matter the headlines associated with this study (of which many have centered on those with anxiety and depression), the study was focused on psychological distress, which includes many factors (not just anxiety and depression, see study objectives below). Anxiety and depression were also not clinically diagnosed in these patients. We are a long way from making a generizable claim that clinically diagnosed anxiety and depression are causative, not just correlated, with long covid.

Study objectives:

To determine whether high levels of psychological distress before SARS-CoV-2 infection, characterized by depression, anxiety, worry, perceived stress, and loneliness, are prospectively associated with increased risk of developing postā€“COVID-19 conditions (sometimes called long COVID).

And the conclusion:

The findings of this study suggest that preexisting psychological distress is associated with subsequent risk of developing postā€“COVID-19 conditions. Further research should investigate whether interventions that reduce distress help prevent or treat postā€“COVID-19 conditions. Identification and treatment of biological pathways linking distress with long-term COVID-19 symptoms may benefit individuals with postā€“COVID-19 conditions or other chronic postinfection syndromes

And the study weaknesses:

Our study has several limitations. First, our study population was predominantly White and female and had a significant proportion of health care personnel, limiting generalizability. Second, a positive result on a SARS-CoV-2 test was self-reported, though self-reported health information has had high validity in these cohorts.61,62 Third, data were not missing at random, which might have introduced bias. However, results were similar in analyses using multiple imputation. Fourth, the agreement between symptoms reported on the final and monthly/quarterly questionnaires was moderate, suggesting a chance of outcome misclassification, which may bias our results toward null. Nevertheless, symptoms of postā€“COVID-19 conditions change over the course of the illness.63 Fifth, depression and anxiety were measured using validated scales rather than clinical diagnoses.

Hereā€™s the full study: Association of Psychological Distress Prior to Infection With Risk of Postā€“COVID-19 Conditions

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5673

Please see my comment again ā€œMy own interpretation of the information providedā€

I take this to mean that the anxiety and depression are not the cause of Long Covid but correlated which is what I was implying when I reference the biochemical differences. I can also pull up a recent paper that still identifies the genetic and biochemical causes of depression, which also needs a lot more study. When talking about the psychological with Long Covid, the impression I got from the previous poster is that people think Long Covid was a psychological issue (people have Long Covid symptoms because ā€œit is all in their headā€). No one believes that and if that impression is wrong, I apologize for the mischaracterization. This study is just a starting point and 1st needs to be repeated by other groups. The study definitely has some weaknesses so it is just one data point that may or may not tell us something long term.

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5674

From Stat this morning:

Covid-19 raises the risk of long-term brain problems, large study confirms

At this stage of long Covid research, calls for longer-term studies are coming due. Research in Nature Medicine offers an update based on 12 months of data from the VA system (before vaccines were widely available) looking at the longer-term impact of Covid-19 on neurological outcomes after patients recovered from their acute infections. Compared to a control group of 11 million patients, the 154,068 Covid-19 patients had a higher risk of complications including stroke (50%), memory and cognition disorders (77%), seizures (80%), movement disorders (42%), and mental health disorders (43%). Their average age was 61, and the sicker they were, the greater their risk.

Younger adults had a higher risk of memory and cognitive disorders, sensory disorders, Guillain-BarrĆ© syndrome, and encephalitis or encephalopathy. Older adults were more vulnerable to mental health disorders, musculoskeletal disorders, and migraine and seizures. ā€œSome of the neurologic disorders reported here are serious chronic conditions that will impact some people for a lifetime,ā€ the authors warn.

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I too worry that people might interpret this study as ā€œahh, so itā€™s all just in their heads!,ā€ as weā€™ve done with so many other diseases (chronic fatigue and lyme among others).

Interestingly, I ran across this study just the other day. Apparently, depressive symptoms can also predict the actual immune response and level of antibodies generated after covid vaccines:

There must be some biological process at workā€“correlated with mental healthā€“affecting the immune system, that we have yet to uncover.

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5676

My PT is very happy that using the antiviral spray regularly she can now jog again and is feeling much better finally after 2+ years, taking oral antiviral and now taking anitviral spray several times/day.

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My neurologist resident would probably say, ā€œYeah, weā€™ve been telling people that all along. One of the first things we ask new people when they come in is if they have had Covid, esp in the past 6 months.ā€ I gather thereā€™s a study now that backs up what his experience has been.

5678

I think that part of the problem with this data set is that all of the Covid positive results are from March 2020-January 2021 so none of the VA data is from fully vaccinated and boosted people who have had a breakthrough infection.

The results of the study are very real, but it is hard for me to fear any of the results when the current circumstances are so different from those who had Covid in 2020.

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5679

Just sharing something that came in my email box. I am skeptical of most studies at this point: we really have to read the fine print :slight_smile: