A new paradigm is needed to explain long COVID, Saunders et al 2023

UGH More bogus nonsense. What is needed are treatments, not “New paradigms”.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00501-X/fulltext#

 

Oh, we need new paradigms. There's no good models to explain PEM. But for goodness sake, not this. It's far from new anyways.

 

That the authors are based at Aarhus University is no surprise. Looking at the references also shows their influences (my bolding).


1. Ballering AV, van Zon SKR, Olde Hartman TC, Rosmalen JGM
Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study.
Lancet. 2022; 400: 452-461

2. Merad M, Blish CA, Sallusto F, Iwasaki A
The immunology and immunopathology of COVID-19. Science. 2022; 375: 1122-1127

3. Sneller MC, Liang CJ, Marques AR et al.
A longitudinal study of COVID-19 sequelae and immunity: baseline findings. Ann Intern Med. 2022; 175: 969-979

4. Nimnuan C, Hotopf M, Wessely S
Medically unexplained symptoms: an epidemiological study in seven specialities. J Psychosom Res. 2001; 51: 361-367

5. Petersen MW, Schröder A, Jørgensen T et al.
Prevalence of functional somatic syndromes and bodily distress syndrome in the Danish population: the DanFunD study. Scand J Public Health. 2020; 48: 567-576

6. Sullivan PW, Ghushchyan VH, Marvel J, Barrett YC, Fuhlbrigge AL
Association between pulmonary function and asthma symptoms. J Allergy Clin Immunol Pract. 2019; 7: 2319-2325

7. Henningsen P
Management of somatic symptom disorder. Dialogues Clin Neurosci. 2018; 20: 23-31

8. Nielsen G, Stone J, Matthews A et al.
Physiotherapy for functional motor disorders: a consensus recommendation.J Neurol Neurosurg Psychiatry. 2015; 86: 1113-1119

 

Oddly the authors (Sperling and Bendstrup) don't quote their own work on PASCs:

Fatigue Is a Major Symptom at COVID-19 Hospitalization Follow-Up https://www.s4me.info/threads/fatig...lization-follow-up-2022-sperling-et-al.27655/

"Abstract
Persistent symptoms after hospitalization with COVID-19 are common, but the frequency and severity of these symptoms are insufficiently understood. We aimed to describe symptoms and pulmonary function after hospitalization with COVID-19. Patients hospitalized with COVID-19 in Central Denmark Region were invited for follow-up 3 months after discharge. Clinical characteristics, patient reported outcomes (Fatigue Assessment Scale (FAS), anxiety and depression (HADS)), symptoms, pulmonary function test and 6-min walk test were collected. We included 218 patients (mean age 59.9 (95% CI: 58.2, 61.7), 59% males). Fatigue, dyspnea and impaired concentration were the most prevalent symptoms at follow-up. Using FAS, 47% reported mild-to-moderate fatigue and 18% severe fatigue. Mean HADS was 7.9 (95% CI: 6.9, 8.9). FAS was correlated to HADS (β = 0.52 (95% CI: 0.44, 0.59, p < 0.001)). Mean DLCO was 80.4% (95% CI: 77.8, 83.0) and 45% had DLCO ˂ 80%. Mean DLCO was significantly reduced in patients treated in the ICU (70.46% (95% CI 65.13, 75.79)). The highest FAS and HADS were seen in patients with the shortest period of hospitalization (2.1 days (95% CI: 1.4, 2.7)) with no need for oxygen. In conclusion, fatigue is a common symptom after hospitalization for COVID-19 and ICU treatment is associated to decreased diffusion capacity."

A shame that Sperling and Bendstrup felt there was value in going down the FND rabbit hole with Saunders: Chloe Saunders PhD Student

 

also no surprise;link to paper retweeted by Paul Garner.

 

Is this a new paradigm, isn’t it just what Freud was attempting to do when he started developing Psychoanalysis? And aren’t we seeing a similar approach here where individuals with tremendous self belief are finding proper science too slow and too much like hard work so they drift off into myth making and fantasy.

 

One good thing is that long-Covid is bringing a lot of awareness to post-infectious dysautonomia in the news and research.

 

What does Garner get, aside from publicity, with his continued bloviating in this space? Do patients who have recovered from other conditions devote their lives to discussing it? I would think someone would want to move as far away from that traumatic period as possible.

 

Spoiler: large image attachment of tweet

This individual’s profile indicates he is a physician. Unsurprisingly, very few coming to correct this commonly held prejudice. I hope that changes!

 

A "new" paradigm? Literally the current failed paradigm. This is making a mockery of science. The amount of lying that goes on in healthcare is absurd, it actually manages to be more inept than cable news at times.

At this point it requires to ask whether the people involved in this suffer from crippling memory and cognitive issues, because it's the only explanation for submitting the same old thing that has been obsessively asserted for decades and is the literally treatment model that formed all LC care as "new".

Even worse is that there is a paradigm for this: chronic illness. Medicine's inability to handle the truth doesn't change that it's the only relevant model because it actually describes reality. But the fact that medicine is still incapable of handling the truth demands massive reforms, this is extremely dysfunctional in ways no other profession ever gets anywhere close to.

Folks, I have a genius new idea and demand royalties for every item sold based on my groundbreaking model of the wheel. It's revolutionary, literally.

 

I'm pretty sure it's the Cochrane connection and what it would mean for evidence-based medicine. The GET review being discredited would be a huge blow and he staked in entire "expertise" in medical evidence on it anyway, can't walk it back without looking like a fool.

 

The lead author's Linkedin blurb tells me all I need to know about how seriously she should be taken.

 

Why does this Topol guy feel the need to dredge up this conversation. What good is he expecting to come of it?

 

If they think a new paradigm is needed, why are they digging up the old one?

 

monty pythons dead parrot (paradigm) sketch springs to mind.....

eta:

 

This is not an scientific journal, it's controlled messaging. With an editor-in-chief who has blatant bias and conflict of interest. It's completely one-sided, charlatans can say whatever they want, dissent is not allowed. About an issue where consent has been violated on a mass scale. Absurd, this is not legitimate scientific discourse, it's not academic freedom either.

https://twitter.com/user/status/1619256385308614656