Factors associated with the presence and intensity of ongoing symptoms in Long COVID 2025 Ring et al

[Andy]

Abstract

Objective
Identification of modifiable factors associated with symptom intensity among people seeking care for Post-Acute Sequelae of SARS-CoV-2 infection (PASC) could help guide the development of comprehensive, whole-person care pathways to alleviate symptoms irrespective of potential underlying pathophysiologies. We aimed to better define the key contributors to PASC, and sought the factors associated with PASC symptom presence and intensity.

Methods
In this cross-sectional study, 249 patients presenting for PASC care at a dedicated Post-COVID-19 clinic completed a standardized screening assessment prior to initial visit and evaluation by a general internist or nurse practitioner. We measured 46 symptoms based on the WHO’s Global COVID-19 Clinical Platform Case Report Form for Post COVID Condition and performed a factor analysis and item response theory based 2-parameter logistic model to develop a population-based t-score to measure PASC symptom presence and intensity (PASC-SPI). A multivariable linear regression analysis was used to assess factors associated with PASC-SPI, accounting for demographics, comorbidities, COVID-19 infection duration and severity, and mental health.

Results
Greater PASC-SPI was associated with greater symptoms of anxiety, a longer duration of COVID-19 infection, and hypercholesterolemia. Lower PASC-SPI was associated with older age, self-reported 1–3 units of alcohol per week, and self-reported clinician confirmation of COVID-19 diagnosis. Symptoms of anxiety accounted for a considerably higher proportion of variation in PASC-SPI than other variables.

Conclusion
Symptoms of anxiety were the strongest correlate of PASC-SPI, highlighting it as both a potential neuroinflammatory marker of PASC and a modifiable component of the illness. This emphasizes the need for comprehensive, whole person treatment strategies that integrate evidence-based interventions to address the multifaceted nature of PASC.

Open access

 

[Utsikt]

Identification of modifiable factors associated with symptom intensity among people seeking care for Post-Acute Sequelae of SARS-CoV-2 infection (PASC) could help guide the development of comprehensive, whole-person care pathways to alleviate symptoms irrespective of potential underlying pathophysiologies.

If alleviate symptoms means to convince them that there is no need to report having these symptoms, sure.

We aimed to better define the key contributors to PASC, and sought the factors associated with PASC symptom presence and intensity.

Correlation isn’t causation. How did this get published?

Symptoms of anxiety were the strongest correlate of PASC-SPI, highlighting it as both a potential neuroinflammatory marker of PASC and a modifiable component of the illness.

Anxiety as a neuroinflammatory marker?

Why do I get the feeling that «modifiable» implies that the illness as a whole will improve if we get people to report less anxiety?

 

[rvallee]

Symptoms of anxiety were the strongest correlate of PASC-SPI, highlighting it as both a potential neuroinflammatory marker of PASC and a modifiable component of the illness. This emphasizes the need for comprehensive, whole person treatment strategies that integrate evidence-based interventions to address the multifaceted nature of PASC.

<poop emoji>

Ask useless questions, get useless non-answers.

Second, one investigation found that a pre-infection threshold level of symptoms of depression (2-item Patient Health Questionnaire score ≥3), a threshold level of symptoms of anxiety (2-item Generalized Anxiety Disorder scale ≥3)

This is an entirely useless way of assessing this: https://www.hiv.uw.edu/page/mental-health-screening/gad-2. You could apply the same BS to muggings or home fires and find the same useless non-answer.

They do feature some minimal discussion of how the abstract is likely misleading, but it didn't sway them from writing a wildly misleading abstract nonetheless:

The finding that greater PASC-SPI was strongly associated with greater symptoms of anxiety and longer duration of acute COVID-19 infection points to the importance of anticipating and addressing the psychosocial aspects of PASC. The correlation with symptoms of anxiety is likely bidirectional and could be related to manifestations of COVID-related central nervous system pathophysiology, a product of the stress associated with infection and the pandemic, or pre-morbid traits or tendencies. The social health aspects may include financial stress related to costs of hospitalization[34,35], the need to ration food, heat, housing, and medication[35], reduced income related to reduced hours at work or inability to work[36], and prolonged isolation[37]. It is important to recognize that symptoms of anxiety might stem directly from neuroinflammatory disruptions. Multiple studies have demonstrated decreased serum serotonin, catecholamines and their metabolites in PASC, and autonomic testing in patients with post-infectious ME/CFS indicated heightened sympathetic and reduced parasympathetic activity[9,38–40]. In the absence of a biomarker to assess the severity or impact of these physiological alterations, clinicians treating PASC should proactively anticipate and address feelings of distress as a strategy to alleviate physical symptoms.

Say the line, Bart:

Future studies might elaborate on the relationship of psychosocial factors with PASC symptom intensity as well as the best ways to incorporate these aspects into comprehensive, whole person care for patients diagnosed with PASC regardless of the underlying pathophysiology.

A truly stupid number of past studies have done this and only ever conclude that more money should be sent their way. Future studies will not shine any light on this nonsense, because this is simply not something that can be reliably studied.