Long-term sequelae of SARS-CoV-2 two years following infection: exploring the interplay of (BPS) factors, 2024, Nieuwkerk et al

[rvallee]

Long-term sequelae of SARS-CoV-2 two years following infection: exploring the interplay of biological, psychological, and social factors
https://www.cambridge.org/core/jour...cial-factors/97539C47FA291E10F0FDA2BAA438BDC5

Abstract

Background
Severe fatigue and cognitive complaints are frequently reported after SARS-CoV-2 infection and may be accompanied by depressive symptoms and/or limitations in physical functioning. The long-term sequelae of COVID-19 may be influenced by biomedical, psychological, and social factors, the interplay of which is largely understudied over time. We aimed to investigate how the interplay of these factors contribute to the persistence of symptoms after COVID-19.

Methods
RECoVERED, a prospective cohort study in Amsterdam, the Netherlands, enrolled participants aged⩾16 years after SARS-CoV-2 diagnosis. We used a structural network analysis to assess relationships between biomedical (initial COVID-19 severity, inflammation markers), psychological (illness perceptions, coping, resilience), and social factors (loneliness, negative life events) and persistent symptoms 24 months after initial disease (severe fatigue, difficulty concentrating, depressive symptoms and limitations in physical functioning). Causal discovery, an explorative data-driven approach testing all possible associations and retaining the most likely model, was performed.

Results
Data from 235/303 participants (77.6%) who completed the month 24 study visit were analysed. The structural model revealed associations between the putative factors and outcomes. The outcomes clustered together with severe fatigue as its central point. Loneliness, fear avoidance in response to symptoms, and illness perceptions were directly linked to the outcomes. Biological (inflammatory markers) and clinical (severity of initial illness) variables were connected to the outcomes only via psychological or social variables.

Conclusions
Our findings support a model where biomedical, psychological, and social factors contribute to the development of long-term sequelae of SARS-CoV-2 infection.

 

[rvallee]

(Knoop mention)

The background clearly spells out that they started with a conclusion and made it retroactively fit, as best as I can tell by taking the most common symptoms and classifying them as depressive symptoms. It's not even subtle. They pretty much gave up bothering to hide the fact that this is what they are doing.

They have boxes with labels, even some arrows, that they drew to represent their model, and are actually arguing that this proves their model. This would be about as hilarious as the chicken paper if it wasn't for the terrible consequences this is meant to inflict on people.

We did not find any causal links with a stability score above 0.5. This suggest that there are no stable causal patterns that can be ascertained from our data sample alone.

Which somehow does not stop them from making the paper entirely about arguing exactly this. Or I guess they simply argue that the patterns are complex and mysterious, but that they understand those and know how to treat them, based on no evidence at all.

In this study we present a structural model of biomedical, psychological, and social factors that contribute to the persistence of fatigue, difficulty concentrating, depressive symptoms and limitations in physical functioning at 24 months after COVID-19 onset. To the best of our knowledge, we are the first to use this approach to gain insight into the factors associated with these outcomes. Similar approaches have been used with outcomes such as chronic back pain (Huie et al., Reference Huie, Vashisht, Galivanche, Hadjadj, Morshed, Butte and O'Neill2022) or alcohol-related cognitive deficits (Fidder et al., Reference Fidder, Veenhuizen, Gerridzen, van Wieringen, Smalbrugge, Hertogh and van Loon2023).

It's true that they present a model. This is actually a factual statement. It's the same model they always present, despite lacking in plausibility, validity and evidence. They are not the first to do this, not even for LC, but also quite telling that they point to identical models for chronic back pain and alcohol-reated cognitive deficits, when this is their hammer-looks-at-nails-suggestively one-size-fits-all model that they generally apply to anything and everything, especially ME/CFS.

Just a rehash of the same old debunked tropes, because nothing matters in this ideology:

Our findings are in line with previous findings from other post-infectious syndromes. Predictors of persistent symptoms after Lyme Borreliosis include impaired physical and social functioning, higher depression and anxiety scores, and more serious illness perceptions at baseline (Vrijmoeth et al., Reference Vrijmoeth, Ursinus, Harms, Tulen, Baarsma, van de Schoor and Ferreira2023). In chronic Q fever and Q fever fatigue syndrome, illness perceptions, physical and cognitive functioning partially mediated the impact of infection on psychosocial functioning and quality of life years after infection, where fatigue was the main mediator (Reukers et al., Reference Reukers, van Jaarsveld, Knoop, Bleeker-Rovers, Akkermans, de Grauw and Hautvast2019). Also following glandular fever, negative illness beliefs were associated with chronic fatigue (Moss-Morris, Spence, & Hou, Reference Moss-Morris, Spence and Hou2011). It has previously been reported that reporting a greater number of persistent symptoms after COVID-19 was congruent with more serious illness perceptions (Wynberg et al., Reference Wynberg, Verveen, van Willigen, Nieuwkerk, Davidovich, Lok and Grp2023). In our analysis, all-or-nothing behavior linked to the outcomes through illness perceptions. The link from illness perceptions to the outcomes was consistent across models and was very stable in the sensitivity models with just one outcome.

 

[rvallee]

Notable that in their model, they simply lump them up as those symptoms deriving from depressive symptoms, in a "drugs and alcohol" kind of way, along with lots of other weird stuff:

Severe fatigue and cognitive complaints are frequently reported after SARS-CoV-2 infection and may be accompanied by depressive symptoms and/or limitations in physical functioning

They explicitly define depressive symptoms as severe fatigue and cognitive complaints, then split them and put them under themselves in arbitrary labeling. It's all just convoluted nonsense but this stuff is now completely normalized in medical academia so no one outside of us will ever object to this.

Some dictionary named brain rot as the term of the year. This is institutional weapons-grade brain rot.

 

[Yann04]

Loneliness, fear avoidance in response to symptoms, and illness perceptions were directly linked to the outcomes.

Rephrased without psychsomatic assumptions:
Functional disability preventing normal social activities, post-exertional malaise, and self-reported illness severity, were directly linked to outcomes.

 

[rvallee]

Rephrased without psychsomatic assumptions:
Functional disability preventing normal social activities, post-exertional malaise, and self-reported illness severity, were directly linked to outcomes.

I would actually go further in that they are the outcomes. Which have outcomes of their own. And they are not linked to outcomes, they are the outcomes. But in biopsychosocial tradition, the outcome is retroactively attributed as the cause, because they literally have nothing else.

 

[Sean]

It has previously been reported that reporting a greater number of persistent symptoms after COVID-19 was congruent with more serious illness perceptions

People who are sicker tend to report themselves as being sicker.

No shit, Einstein.