Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to postacute sequelae in multiple organ systems, but evidence is mostly limited to the first year postinfection. We built a cohort of 138,818 individuals with SARS-CoV-2 infection and 5,985,227 noninfected control group from the US Department of Veterans Affairs and followed them for 2 years to estimate the risks of death and 80 prespecified postacute sequelae of COVID-19 (PASC) according to care setting during the acute phase of infection. The increased risk of death was not significant beyond 6 months after infection among nonhospitalized but remained significantly elevated through the 2 years in hospitalized individuals. Within the 80 prespecified sequelae, 69% and 35% of them became not significant at 2 years after infection among nonhospitalized and hospitalized individuals, respectively. Cumulatively at 2 years, PASC contributed 80.4 (95% confidence interval (CI): 71.6–89.6) and 642.8 (95% CI: 596.9–689.3) disability-adjusted life years (DALYs) per 1,000 persons among nonhospitalized and hospitalized individuals; 25.3% (18.9–31.0%) and 21.3% (18.2–24.5%) of the cumulative 2-year DALYs in nonhospitalized and hospitalized were from the second year. In sum, while risks of many sequelae declined 2 years after infection, the substantial cumulative burden of health loss due to PASC calls for attention to the care needs of people with long-term health effects due to SARS-CoV-2 infection. https://www.nature.com/articles/s41591-023-02521-2
CNN health Long Covid symptoms create a greater burden of disability than heart disease or cancer, new study shows Quote: ...long Covid creates a higher burden of disability than either heart disease or cancer, which cause about 52 and 50 DALYs for every 1,000 Americans, respectively, according to the Institute for Health Metrics and Evaluation’s Global Burden of Disease study. “When I looked at that initially, I was really shocked,” said study author Dr. Ziyad Al-Aly, who is director of the clinical epidemiology center at the Veterans Affairs St. Louis Health Care System. “That’s actually a huge number. “We did the analyses multiple times and, and then it just always can come back to be to be the same.” After considering their findings, though, Al-Aly said it really shouldn’t be such a huge surprise that long Covid is so disabling, because it affects so many different parts of the body. Al-Aly said his study should be a wake-up call. “I think that we need to understand that infections lead to chronic disease and we need to take infection seriously,” even when it seems to be mild, Al-Aly said.
Fortune Long COVID. Shorter Life? New research reveals an arduous road to recovery quote According to a paper published today in Nature Medicine, the physical fallout from long COVID may last two years or longer–and it can take a toll on quality of life even for those whose initial cases didn’t require hospital care. “I think this is a sobering reminder that SARS COV-2 infection can have long-lasting risks on people even among the non-hospitalized, that they really need to consider this data very seriously,” Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis and the senior author of the study, told me in an interview. “I mean, this is data at two years. This is not like six months or a year out.”
One caveat is that the mean age of participants was 60 and they were recruited before vaccination became widely available.
Sorry but Six months and one year is pretty bad for most people to be suffering after an initial mild infection.
Science News Health risks can persist at least 2 years after COVID-19, new data suggest quote: “When it comes to a symptom clinicians have never heard of before, like PEM, [health records don’t capture] the full picture,” says Jaime Seltzer, an expert on myalgic encephalomyelitis/chronic fatigue syndrome who heads scientific and medical outreach with the advocacy group #MEAction. This chronic condition shares many symptoms with long COVID. Seltzer also notes that the study may be skewed by its veteran population. About 90 percent of veteran records included were from men, while long COVID and other similar chronic conditions are more common among women. Some health issues that are more common for women with long COVID, such as long-term neurological and endocrine symptoms, may be underrepresented, she says.
Second Infection Hikes Long COVID Risk: Expert Q&A https://www.medscape.com/viewarticle/998107 (no paywall, may need to register) This quote made me despair for the medical profession: It took Long Covid for doctors to learn that infections can cause chronic disease? I'm not even being snarky at this point. Was there seriously zero proof before the pandemic? Or no evidence that doctors deemed strong enough to be reliable?
In the discussion section (highlighting some limitations of the study), they point out that the population studied in the Veterans Administration are majority male and older individuals.
Don't worry, they won't be able to do anything with this "newfound knowledge". Certain US presidential candidates have indicated that they will restrict the NIH's budget so they take an 8 year break from infectious disease in order to pivot the agency to the study of chronic diseases. There's a teeny-tiny flaw in that plan though.
Even I, without any sort of BPS filter on things, think that statement "most never fully recover from the condition" is unevidenced. The link is to the paper that is the subject of this thread - they followed veterans for two years only. Two years of no recovery is not 'never fully recover". I've seen a person be close to recovered after two years but take another year to probably recover fully. Even if it was true that people don't ever fully recover, you can't conclude that based on observing people for two years. Edit - and, as was noted up thread, this cohort was mostly male and older. Much of the 'Long Covid' was probably due to lung or other damage rather than the Long Covid that looks like ME/CFS. And we have seen people, lots of people, recover from Long Covid over the first 6 months in other studies.
Maybe 1-2K MDs have learned this lesson. Tops. Out of, what, 50M or so? That's not even close to 1%. Instead, it has massively reinforced beliefs in psychosomatic ideology. Loooong way to go yet before this gets accepted, and most likely still because of medical AIs making the evidence impossible to ignore. It turns out that humans are really terrible at science, still stuck in the brute force stage where we luck out and stumble on most findings.
