News about Long Covid including its relationship to ME/CFS 2020 to 2021

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Did you see this @dave30th ?

rvallee said:
Long covid military rehab programme 'helping to save careers'

https://www.bbc.com/news/uk-england-nottinghamshire-57599256


Look at the sleights of language:

Nearly all the patients that took part last year were able to return to work within three months.

...

At the centre they are tested for signs of long-term organ damage and taught how to overcome the key symptoms - shortness of breath, fatigue, low mood and "brain fog".

So far, about 150 patients have taken part in the programme.

...

Lt Col Sadar Bahadur, a DMRC consultant, said more than 90% of the 55 patients who completed the programme last year were back in work after three months.
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Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: A systematic review and meta-analysis

Pre-print (or whatever else "online ahead of print means"): https://pubmed.ncbi.nlm.nih.gov/34167876/


Aim
Single studies support the presence of several post-COVID-19 symptoms; however, no meta-analysis differentiating hospitalized and non-hospitalized patients has been published to date. This meta-analysis analyses the prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized patients recovered from COVID-19 .​

Results
From 15,577 studies identified, 29 peer-reviewed studies and 4 preprints met inclusion criteria. The sample included 15,244 hospitalized and 9011 non-hospitalized patients. The methodological quality of most studies was fair. The results showed that 63.2, 71.9 and 45.9% of the sample exhibited ≥one post-COVID-19 symptom at 30, 60, or ≥90days after onset/hospitalization. Fatigue and dyspnea were the most prevalent symptoms with a pooled prevalence ranging from 35 to 60% depending on the follow-up. Other post-COVID-19 symptoms included cough (20-25%), anosmia (10-20%), ageusia (15-20%) or joint pain (15-20%). Time trend analysis revealed a decreased prevalence 30days after with an increase after 60days .​

Conclusions
This meta-analysis shows that post-COVID-19 symptoms are present in more than 60% of patients infected by SARS-CoV‑2. Fatigue and dyspnea were the most prevalent post-COVID-19 symptoms, particularly 60 and ≥90 days after.​

Mostly confirms what we know but one interesting detail is noting that symptoms slightly increase at 60 days. The Body Politic study was the only one really looking at temporal patterns so it's good that institutional researchers are paying attention to it. A full year later...

And of course when we consider that the most common symptoms are all common symptoms of ME, it shows the absurd level of failure in making such a complex symptomatic presentation to be about strictly and nothing but a single symptom. What an incredible failure this has been, ongoing to this day.
 
Kalliope said:
Study from Norway on Long Covid. Among the references are studies from White, Wessely and Chalder.
The Norwegian public broadcaster NRK has an article today about the study saying that over half of young people with milder symptoms during Covid-19 infection got long term issues afterwards. It's good to final see some articles here that are not dismissive of Long Covid.

Nature Medicine Long COVID in a prospective cohort of home-isolated patients - Bjørn Blomberg et al

Abstract
Long-term complications after coronavirus disease 2019 (COVID-19) are common in hospitalized patients, but the spectrum of symptoms in milder cases needs further investigation. We conducted a long-term follow-up in a prospective cohort study of 312 patients—247 home-isolated and 65 hospitalized—comprising 82% of total cases in Bergen during the first pandemic wave in Norway. At 6 months, 61% (189/312) of all patients had persistent symptoms, which were independently associated with severity of initial illness, increased convalescent antibody titers and pre-existing chronic lung disease. We found that 52% (32/61) of home-isolated young adults, aged 16–30 years, had symptoms at 6 months, including loss of taste and/or smell (28%, 17/61), fatigue (21%, 13/61), dyspnea (13%, 8/61), impaired concentration (13%, 8/61) and memory problems (11%, 7/61). Our findings that young, home-isolated adults with mild COVID-19 are at risk of long-lasting dyspnea and cognitive symptoms highlight the importance of infection control measures, such as vaccination.
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This study got quite a lot of coverage in the news here. One of the articles got translated into English

ScienceNorway: Norwegian study: More than half of young people with mild Covid-19 infections experienced Long Covid

Quote:
Blomberg says that few other studies have the same level of overview of their patients as the Haukeland study.

“Others have studied this by looking at patient registries and prescription registries, or they have recruited people through media or through apps. This makes it difficult to know for sure how many have actually experienced ailments, and the total population of people who have been ill,” Blomberg says to Aftenposten.

“One of the strengths of our study is that we have a good overview of nearly all those who have been ill, and we have followed them throughout this personally with regular consultations,” he says.
 
Fitting that with medicine having politicized this disease category into oblivion, that political leadership bypassing medicine will likely be the way out. Wherever it comes from, this is a problem that requires leadership and with medicine paralyzed by past failures, this is the only way it ever ends.

It was mentioned a few times but little has been made public. Basically there was a presentation made by long haulers and experts to a White House task force and this presentation is their takeaway of what they learned. Encouraging.

 
Informative graphic. Those numbers... Although this is for one symptom only so most are not significantly impaired. But it sure would be useful to know more about how symptoms occur, maybe learn something about them for once.

The gender ratio is closer to 60:40, not that big.

 
I happened to find this recording of the WNYC 2021 Health Convening discussion from Wednesday, June 23, 2021, which discusses Long COVID and ME/CFS.

https://thegreenespace.org/event/wnyc-2021-health-convening/

I have not watched this video myself (it's about 2.5 hours long).

I found out about it on twitter when the Solve M.E. account shared a quote from Dr. Walter Koroshetz (NINDS director):
Solve M.E. said:
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The video includes three sessions on different topics. Here's a description of the session related to ME/CFS (starts at about 1:24 in the video):
https://thegreenespace.org/event/wnyc-2021-health-convening/ said:
The Long-Term Effects & Chronic Fatigue Syndrome

Chronic and mental health conditions account for 90% of the $3.8 trillion health care expenditures spent in the United States every year. Long COVID Syndrome threatens to add to this burden, as millions of people who recover from the virus are expected to deal with lingering symptoms. This panel will explore what research is underway to classify this chronic condition and how past experience with viral syndromes can guide the path forward. With panelist Dr. Mady Hornig, Associate Professor of Epidemiology at the Columbia University Medical Center and Dr. Walter Koroshetz, Director of the National Institute of Neurological Disorders and Stroke (NINDS). Moderated by Nsikan Akpan, PhD, WNYC Health and Science Editor.
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During the Q&A session of the last weekly clinical update with dr. Daniel Griffin he's asked about similarities between Long Covid and CFS by an Australian clinician. Dr. Griffin says there certainly are similarities and that the CFS population has taught them that a subset can deteriorate with exercise and rehabilitation.

They see a very similar pattern in a subset of these patients. He says this might be good and it might be bad. There WAS a lot of research going on in CFS, but not a lot of headway was made. But the big difference according to him is that people got Long Covid at the same time. And he hopes the insights that will be gained from Long Covid will go back to the CFS patients.

YouTube video starts at the session with the question about Long Covid and ME.

 
Dr. Griffin also said that United States physicians need to be aware of that a medical code for Long COVID Will not be officially available until October 2021 and until that time period a different code was to used. It’s one of those seemingly small things that I’m sure makes a huge difference when researching records later on (not to mention the USA insurance issues that may arise).
 
Article in the Guardian written by Susan Evan - a gynaecologist and chair of the Pelvic Pain Foundation of Australia and
Mark Hutchinson - a professor at the Adelaide Medical School who specialises in pain research

What do you think? Is the connection they're pointing to between repeated TLR stimulation and chronic pain viable?

The Guardian Why women are more likely to suffer from long Covid

Post-Covid, Post-Sars and Post-Mers syndromes all include persistent fatigue and pain, and show strong similarities to Chronic Fatigue Syndrome, a condition more common in women than men.
Importantly, these conditions are all associated with excessive activation of immune cells in the blood (eg macrophages), and immune-competent cells in the brain (glia). The initial immune response occurs, at least in part, via special receptors on the surface of innate immune cells called Toll-Like Receptors. When TLRs recognise Covid-19 within the body, their cell releases molecular signals called cytokines that make us feel unwell. Cytokine storm, the extreme form of cytokine release, is a feature of the most severe aspects of Covid-19 infection. Repeated TLR stimulation provides a stimulus to chronic medical conditions, including chronic pain and the severity of symptoms is associated with the severity of glial activation within the brain.

...
Conditions including severe period pain, endometriosis and chronic pelvic pain are already associated with an increase in TLR activity, and the presence of Chronic Fatigue Syndrome is highly associated with pre-existing gynaecological pain conditions. Repeated stimulation of the immune system predisposes to chronic pain conditions, and infection with Covid-19 presents a major immune stimulus.
 
Kalliope said:
What do you think? Is the connection they're pointing to between repeated TLR stimulation and chronic pain viable?
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It sounds like something anyone could pull out of the textbooks as a trendy idea, no more than that.
It is also rather full of holes. Bacteria stimulate TLRs much better than viruses and ME does not occur after bacterial infection so much as viral. Covid does not show much cytokine storm. And so on.
 
This statement indicates the low level of analysis:

Women have a higher lifetime risk of inflammatory immune conditions such as chronic pain, chronic fatigue and autoimmune disease.

There is little or no evidence for chronic ('primary') pain being inflammatory. If it was it wouldn't be called chronic pain, it would be called by the type of inflammation. Chronic fatigue does not seem to be inflammatory at all. Even autoimmune disease is not inflammatory per se. Some autoantibodies induce inflammation (rheumatoid factor) but a lot do not (antibodies to platelets). The link to being female is not the inflammation it is the antibody response. So far I don't think any long term problems after Covid have been shown to link to antibodies.
 
Conditions including severe period pain, endometriosis and chronic pelvic pain are already associated with an increase in TLR activity, and the presence of Chronic Fatigue Syndrome is highly associated with pre-existing gynaecological pain conditions. Repeated stimulation of the immune system predisposes to chronic pain conditions, and infection with Covid-19 presents a major immune stimulus.
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It would be useful to know the definition of CFS they are using, and on what basis they ‘know’ it is highly associated with pre-existing gynaecological pain conditions. A gynaecologigist might be unduly predisposed to see gynaecology.
 
Chronic Fatigue Syndrome and Long-Covid: Q&A with Dr Jenner
28 Jun 2021
Is it possible to distinguish between a patient suffering from post-traumatic Chronic Fatigue Syndrome (CFS) and a patient suffering from long Covid?
There is a considerable overlap in symptoms between these two conditions, which would make a definite diagnosis hard to establish. Furthermore, the current understanding of long COVID is limited as it is such a new phenomenon. It is possible that the two conditions form part of a spectrum of dysregulated inflammatory and immune responses by the body to viral illnesses, where long COVID is distinguishable by its known aetiology.

What are the hallmarks of each?
CFS is characterised by chronic exhaustion and fatigue, typically lasting for at least 6 months. Women are more commonly affected than men. Other major symptoms include post-exercise malaise and sleep disturbances. Less common symptoms are pain (headaches, muscular pain, joint pain), cognitive difficulties (brain fog) and muscle weakness (1,2).

There is currently no universal definition for long COVID. The three major symptoms of CFS, chronic fatigue, post-exercise malaise and reduced daily activity are also frequently reported in long COVID patients, as are the minor symptoms (1,2). The only symptoms that appear to be unique to long COVID are disturbances of taste and smell, and to a lesser extent hearing, and the presence of a rash (1).
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https://www.medicolegal-partners.co...ue-syndrome-and-long-covid-qa-with-dr-jenner/

previous article by Dr Jenner
The Link Between Long COVID and Chronic Fatigue Syndrome
13 May 2021
https://www.medicolegal-partners.co...ween-long-covid-and-chronic-fatigue-syndrome/

post traumatic CFS?? that's a new one (to me anyway).
 


There are many long haulers who had a period of, I guess remission would be more accurate, between the initial acute illness and the PVFS type symptoms, but some were ill the whole time with no respite so there is really no basis to say that they recovered from the acute illness, unless we define it as the virus replicating, which is the process, not the illness.

Decades of mushy brain over this issue have really destroyed any ability for critical thinking. All assumptions all the time.
 
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