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Post-Acute Sequelae of COVID (PASC or Long COVID): An Evidenced-based Approach, 2024, Griffin

Discussion in 'Long Covid research' started by Nightsong, Aug 29, 2024.

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  1. Nightsong

    Nightsong Senior Member (Voting Rights)

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    Abstract
    While the acute manifestations of infectious diseases are well known, in some individuals, symptoms can either persist or appear after the acute period. Post-viral fatigue syndromes are recognized with other viral infections and are described after COVID-19. We have a growing number of individuals with symptoms that persist for weeks, months, and years. Here, we share the evidence regarding the abnormalities associated with post-acute sequelae of COVID-19 (PASC) and therapeutics. We describe physiological and biochemical abnormalities seen in individuals reporting PASC. We describe the several evidence-based interventions to offer patients. It is expected that this growing understanding of the mechanisms driving PASC, and the benefits seen with certain therapeutics may not only lead to better outcomes for those with PASC but may also have the potential for understanding and treating other post-infectious sequelae.

    Open Forum Infectious Disease (August 2024) | https://doi.org/10.1093/ofid/ofae462 | Link | PDF
     
    Nightsong, Aug 29, 2024
    #1
    Turtle, Hutan, oldtimer and 1 other person like this.
  2. Nightsong

    Nightsong Senior Member (Voting Rights)

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    Review article based on TWIV / Parasites without Borders / MicrobeTV discussions:
     
    Nightsong, Aug 29, 2024
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    Michelle, Turtle, Hutan and 1 other person like this.
  3. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights) Staff Member

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    Pretty good.

     
    SNT Gatchaman, Aug 30, 2024
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    Michelle, alktipping, rvallee and 4 others like this.
  4. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights) Staff Member

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    But again note the confusion of terms generated by the PACE trial, pacing-up etc.
     
    SNT Gatchaman, Aug 30, 2024
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    Michelle, alktipping, rvallee and 1 other person like this.
  5. Hutan

    Hutan Moderator Staff Member

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    On the idea that most people improve and even recover in the first two years:

    43 Servier, C., Porcher, R., Pane, I., Ravaud, P. & Tran, V.T. Trajectories of the evolution of post- COVID-19 condition, up to two years after symptoms onset. Int J Infect Dis 133, 67-74 (2023).
    Forum thread
    French team. Large prospective study with periodic tracking. Three trajectories of the evolution of post-COVID-19 condition were identified: “high persistent symptoms” (4%), “rapidly decreasing symptoms” (5%), and “slowly decreasing symptoms” (91%).


    44 Bowe, B., Xie, Y. & Al-Aly, Z. Postacute sequelae of COVID-19 at 2 years. Nature medicine 29, 2347-2357 (2023).
    Forum thread
    US Dept of Veterans Affairs. Very large prospective study.
    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.
    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.


    45 Boscolo-Rizzo, P., et al. Olfactory and Gustatory Function 3 Years After Mild COVID-19—A Cohort Psychophysical Study. JAMA Otolaryngology–Head & Neck Surgery 150, 79-81 (2024).
    Paywall and uninformative abstract


    46 Demko, Z.O., et al. Two-Year Longitudinal Study Reveals That Long COVID Symptoms Peak and Quality of Life Nadirs at 6–12 Months Postinfection. Open Forum Infectious Diseases 11(2024)
    John Hopkins Baltimore team
    Small study, only 51 participants provided data at 2 year followup.
    During the study period, 33% of participants experienced long COVID (had not returned to pre-COVID-19 health status and reported at least 1 symptom >90 days postinfection); 8% had not returned to their pre-COVID-19 health status 24 months postinfection.
    Forum thread
     
    Last edited: Aug 30, 2024
    Hutan, Aug 30, 2024
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  6. rvallee

    rvallee Senior Member (Voting Rights)

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    Sums up the controversy pretty well. Lots of charlatans are taking advantage of patients here, and the worst of them have MDs and medical licenses. And a whole lot of cowards allowing them to dominate the issue despite having delivered absolute fuck all in decades. That's a unique challenge, exists nowhere else in the world than in health care, where it is actually common. So there's no precedent or examples to draw from. Other than in medicine. Where similar examples are never actually dealt with. Hence why they continue without challenge.
     
    rvallee, Aug 30, 2024
    #6
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  7. Kalliope

    Kalliope Senior Member (Voting Rights)

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    Next week's episode in the podcast TWiV: Clinical update with Dr. Daniel Griffin will be dedicated Long Covid and this paper, according to yesterday's episode.
     
    Kalliope, Sep 1, 2024
    #7
    mcfunk, Trish, oldtimer and 1 other person like this.

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