Into the looking glass: Post-viral syndrome post COVID-19
ncbi.nlm.nih.gov
ncbi.nlm.nih.gov
After just never really felt the same. Assumed adderall “wasn’t working”. Couldn’t explain the lethargy or sharp uptick in anxiety and general inability to work. Luckily with the world it’s been easier to lay low, but the symptoms generally track even the muscle piece.
Is there more research on this? Where does one get this “Fatigue Scale” test? The linked article suggests they tested at an osteopathic clinic but that doesn’t really make sense.
Physical symptoms from anxiety are real and hard to separate from non-anxiety related symptoms. The current covid/election/general global craziness sets anxiety levels high.
I haven’t caught covid, but if I had I imagine I’d be similarly freaking out over every anxious feeling via hypervigilance.
None of this means that there aren’t real long term effects, but it’s worth being skeptical in context of anecdotes.
You can find anxious people going down rabbit holes of vague symptoms for basically every possible disease. People are not able to adequately assess themselves.
Do you live in an area with a lot of sunshine in a low enough latitude or take vit D supplements before?
Honestly the base hypothesis is that it’s the societal change, and not the n=1 study.
I'm only speculating based on some articles I've read.
Best wishes!
Not for nothing: all of these symptoms could also be caused by depression, which is not without precedent, considering that we've completely obliterated normal life in the last seven months.
Anyway, you should seriously consider seeing a therapist. There are a lot of other people who are feeling depressed and anxious and distracted right now.
You’re likely correct. Psychological from social changes seems most likely thing.
I personally feel like I have intermittent shortness of breath. Comes and goes every few days. It also goes away within 10-20min of exercise. Never had anything like this before. Interestingly enough, there has been little impact on actual performance.
Anecdotal and so forth.
https://en.wikipedia.org/wiki/Safe_(1995_film)
It starts off a little slow but I promise you will never forget it.
Ironically, one of the challenges as a CFS patient is communicating that your fatigue is abnormal. Try telling someone you have a disorder that makes you always feel tired and too many people respond that "Hey, I'm always tired too!". It gets old fast, so most patients just quit talking to other people about it.
Trust me, post-viral fatigue is on a different level. The parent comment is likely feeling quarantine-related negative effects on top of the COVID recovery.
"Manual treatment was provided to aid central lymphatic drainage, improve mechanics and reduce the inflammation of the spine and reduce the allostatic load by improving the sympathetic tone."
This indicates they are doing some sort of massage or physical therapy to induce drainage. This would be in line with osteopathic therapy.
"Post-viral fatigue syndrome" was a real thing long before COVID. There's heavy overlap with Chronic Fatigue Syndrome, which for many people starts after an infection.
I will warn you: The online forums and communities around post-viral fatigue syndrome and chronic fatigue syndrome are nightmarishly bad. Don't expect to get any real information out of them. They tend to be more about support groups turned vent sessions for people who are frustrated with their condition.
Personally, I've had decent success with a version of graded exercise therapy combined with psychiatric help. Ironically, these two interventions are despised by the online CFS community because people are afraid that seeking therapy or psychiatric help is an admission that their symptoms are purely psychological. It's not, and any good therapist will understand that.
I've taken the position that my energy levels are diminished, my stress tolerance is reduced, and therefore I need to do everything in my power to minimize stressors in my life. Therapy is perfect for that, so use it to your advantage.
As for graded exercise therapy: Pick a couple basic activities that are easily quantified. Something like walking a specific number of miles, doing a specific number of pushups, or other basic, repeatable tasks. Start an exercise routine with a very low number. Maybe 0.2 miles of walking, or doing 3 pushups in a day if you're really bad. Track your progress and slowly increase the amount over time, backing off immediately when you feel like you've over-exerted yourself. Keep your expectations realistic and resist the temptation to jump ahead of schedule if you're feeling particularly good.
Finally, stay out of the online CFS / post-viral fatigue / chronic illness forums. They're nightmarishly cynical. The good posters have all left, leaving what feels like the "suffering olympics" as people compete to one-up each other on the severity of their illness. It doesn't help, so don't go there.
This is how many of those online health communities operate. They collect anecdotes and combine them with morsels of information from publicly available papers to give themselves a false impression that they're on the cutting edge of research. If you search their history, they've usually been doing it for years or even decades. Their past is littered with dead ends that everyone thought was the next big thing. Meanwhile, they're all convinced that the latest pet theories or the latest supplement hold the key to unlocking the secrets to their illness.
There's a minimum amount of online reading that can help direct your own treatment, but getting caught up in the endless posting, negativity, and dead-end theories becomes counterproductive very quickly. Unfortunately, the loudest voices and most frequent posters tend to be the least qualified to be dispensing information. There's an added complication where these people start building their online identities around their illness, which can result in weird turf wars intertwining of egos with discussions.
All viral respiratory infections have the potential to have some side effects to varying degrees but I can't help but feel that this letter will be used to support the concept of "long covid" on an unsuspecting public.
Yes, covid is terrible but it's a different strain of a coronavirus (of which 20% of common colds are too), it's not something mystical. There's a strong chance we have substantial cross immunity to it though T-Cells defence. The literature is saying that if you're under 48 the flu has a higher mortality rate. We've mostly passed through the gompertz curve of the virus mortality as described by initial research by Hope Simpson regarding the seasonality of influenza viruses.
We can't base national health policy on individual health outcomes. Covid has been turned into a religion completely lacking any scientific rigour and I feel this paper will be used as a tool to add to the fear.
So is classic SARS, which is known to cause a post-viral syndrome similar to the one the letter proposes. Indeed, the letter opens with a discussion of exactly that syndrome. So it seems a bit odd to be talking about mysticism and religion in this context.
It's odd to me that anyone would mistake it for a study, actually, seeing as it says "Letter to the Editor" right at the top and has no gross morphological features in common with a research paper. No one seems to be trying to represent it as something it makes no pretense of being, except for people who seem to want to discount it without any significant consideration. That's an odd correlation to observe, but there is a lot that's odd about how people have reacted to this pandemic, I suppose.
You're kidding, right? Anecdotes like this one are dominating the media coverage, especially with regards to 'extended' symptoms of covid.
>Covid has been turned into a religion completely lacking any scientific rigour and I feel this paper will be used as a tool to add to the fear.
I don't think that's correct. Covid is well above influenza mortality in every cohort except children, I believe.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
Politics must decide whether to subject a large fraction of the population to the risk of this disease or whether to convince or coerce people to not go to football games, movie theaters and cocktail parties for a year or two.
Luckily, we as individuals still have the choice of not getting infected, although the risks of everyday activities increase dramatically when there are high levels of transmission in the community.
Do we restrict the community for the individual or the individual for the community?
Your feelings on this aren't universal and neither are mine.
Mask use is an individual issue in that it protects other individuals around you. Your right to throw punches stops at my nose. Suppose that we did nothing and let it spread. There would inevitably be a whole lot of people going around spreading it to people who don't want to be infected. This would be the case regardless of how individuals chose to self-isolate. People would go to the grocery store sick and breathe on everyone else there. This is the normal MO when in Flu season.
So it is an individual issue in the sense that as an individual I need to be able to buy food safely, and your choice to spread this unimpeded would infringe on that fundamental right.
And at the end of the day we're weighing the inconvenience of wearing a mask and staying home when sick for a few months versus the inconvenience of wheeling an oxygen bottle around with you for the rest of your life. If you have a cogent argument for why I should be stricken to save you the inconvenience then I'll listen.
Please do show us the people who are now seeking an oxygen bottle around for the rest of their lives because of covid that could have been stopped by a mask.
That said - I would expect some extremely rare outcomes in a sample of 35 million people. We live in a connected world: https://www.gwern.net/Littlewood
I really want to see good stats.
Even for, the simple you would think, case of CFR - what are the current reliable numbers here? In https://ourworldindata.org/mortality-risk-covid I only see cumulative nubers - that is not very informative when we can see how the mortality now is incomparable with the mortality in April and May, we need monthly or weekly cohorts data!
Until there is a good study that controls for biases as well as expected side effects of severe disease like pneumonia, we can conclude nothing about the population
Sure. But COVID-19 is currently in pandemic mode, having now infected at least 10% of the worlds population with zero signs of slowing down. This is not an endemic virus with a known cap on seasonal infections like the flu or colds. The area under the curve is going to be massive in comparison. That's the issue. Yes, it may have many similarities to the long term effects of other viruses. But now we will have hundreds of millions of people dealing with this, rather than hundreds of thousands. Quantity has a quality all of its' own.
If the number really is 10%, that's significant. This letter is merely suggesting further research; I think it's far from fear-mongering.
Do other respiratory viruses attack the blood and kidneys?Genuinely curious. My mother has Leukemia leading to kidney damage. Definitely some fear of contracting it and passing it to her.
I have a friend in the “long hauler” group that is 38yo. Of the people I am one or two steps from, 45% are dead, 45% had mild issues, and 10% long hauler.
So, low number of N is definitely a problem, for both my experience and the paper.
> Coronavirus. These tend to do their dirty work in the winter and early spring. The coronavirus is the cause of about 20% of colds. There are more than 30 kinds, but only three or four affect people.
https://www.webmd.com/cold-and-flu/cold-guide/common_cold_ca...
My mind was definitely in the mode of what number and kinds of viruses that a body is exposed to, not so much how contagious it is, but I see your point.
> There are more than 30 kinds, but only three or four affect people.
There aren't enough cold viruses around to allow for a 0.2% fraction.
From the US standpoint, the shutdown should have happened in January. After the first US case, there was no purpose in locking down the boarder. Politician fail.
Physicians stressed harsh lockdowns and played into the fear. This wasn't science or statistics, this was fear. Physician fail.
After hundreds of coronavirus cases in the US, governors created their own lockdowns, but had no control over traveling between state lines. This created no benefit but created poor economic conditions. Politician fail.
You know who has been correct but seemingly unheard during all of this? Scientists/epidemiologists.
They predicted the spread perfectly but Politicians, citizens, and Physicians did not listen.
The bigger takeaways were our options for how to handle the pandemic and expected outcomes.
You criticise the article but then post this without any backup.
> The literature is saying that if you're under 48 the flu has a higher mortality rate
ditto. Show us the figures please.
> N=1 in this study
It's not a study.
https://www.nature.com/articles/s41590-020-00808-x SARS-CoV-2-derived peptides define heterologous and COVID-19-induced T cell recognition
>ditto. Show us the figures please.
When I have more time I'll pull out this figure. Let me know if you find it in the meantime.
"With regard to SARS-CoV-2, very recent studies described CD4+ and CD8+ T cell responses to viral peptide megapools in donors that had recovered from COVID-19 and individuals not exposed to SARS-CoV-2, the latter being indicative of potential T cell cross-reactivity21"
They seem to be saying there's value in peptide donors who had recovered from covid, a transfusion of which to those who've not had covid seem to be valuable. It does not say (AIUI) that there is "substantial cross immunity to it though T-Cells defence" in the sense of having a similar disease gives you cross immunity. If I'm wrong, which is likely, please point out the correct passage.
> Manual treatment was provided to aid central lymphatic drainage, improve mechanics and reduce the inflammation of the spine and reduce the allostatic load by improving the sympathetic tone.
> ... and the patient followed a self-massage routine to aid lymph drainage along with gentle exercises to improve thoracic spinal mobility.
Chiropractors on the other hand are indeed completely dangerous quacks that routinely give people severe injuries. I know two people that have been disabled by chiropractors manipulating their necks and damaging the tissues and causes stenosis of the veins which has ruined their lives.