Long Covid: How It Keeps Us Sick | Hacker News Reader

Long Covid: How It Keeps Us Sick

quantamagazine.org

54 pointsrbanffy23 comments

> These infections can cause long-term damage via [...] reactivation of a latent pathogen that begins reproducing again in times of stress.

Oddly, Quanta Magazine's article doesn't mention recent research indicating that COVID is reactivating the Epstein-Barr virus in COVID patients and that this is likely responsible for a large proportion of "long COVID" symptoms. From the study's abstract:

> Our aim was to first determine long COVID prevalence in 185 randomly surveyed COVID-19 patients and, subsequently, to determine if there was an association between occurrence of long COVID symptoms and reactivation of Epstein–Barr virus (EBV) in 68 COVID-19 patients recruited from those surveyed. We found the prevalence of long COVID symptoms to be 30.3% (56/185), which included 4 initially asymptomatic COVID-19 patients who later developed long COVID symptoms. Next, we found that 66.7% (20/30) of long COVID subjects versus 10% (2/20) of control subjects in our primary study group were positive for EBV reactivation based on positive titers for EBV early antigen-diffuse (EA-D) IgG or EBV viral capsid antigen (VCA) IgM. The difference was significant (p < 0.001, Fisher’s exact test). A similar ratio was observed in a secondary group of 18 subjects 21–90 days after testing positive for COVID-19, indicating reactivation may occur soon after or concurrently with COVID-19 infection.

https://doi.org/10.3390/pathogens10060763 (open-access)

Editing to add a caution that MDPI, the publisher of Pathogens, isn't a particularly well-regarded publisher: https://en.wikipedia.org/wiki/MDPI

Interesting; one thing though:

1 World Organization, Watkinsville, GA 30677, USA

2 Department of Public Health, Kahramanmaraş Sütçü İmam University, Kahramanmaraş 46040, Turkey

3 Warren Alpert Medical School of Brown University, Providence, RI 02903, USA

4 College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA

One of these authors is not like the others.

That is a little confusing, "World Organization" seems to be a pet rescue charity?

I'm trying to figure out what the guy's interest is, how he is doing this research, and why academically-affiliated researchers are working with him (because that's potentially a positive sign for legitimacy). Apparently he previously authored a study saying that the MMR vaccine could keep people safe from covid: https://journals.asm.org/doi/full/10.1128/mBio.02628-20

The Daily Beast of all places has a pretty negative article which as a bit of a profile of him: https://www.thedailybeast.com/beware-this-covid-19-vaccine-s...

I don't know enough about this field to know if any of the journals involved are reputable.

Alternatively, none of those authors is like the others!

1. Independent researcher (USA) 2. Public health researcher with a few odd publications (Turkey) 3. A university-associated physician in internal medicine, who's only publications are with this group. (USA) 4. A university professor with expertise in immunology and vaccinations.

The urgency of the COVID-19 pandemic has wrought some rather unusual partnerships, so while in a normal world it would be weird and surprising, it's also not entirely weird and surprising given other alliances brought together by COVID.

Interesting read. From a layman's point of view the main issue I have with this study is that they have a selection bias to select those who have had severe COVID symptoms.

"Subjects were chosen from applicants who responded to online advertisements seeking recovered COVID-19 patients for this study."

Those who had asymptomatic/mild COVID symptoms might not even know they had COVID and they therefore would not apply to participate in the study. This biases the applicant pool to those who had severe enough COVID symptoms to either go to a hospital or get tested.

For the duration of the pandemic I have always advocated that COVID related studies should take random samples from the general population instead of selecting patients which are known to have COVID. Of course it would be much more work to pick a random 10000 people from the general population to participate in your study, but I think it would give better insight into the asymptomatic or mild COVID cases which would not be selected for a trial since the applicant themselves doesn't know they have COVID.

Generally, studies with the selection bias make COVID look worse since the mild/asymptomatic cases are ignored.

One of the issues with the medical industry is the refusal to use numbers.

Most familiar to you is when a physician will say "It's rare", without mentioning rare could be 1/10 or 1/10000.

In this article, "long term" seems to be about 6 months on the longest term. (Not mentioned in this article, but I recall reading something similar).

So when politicians/physicians/me/you need to make difficult decisions we are given words like "common, rare, long term, and short term" that contain little meaning.

I'm just not sure why the medical industry does this when the data is available. I sure wish we could push back against this. It's irresponsible.

I am always told probabilities when I am alerted of complexities of e.g. a wisdom tooth operation. This is in the UK.

Given how wildly different they can grow that is a suprise.

I doubt you'll get much off a probability with that range.

Of course Long COVID has a short upper bound; this is a new disease! But similar conditions that predate COVID can last decades.

I have a colleague based in the UK who got infected with COVID in the early days of the pandemic, before any measures were taken. He still has important health issues - and he's young (under 30).

Similarly, I have a friend who got infected over the 2020 summer (even though he was taking precautions), and again, he's still seeing doctors, taking medical trials, etc. because of his long COVID symptoms.

I know it's n=2, but I would not dare being so fast to say "it's about 6 months on the longer term, and very rare". I didn't take this very seriously as I'm young, but these two cases shifted my perception on the issue and made me adjust my routines just to err on the side of caution.

I'm at 16 months now.

there has been an analysis of the second biggest public health insurer in Germany (Barmer) that had a statistic that said that 6-7% of all of those infected were ill (and not working) for more than 12 weeks (and the numbers for young people weren't far of, like 4-5%)[1]. Also, there has been a study in UK that 400k people suffer from long covid [2]. Caution really is the only way as long as one doesn't have the double vaccination.

[1]https://www.spiegel.de/gesundheit/corona-fast-jeder-fuenfte-...

[2]https://www.telegraph.co.uk/news/2021/07/01/almost-400000-ha...

One could also see this differently.

The medical industry has to deal with the general population. Just like the food industry does. Now for both I do agree with you that I personally want the details, the numbers and make up my own mind. So give me those numbers. I want to know, this side effect happened to 1/100 people and this other one happened to 1/1000000. I want to know that 100g of this food contains 4mg of iron. I don't even want % of RDA as RDA is both a moving target and an assessment/decision someone made based on stuff I might not fit into. I.e. I'm male and not pregnant, my RDA is different from a pregnant woman's RDA.

I think it is still very important to have something that is easily understandable by the general population though. I.e. I'm totally for saying "this is rare" and "this is common". Food wise, I think it does make sense to have something like that color system some countries have "This contains a high amount of sugar". As long as you put the actual numbers on there too!

I personally, closely know at least 20 people who have had COVID so far and not one of them has had what is being called "long COVID". They range in age from 19 to 92 and all had varying degrees of confirmed illness at one time or another during the last year and a fraction (one of them twice) and all recovered fully within a few days to maybe a month or so at the most.

This of course is just anecdote, but it underscores a few points I think are important:

1. If long COVID is rare, well, how rare? That's a key question because its range makes a huge difference. Nearly every illness can have its extreme worse case examples, but they should by no means always be taken as causes for hysterical hypochondria if we're talking about an average 1 in 10,000 chance vs. a 1 in 5 chance.

2.Perhaps other factors, still poorly known in specific cases, played a large part in creating most cases of people with long COVID for extended periods. Speculative examples: coincidental separate illnesses that happened soon after, underlying problems that were somehow triggered by a normal period of COVID, other infections that came along because the virus created a temporary weakness, etc.

3. People are often notoriously unreliable at perceiving and narrating their health experience to doctors or each other, or even to themselves for that matter. In a pandemic atmosphere of frequent hysteria further exacerbated by digital media feedback, it's easy to imagine at least some people, especially those of a more suggestive or nervous persuasion, convincing themselves of extended COVID symptoms when much of what they feel is either unrelated and incidental or even completely in their heads, for months after their initial infection. then there are those who just enjoy painting themselves as dramatic victims and will latch onto anything they can exaggerate for effect. This last overall point isn't just a flippant dismissal, all of these characteristics are documented psychological tendencies in a certain subset of people.

> fatigue, headaches, joint pain, muscle aches and shortness of breath

> “brain fog,” depression, anxiety and issues with sleep

Given that this constellation of symptoms existed as "Chronic Fatigue Syndrome" for decades before 2020, don't we need a more convincing reason to attribute it to a disease that has existed only since September 2019?

In fact, it could be anything.

CFS sure.

Also...a vitamin B12 deficiency, a spectrum of autoimmune diseases, alcohol withdrawal, generalized anxiety disorder, lime disease, post treatment lime disease syndrome, various nerve disorders, early onset of MS (which is of course an autoimmune disease), stress, emotional trauma, an undetected previous stroke, post traumatic stress disorder, burnout...

..and a serious bout of COVID with say hospitalization might be the tipping point for many of the above conditions.

... another possible cause is the western diet and your gut microbiome being "shot", potentially from over-prescription of anti-biotics in youth.

At least that was it for me. This was the year before Covid and the right pro-biotics plus a ~1 year long Keto diet got me out of that. I still take the pro biotics and eat differently, though no longer Keto. Never felt better.

Yeah, you found it effective -- interesting. I have tried the keto diet a few times and was incredibly fatigued so stopped it. I like the idea -- I might try again.

Interesting. I was fatigued before I tried it anyway, so I might not have noticed any change. I have read about this online.

How long did you try it out for? I do remember the first ~two weeks of the pro biotic I felt really bad. After that it got better and better and w/ Keto I stopped feeling hungry. There wasn't much of the craving sugar after a little while and even just some regular bread tasted 'sweet' when I finally had it again. Might be the combination of the two that helped w/ all of this.

Or conversely "Chronic Fatigue Syndrome" could be an outcome that happens from time to time after different viral infections, COVID-19 just being the latest one of these.

> The cause of chronic fatigue syndrome is unknown, although there are many theories — ranging from viral infections

https://www.mayoclinic.org/diseases-conditions/chronic-fatig...

I got my 2nd covid shot (Pfizer) two days ago and for the last two days have had all those mention as "side effects" of the vaccine. yesterday was a complete write off for me. I nearly passed out just walking to my kitchen to make lunch.

feeling better today but am still weak and "dopey" in the brain. and my back still aches.

In theory this will all go away fairly quickly, but if I had not gotten covid vaccines and had instead gotten covid I feel this might have been a lot worse.

Although I’m not diagnosed with long covid, I can confirm that 8 weeks after being sick, my body is not what is was before.

Muscle twitches, joint pains, headaches, and low energy is all nee to me. And it comes and goes. I’ll be fine for 4 days then some symptoms come back and so it continues.

Been to two doctors and both just told me to get more rest. Blood tests and ekg all seemed fine according to them.

The current strain in South Africa is so much worse than the first. First wave most of my friends who had it did not show any symptoms. Now every one who gets it ends up in bed for at least a week. Most friends are younger than 30. We are more scared than ever, and a vaccine is not yet an option for us.

Also feel that it has impacted my work considerably over the last two months. So sad.

Long COVID is essentially post viral syndrome. It's real, but not unique.

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