Study suggests long-Covid may be mostly psychological
jamanetwork.com
jamanetwork.com
The symptoms and symptom clusters mentioned - like fatigue, body ache, breathlessness, headache, and strained attention or focus - have many causes both physical and psychological. What the study is saying is that people think they've had COVID-19 because they experience these symptoms or that they've had these symptoms in addition to COVID-19 and have perhaps mistakenly attributed these symptoms to the disease.
In the words of the article itself, from the Discussion section:
Two main mechanisms may account for our findings. First, having persistent
physical symptoms may have led to the belief in having had COVID-19,
especially in the context of a growing concern regarding long COVID. Although
adjusting for self-rated health before the pandemic did not affect our
results, another disease may underlie symptoms attributed to COVID-19
infection. Second, the belief in having had COVID-19 infection may have
increased the likelihood of symptoms, either directly by affecting
perception19,20 or indirectly by prompting maladaptive health behaviors, such
as physical activity reduction or dietary exclusion. These mechanisms are
thought to contribute to the long-described persistence of physical symptoms
after acute infections.That implies that people only believe that they have long-COVID symptoms, when in fact some other phenomenon is causing them. You're right that the cause may not be psychological however.
> It says that people who self-diagnosed as having COVID-19 attributed those symptoms to COVID-19 whether or not they showed antibodies for the virus.
>>You're right that the cause may not be psychological however.
What I was asking is: does the study not show that symptoms associated with long-COVID are not, in fact, correlated with having had a COVID infection? That they are only correlated with believing one had COVID?
I don't follow. What do you mean? What's the difference between an "effect" and a "side effect"? And what's an "inert" effect?
So I mean that when 'active placebos' are used, rather than ones that have no side effect (like dry mouth), the effects are larger. So in basic terms, the more noise there is in the system, the more signal error there is. The main point is about the reason they do blind control studies. People are not very good at correct attribution.
I don’t follow.
These people likely have one of any number of other illnesses though right? Allergies, common cold, flu, etc?
This is a problem because data from this group purportedly about covid, such as "long covid" symptoms or the robustness of natural immunity, is seriously compromised.
You can see that idea here in this study and also in the difference between natural immunity studies which use self-reported data (which may indicate weak, declining or no protection), compared to studies which use PCR or serological confirmation. The studies in the latter group unanimously confirm the robustness and longevity of natural immunity.
There's a large contingent of HN readers that seem to think long covid doesn't exist because it hasn't been firmly confirmed by a study. To be more accurate, they would prefer it didn't exist because its existence would justify some of the stricter covid restrictions. I imagine these are the same people that would let their Tesla drive them into a wall because the camera didn't see it there. Not proven to exist != proven not to exist. If it hasn't been proven to exist, then we'll need to do better science until we find it, because it definitely exists without any measure of doubt.
And by the way, this is the exact same nonsense that has quagmired ME/CFS research for decades. The government requires that diseases have a biomarker in order to claim disability--the lack of a biomarker for this illness doesn't meant that it doesn't exist, but it has meant that research on it has been tragically and dramatically underfunded and sufferers struggle to claim disability benefits.
There is a very good podcast in Germany that involves two of the country's leading virologists [1]. In a recent episode they reviewed the current literature on long Covid.
One of the key take-aways was that it's likely not a single disease but a combination of several distinct components. E.g. there is a component that's related to lung damage, one related to fatigue and exhaustion, there's a neurological component related to loss of taste etc. - it's very much work in progress what these components are and how to best treat them.
Low energy
Headaches
Upset stomach, including diarrhea, constipation, and nausea
Aches, pains, and tense muscles
Chest pain and rapid heartbeat
Insomnia
Frequent colds and infections
Loss of sexual desire and/or ability
Nervousness and shaking, ringing in the ear, cold or sweaty hands and feet
Dry mouth and difficulty swallowing
Clenched jaw and grinding teeth
Sounds like all of the physical symptoms of so-called long-COVID.
On top of the stress that would undoubtedly afflict a significant fraction of COVID patients, due to the massively inflated fears surrounding COVID, is the effects of physical isolation.
One of the requirements for all COVID positive cases is two weeks of total physical isolation. Numerous studies have shown that humans being physically isolated has significant negative health effects. No in person contact. No physical touch. For two weeks. All COVID positive cases, even asymptomatic ones.
There are no randomized studies, that control for factors, like the aforementioned psychological distress emanating from fear of COVID, and physical isolation, that suggests COVID causes these long-term symptoms. There are a host of potential confounding factors that could explain these correlations better than damage from the COVID infection.
Notice how extreme rigor is demanded for the ivermectin studies but then really just mere correlations is enough to draw scare mongering conclusions about COVID.
I don't understand - are you saying lung damage and neurological issues like loss of taste are not distinct factors of long Covid?
Or did you come to the realisation that psychological stress often manifests in physiological symptoms? Are you even saying that there is not such a clear distinction between psychological and physiological diseases?
> There are no randomized studies, that control for factors, like the aforementioned psychological distress [...] here are a host of potential confounding factors [...]
It sounds like you are seriously underestimating medical research and researchers/scientists.
> Notice how extreme rigor is demanded ivermectin studies [...] scare mongering conclusions [...]
I'm even more confused - who is demanding and scare mongering?
>>It sounds like you are seriously underestimating medical research and researchers/scientists.
In what sense?
Also if one have been in needed for artificial rebreathening, alone that, blowing in pressurized air into lungs of exactly 1 bar or something, is a damage by itself. So that's why people can't breathe persistently for a long time.
It's not psychology :) it's damage and scars everywhere in the substance.
Most COVID cases are mild and could not possibly explain the incidence of 'abnormal breathing' symptoms.
They also found thrombosed capillaries on the surface of the brain and showed less bloodflow in that regions and some starting damage of the brain substance. That may cause tiredness and all the other symptoms which may be interpreted as psychological biased
>>Lung damage is certainly a symptom of some COVID cases, but a significant fraction of "long-COVID" 'abnormal breathing' symptoms may be related to anxiety.
>>then we'll need to do better science until we find it, because it definitely exists without any measure of doubt.
Nothing "definitely exists" when no compelling evidence for it has been found.
This is exactly the kind of Dunning-Kruger certainly that anti-vaxxers exhibit.
The problem here is that covid is a respiratory disease, and as with any other serious respiratory disease, there can be a whole host of consequences that are long lasting. Everything from brain damage, lung damage, and that will then affect pretty much every other system in your body.
And then ontop of that you have a full blown viral outbreak, which can damage pretty much any organ. What we know only scratches the surface.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082798/#:~:tex...
https://medlineplus.gov/genetics/condition/acute-necrotizing...
But we do not call someone struggling with the results of acute cute necrotizing encephalopathy as a "long flu" sufferer, as if this meant their flu infection was never cured.
Just like we do not call it "long pneumonia" when someone discovers that damage to their lungs has caused a whole host of permanent ailments, from difficulty climbing stairs, to dizziness and short term memory loss, or even weakness, loss of muscle mass, joint pains. Nor we do not say "long oil-burn" when a failure to replace burnt oil causes long term damage to your car.
As long as this keeps being framed as some special form of long lasting covid infection, rather than damage caused by covid, you are going to run into all sorts of problems with people who point out that no covid can be detected in the person, and so there isn't any scientific basis for the long covid theory.
Of course I could be completely wrong, and perhaps covid does create a unique set of complications.
This is despite no large randomized controlled studies proving that it is exists as a widespread phenemenon, and nothing in the pathophysiology of COVID to suggest it would create the kind of pervasiveness of long-term complications that many media stories have sounded the alarm about.
Safety.
People want to be safe, and the governments obliging them. You can't be in danger if you don't leave your house right?
Edit: I can't count apparently - I'm blaming it on long-covid!
The dangers of coved and the efficacy of vaccines are a reproducible analysis.
Does this mean that they excluded those who changed their opinion based on the test results? Or those that believed they had a novel infection after they had been tested?
This was to isolate the psychosocial impact on health of believing one has COVID from the direct biological effects of having COVID.
"...during the COVID-19 pandemic, *self-reported COVID-19* infection was associated *with most persistent physical symptoms*, whereas *laboratory-confirmed* COVID-19 infection was associated *only with anosmia*. ..."
They all have been infected, but the ones self reported experienced much more symptoms of COVID infections that were longer persistent as with the other's, who had intentionally/unintentionally a positive lab test as their first confirmation of infection. That group experienced just anosmia.
>>The crude prevalence of persistent physical symptoms was first calculated for 4 groups of participants according to both belief (ie, self-reported COVID-19 infection) and serology test results: belief negative and serology negative; belief positive and serology negative; belief negative and serology positive; and belief positive and serology positive.
Since "long-covid" isn't an issue endemic to the people of France and has been reported about globally, let me post my individual opinion on what might be causing these "fake" cases of "long-covid" with what I guess will be deemed as hyperbole here - I leave it open to discussion.
The lockdowns haven't helped anybody other than the severely vulnerable population both with or without pre-existing conditions, as well as put a temporary band-aid on the failing/already failed medical systems of the countries that implemented them. You've got MAJOR factors causing uncalculated amounts of mental strain on everybody, like:
- Increases in (un)diagnosed mental health illnesses from any variety of reasons - domestic violence, emotional abuse, new drug addictions (prescription or otherwise), decreased/non-existant IN-PERSON social interactions with your friends and family definitely don't help. Humans need face-to-face in-person contact.
- Constant bombardment by the media about how we're horrible people if we meet with our families and friends, Articles about how inflation is starting to catch up to us, "But that's okay, and here's why!" (I am completely convinced that government, corporations, and media outlets are colluding behind the scenes to control the national narrative of the pandemic and the economy, though I'm more talking about my home country USA)
- Failures of the healthcare systems in NUMEROUS countries (in Canada, I know 2 people who have been on the wait-list for joint replacement for TWO YEARS with no estimated date, meanwhile they're taking HEAVY doses of painkillers, destroying their liver/kidneys in order to just function normally. All they're told is "there's nothing we can do but wait".
- (again, in the USA) The constant run-around by public officials about how "this is what's going to get us out of this. BE HONEST straight from the start. Say "this virus has the potential to infect everyone in X country, we don't know anything about it (at the time), please try not to panic" - but instead we got platitudes and slogans like "two weeks to flatten the curve!" "Don't wear masks!" "wait, actually wear masks!"
I'm not surprised that there's lots of people getting sick with something either viral, or mental, and then say they've got long-covid afterwards due to everything we're being subjected to today. 'We're all in this together' lmao. We should be absolutely livid about our medical systems worldwide and ask our world governments why they haven't been preparing for these types of events. The answer is usually "cost savings" unfortunately.
>Findings In this cross-sectional analysis of 26 823 adults from the population-based French CONSTANCES cohort during the COVID-19 pandemic, self-reported COVID-19 infection was associated with most persistent physical symptoms, whereas laboratory-confirmed COVID-19 infection was associated only with anosmia. Those associations were independent from self-rated health or depressive symptoms.
They are just saying that some guys who had experienced, and following, self reported their infection, did show the most persistent symptoms. ..., lost senses, etc.. That makes the group A.
While
Other's, who obviously did not experience heavy symptoms, where confirmed tested by lab at some point in time. The only symptom this group B experienced in long term was anosmia.
So there is a discrepancy in that, which is or might be psychological. Yes. But it's just perception? A lot of mild symptoms are resulting in unrecognized infections, because they're .. mild. So why that person should think he/she/it is infected? .... Of course, at some point they've been tested, because they've did start to show anosmia. That's group B.
The ones thinking they're infected and experiencing symptoms (yet having COVID not a big surprise), they self reported by going to see the ICS. Group A.
So, is it not obvious to see the doctor if one starts to show symptoms of an infection with covid in the midth of a worldwide pandemic situation? If one is I'll enough to go to doctors, one can expect the illness to be severe.
And is it not obvious to just do a test (which at some point became mandatory in situations) when one's experiences very mild symptoms and not self report to ICS?
SO, what's the sense to compare A an B for obvious? As I understand, the study is about comparing A to B at the time when A/B got their infection. The grade of severeness/feeling ill is directly connected with persistent symptoms, if I may say so?
The psychological part I could derive from thinking could be that anxious people do pay more attention to every mosquito bite ("AHH it's itchi. Could be corona. Let's see the doc") and thus, they're self reporting. in contrary to the ones who say "it's not necessary to report, because it's just a nightsover or a little snooze".
And of course, that anxious people will have psychological persistent thinking they still having the same symptoms as they were at ICS. But is it thinking or perception? Some perceive the purest pain as nothing while others wizzles by the look at a spider.
But why compare that?! For me it would make more sense to compare severeness vs self report vs persistence
The paper doesn't seem to make any effort to ask the far more relevant question: "Do stronger initial symptoms correlate with stronger long term effects?". They probably do. A lot of it is just straight up long term damage that requires a lot of time to recover.
The data seems questionable to me. You really need to dig into it but they've got 50% of people who said they thought had COVID got a negative test in the study. However, 66% of people who believed they had covid actually got diagnosed by a test or doctor. It seems to me that the false negative rate of their serological rate must be abnormally high. Do I really believe that half of people who think they got covid didn't actually have it even though two thirds of them were confirmed by another test? I don't.
It seems much more likely to me that their test is just bad they've got mostly believed-positive vs !believed-negative; and believed-positive vs. !believed-postive-but-minor-infection if that makes sense. Hard doubt.