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Comment by gitfan86 | Hacker News Reader

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There is no evidence that your claims are worth anything.

There are tons of known mechanisms, biomarkers, documented physiological alterations and on and on and on.

Do take note that “there is no evidence for x” is an absolutely gargantuan claim. If you intend to carve swathes of epistemological foundations into the void you better have something a little sharper and a little more substantial.

Ironically, the claim you've made in your comment carries exactly as much weight as the claim of the person you're replying to does, which is zero, as both of you have just typed out some generic wide-sweeping opinion about a topic without linking to a single piece of data to support your claim.

Not quite.

I am armed and ready with sources as part of the game, and the statement on epistemology hardly needs qualification.

The definition that the CDC created backs up my statement. "Long COVID is not one condition. It represents many potentially overlapping entities, likely with different biological causes and different sets of risk factors and outcomes."

https://www.covid.gov/be-informed/longcovid/about#term

Any pain or psychological issue you have after covid can be categorized as "Long Covid". Which is ridiculous because if covid never happened we wouldn't expect joint pain and depression to go away. Those things existed long before covid and should have been expected to exist after covid.

Non reproduced studies that cherry pick data to fit the conclusion do not refute these facts.

The CDC statement does not back up your claim. Neither of the two diseases you mentioned are actually caused by anxiety or depression, and the CDC is not saying that anything you have after COVID is long COVID but rather that the real problems people are having do not have a single simple cause. This is true of many other things - consider how family history, diet, exercise, sleep, past infections, pollution, etc. all affect who develops heart problems or dementia - but if those have unambiguous symptoms, we don’t have people coming out of the woodwork to say that they’re imaginary or the result of poor moral fiber. Not everything is that easy to link to a cause - think about what we now know about tick-born diseases versus how sufferers were told they had a psychosomatic condition or weren’t eating right back in the 80s – but that only means that medical researchers need more time and data to understand the very real things patients are experiencing.

So if the real problems people are having "do not have a single simple cause", why are we calling it "Long Covid"?

The name implies that there is a known cause, and the diagnosis IS Long Covid.

Because diseases are complicated and your body’s response involves a number of factors. We know that there is a large group of people who had no known health conditions prior to some number of COVID cases, at which point they did have a chronic condition, and tests have failed to link it to other known diseases. This again is similar to other things - for example, arthritis has some components like age or genetic predisposition but also risk slog goes up with things like obesity, smoking, exposure to certain chemicals, or bacterial / viral infections in and so there isn’t a simple cause or effect relationship because for any given trait you can find people who have it but did not develop the condition or vice versa. What researchers have done is find correlations in large groups to identify how the many factors increase your odds of developing the disease - even if most people don’t develop it, we have a large enough population that many people will.

Long COVID is similar in that they have identified risk factors like age or not being vaccinated and have some theories for the underlying mechanism and biomarkers which hopefully will make it easier for clinicians to identify patients or warn people with high risk factors.

https://erictopol.substack.com/p/lighting-up-long-covid

Correlation isn't causation. The highest risk factor of Long Covid is probably frequency of hearing about it from social media. Much like Fibromyalgia.

I would strongly suggest reading the previous link and the Science paper it leads with (https://www.science.org/doi/10.1126/science.adg7942). When a large number of medical professionals say there’s something real and there are peer reviewed publications in top journals discussing options for treatment, it is highly unlikely that some rando with no relevant expertise is correct in arbitrarily dismissing it.

I would strongly suggest not blindly trusting "peer reviewed" and "top journals", especially on topics that are not easily provable.

"We conclude that despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction. "https://www.nejm.org/doi/10.1056/NEJM198001103020221 "Our analyses clearly show that SARS-CoV-2 is not a laboratory construct or a purposefully manipulated virus." https://www.nature.com/articles/s41591-020-0820-9

Over 14,000 published articles suggest otherwise:

https://www.ncbi.nlm.nih.gov/research/coronavirus/docsum?fil...

Don't forget the use of bots, AI-generated articles, etc.

You can read more on this here:

https://academic.oup.com/nar/article/51/D1/D1512/6814452

Yes there are general challenges in research, but not sure how that really changes the argument that there's significant amounts of research in this area and novel peer-reviewed findings.

Are you implying there are 14k articles produced by bots just about fibromyalgia? ChatGPT isn’t even 2 years old!

No, I am implying that 14k articles were produced on the topic of Long COVID clearly differentiating it from "fibromyalgia". Which is a viewpoint only shared by a select few not even researching the condition.

These syndromes are best described by their respective pathogen: https://www.nature.com/articles/s41591-022-01810-6

EDIT: Sorry, you were talking to someone else. Disregard this comment.

Here is a study that suggests it is different.

https://www.mdpi.com/2227-9059/11/10/2704

> just that there is no real evidence of this being a real disease

What does this even mean? How do you define a 'real' disease?

Sounds like a god of the gaps fallacy to me. Just because we don't understand and can't treat it yet doesn't mean it's not a real disease. At the very least it looks like a cluster of various kinds of diseases.

Looking at the history of things like fibromyalgia and CFS (remember when that was called “Incline Village Yuppie Syndrome” to dismiss it?), I think your god of the gaps comparison is quite apt and it seems like it’s especially used to minimize diseases which affect people unlike the speaker. It’s no coincidence that all three of these are associated with women, for example.

Cognitive slowing squares with the depression hypothesis.

More like with neuroinflammation and brain hypoperfusion? Both present and measured in long covid sufferers. M1 polarized microglia, damaged endothelium, dysfunctional mitochondria...

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