Spectrum of Covid-19: From Asymptomatic Organ Damage to Long Covid Syndrome | Hacker News Reader

Spectrum of Covid-19: From Asymptomatic Organ Damage to Long Covid Syndrome

whn.global

57 pointsck4570 comments

> COVID-19 can cause brain damage including loss of brain tissue, small blood vessels, and merged brain cells. In some patients, perhaps many, there is also damage to the immune system.

Now that, I did not know. Crazy how much damage COVID can actually do.

I suspect lots of viruses do tons of long-term damage in at least some cases, but it’s just less-studied or comes up less in the media. Flu, colds, hand and foot, all that stuff.

Though even allowing that, it’s still possible Covid-19 is worse than most viruses, as far as that sort of damage goes.

Even if Covid-19 was similar in terms of causing damage, its high transmissibility and mutability means that it's worse on a population level.

That's not true, as you have no idea what the distribution of complications is for almost any illness... you need to understand the complication distribution and the transmissibility in order to judge impact.

They were speaking hypothetically. Even if denotes a scenario where the impact per infection is equal.

In such a scenario Covid has worse impact due to the higher transmissibility. People seem to get it every 6-12 months. Flu infection is much less frequent.

I think the flu data is somewhat difficult here. Most people do not refer to having had it if they didn't get sick. Yet, studies are showing from a third to a half of people with the flu will be asymptomatic. Which, is kind of terrifying to me.

True, but Covid also has plenty of asymptomatic or low symptomatic cases. I’ve known a few who tested positive while reporting no symptoms.

A Chinese field study estimated people got the flu once every five years. It is simply much less contagious. Flu collapsed globally when countries put in place Covid precautions.

https://www.bbc.com/news/health-31698038.amp

Latest study I saw on flu was about 10% of people get it each season. And there was another study showing that families with toddlers are basically always exposed.

COVID does follow the same general rates of corona viruses, from what I remember. Which is to say it is higher than flu. So, I am not trying to downplay that.

If 10% get it then you'd get it roughly once in every ten years.

I'm very hesitant to extrapolate from those numbers. Often times they will use that as "per exposure" number. Such that it will often be far higher than you'd take from a naive reading. Sadly, I don't remember where I saw that number, so can't check up on it.

That said, feels very in the weeds here. My stance is largely to have as much patience with folks as can be. I don't personally go through as much effort as many do, but I see no reason for that to be something to get upset over, either.

Your assumption is that the impact per infection is equal or worse.

I think that there's no real basis to assume that, especially when young. I would expect the distribution of flu complications (externally validated, not based on self-reports) is actually worse.

The big 2024 National Academies consensus paper says that they see similar long term damage from chronic fatigue syndrome and several rare diseases, but don't mention this as an outcome from more common viruses.[1] (Skip ahead to the summary).

The big open question is cumulative damage from multiple COVID-19 infections.[2] There are now many people who have had COVID more than once. (US: 60% at least once, maybe 11% more than once.) A few people have had it many more times, but that seems to involve some pre-existing condition. A VA study of older veterans indicates that cumulative damage is real in older adults. As time goes on, there will be more previously healthy people who have had COVID multiple times, and this question will be answered the hard way.

[1] https://nap.nationalacademies.org/read/27756/chapter/1

[2] https://www.nytimes.com/2023/08/17/well/live/covid-reinfecti...

It's been known for a long time and is called post-viral syndrome and post-acute infection syndrome:

https://en.wikipedia.org/wiki/Post-acute_infection_syndrome

https://www.medicalnewstoday.com/articles/326619

Measles for example wipes out the immune systems memory of everything it has learned to defend against, leaving people newly vulnerable to everything they were immune to before:

https://www.bbc.com/future/article/20211112-the-people-with-...

There's a good chance that a lot of the "mystery diseases" are due to longer lasting damage from viruses, to organs and to the immune system, including ordinary colds and flu. Colds and flu are probably spread via the air also, yet this also remains unstudied (otherwise known as "there is no evidence") and hospitals don't take precautions for most patients, probably because the cost would be large to treat the air in all hospital rooms. It would mean ending practices like putting two patients in each room as well. I think that in the past a lot was overlooked as being too complex to deal with ("we can't cure flu, it mutates too fast") or too costly (but so was mapping DNA), or both (drugs personalized to each persons DNA) so a certain amount of death and disability was allowed and drugs and surgery statistically only work for some people (see "number needed to treat", NNT). Now we have better tools and understanding and these things should change.

> because the cost would be large to treat the air in all hospital rooms.

It would not.

Compared to the rest of hospital maintenance costs, UV-C hydrogen peroxide generators for the HVAC system are cheap, and effective.

I've heard Covid referred to in some quarters as "aerosolised HIV", which should be at least taken seriously, even if it is (possibly) overly alarmist. It's certainly easier to catch than HIV.

While it's useful to have a distinct name for the virus/disease, it really should have been called what it is: It's SARS-CoV-2 not Covid. SARS: severe acute respiratory syndrome.

I wear a n95 mask at work (medical practice) and I consistently wear one in shops, especially shopping centres. It's kept me safe so far.

You’re saying you haven’t caught covid yet? That’s quite the claim. I’d suggest you just never had symptoms when you contracted.

Covid 0 right here.

I work in a medical practice staffed by sane people so we had excellent infection control and procedures from even before the pandemic, and just doubled down on it. I live on a farm in the middle of nowhere. I'm an introvert and seldom socialise. My SO is susceptible to respiratory infections which motivates me to keep as safe as possible.

I haven't even had a cold.

> I've heard Covid referred to in some quarters as "aerosolised HIV", which should be at least taken seriously, even if it is (possibly) overly alarmist.

I've heard it too and it's definitely one of the more deranged takes I've run into.

To be clear, I do find it alarmist, but I take it seriously in the sense that it's definitely clear that Sars-cov-2 isn't "just a cold", and it's perhaps promotes a more healthy and cautious attitude to the virus in the face of the dangerous community apathy and dismissal, even in medical spaces.

In other words, "there would be no smoke without fire". I believe, personally, that this truism is a major cause of injustice and grief in the world, historically and at present time. It is absolutely fair and warranted to be skeptical in every possible way every time it is pronounced.

No, that's not an accurate paraphrasing.

I want to be crystal clear about this:

* Sars-cov-2 is a new virus to us and research into is ongoing.

* It demonstratably has short and long term health effects, and some of those lead to death or disability (see TFA). Repeat infections cause further damage.

* It is an easy virus to catch.

With those factors I believe in erring on the side of caution, and am alarmed at the way the a serious public health problem has become politicised and polarised.

> which should be at least taken seriously

I don't take things said "in some quarters" seriously.

> even if it is (possibly) overly alarmist

It's alarmist to the point of being damaging to prevention efforts and to the mental health of the population in general.

> It's kept me safe so far.

Case in point.

> I consistently wear one in shops, especially shopping centres.

...I don't know how I feel about this, honestly. I respect everyone's right to be as cautious how they want in their life and dress how they choose but after 4+ years I think those who haven't returned to not wearing masks 24/7 outside the home are being a little, uh -- I guess a word for it would be over-dramatic.

I think being over-dramatic would depend on it being burdensome. Wearing a mask is pretty easy and unobtrusive.

If nothing else, there are still legitimate medical risks to catching COVID for people who are immunocompromised (at minimum). A good mask lets them at least have less risk being out and about.

Plus, given how often it mutates, perhaps people just don't want to get sick again even if they don't have any long-term aftereffects.

I do not have long term damage from my COVID infection from February 2023.

Yes, and?

The majority of smokers don't get lung cancer either. Just because it thankfully didn't happen to you, doesn't mean it isn't something that happens to people regularly.

It’s important because in these distinctions, we find what causes disease. For example schizophrenics are less likely to get lung cancer, even though they smoke much more than the average population.

Smoking does not cause lung cancer. Smoking raises the risk of lung cancer.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951592/#:~:tex...).

Smoking is a carcinogen. As is alcohol and processed meats and the sun and a whole host of other things.

The point is that simply because the poster didn't get long Covid, that doesn't mean it's not something that people get. And it doesn't mean it's not attributable to Covid. While these people could be more susceptible to long Covid because they also have some other quality, trying to downplay either Covid or long Covid because of your individual experience is always a bad move.

And the biggest irony is that people will do that to downplay Covid while pushing "vaccines are dangerous" ideology despite far, far more people having taken any vaccine than having gotten Covid. And those people experiencing far far fewer complications from that vaccine.

No one saying people don’t have long Covid. I’m not saying people don’t have long Covid. I took care of a good friend who had long Covid for six months.

I’m just saying there’s something in each person that determines whether or not Covid can cause long Covid. If you don’t make that distinction, all you do is make everyone think they’re going to get long Covid. And by not looking at the distinctions You never find out why people get Covid.

That would be a useful data point if the claim was that everybody who got COVID developed long term damage, but nobody is making that claim or anything like it.

No, but when people say “Covid causes brain damage“ it’s incorrect. Because of Covid caused brain damage than everyone who caught Covid would have brain damage and they know that’s not the case. So it’s not just Covid that causes brain damage. It’s Covid and something that was wrong with the person who caught Covid.

Personally, and this is my own humble opinion, I think what was wrong with the person was they had low ATP and GTP. If you wanna know more about the science behind it, I’ll be glad to explain it.

This is important because this is how you cure diseases by making these distinctions.

Less than 1% of Polio infections cause paralysis. But Polio does cause paralysis.

Only about half of infected, untreated people die of bubonic plague. It's still a deadly disease.

Polio increases the risk of paralysis For a population. It only causes paralysis in the people who become paralyzed.

If I had long Covid, I would rightly say Covid caused my long Covid. But since I don’t have Covid, I can’t say that Covid caused my long Covid so for me Covid did not cause long Covid.

I’m more interested in the distinction of Outcomes and the wording they’re using pay no attention to distinction.

You are being uselessly pedantic.

If there is a statistic that guns killed 40,000 people last year in the USA, everyone knows that it doesn't mean that every gun contributed to the deaths of those people. If someone says the Earth is spherical, the discussion is made worse by saying, "Actually, it is an oblate spheroid, blah blah". When some source states that polio paralyzed xxx thousand people in 1930, what is the value add of saying:

> It only causes paralysis in the people who become paralyzed.

Tautologies are by definition true, but don't really contribute much to an argument.

There's at least one known person who survived a fall from more than 33,000ft: https://en.wikipedia.org/wiki/Vesna_Vulović

So by your logic, a fall from 33,000ft does not cause death.

It also lacks value as a data point because long term damage isn't the same thing as current symptoms.

I don’t know why you’re being downloaded because I think people like us are important. I was focusing on the sick people, but they’re not focusing on what makes the difference between someone who is well and someone who’s sick after catching Covid. And that’s in fact how they discovered Clues to combating the HIV virus.

First line of the study:

> Long COVID, as currently defined by the World Health Organization (WHO) and other authorities, is a symptomatic condition that has been shown to affect an estimated 10-30% of non-hospitalized patients after one infection.

Doesn't say 100%.

Then they need to stop saying that Covid causes these things. They need to say Covid increases a risk of causing these diseases in some people.

I mean, look at the title of the paper

“Spectrum of COVID-19: From Asymptomatic Organ Damage to Long COVID Syndrome”

Where is the part of the spectrum where nothing happens at all? The spectrum of COVID-19 is from nothing happened to dying.

And I can see everyone on Twitter right now yelling at me to wear a mask because the spectrum of Covid is always disabling. It’s just really really bad messaging

> Then they need to stop saying that Covid causes these things.

Well, if it does cause these things, and it's looking like from the literature that's the case, they wouldn't actually need to stop saying that.

People wouldn't have had those issues had it not been for COVID.

So how do you phrase it? Enlighten us without making us laugh.

As someone put it earlier: it would be stupid to say "a gun is a lethal weapon only to someone who's been lethally shot".

How do you know? According to the article, you can have long term damage without having any symptoms.

I suspect that the majority of people could lose 10% or so of their lung capacity, heart strength, memory, analytical ability, fitness recovery, immune system, etc. without ever noticing. People don't use their bodies to the fullest and they have no idea what they are capable of, so if their maximums dropped a bit, it would be practically asymptomatic.

I thought I was fine after my infection until I tried running some high-intensity intervals (max heart rate), I quickly discovered I was not fine. But non-athletes don't push themselves that hard, and even athletes avoid it.

There's also the fact that the body can compensate for injury in subconscious ways, and it is impossible to separate the impact from the Covid-19 infection from everything else that has changed in the past few years, including the constant impact of aging.

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