[Mediterraneo10]

I have been following "long COVID" reports. Firstly, much of the mass media coverage is misleading, often intentionally so in pursuit of clicks and advertising revenue. A lot of the people claiming to have debilitating "long COVID" were never actually tested positive for COVID in the first place. They are the broadly the same demographic that, before COVID, were claiming to have "chronic Lyme" or whatever. Certainly mainly of them do have symptoms and distress, but it is questionable what relationship they have to COVID.

Then, if one starts digging into more serious discussion – even your link above – one finds that "long term" in medical parlance may mean a series of months but not necessarily years, and similar months-long impacts are known from diseases that we have generally tolerated among society. It also isn’t clear that these lingering symptoms affect enough people to impact the economy if measures are lifted once hospitalizations fall.

[rcpt]

Here: https://www.medrxiv.org/content/10.1101/2021.01.16.21249950v...

Hundreds of thousands of people. Average age mid 40s and sliced by hospitalized or not. Controlled against people who had the flu during lockdown.

Double digit percentages have issues 6 months on. Unsurprisingly not very different from SARS 1 and those people are still sick since 2003.

[Mediterraneo10]

Yes, indeed, the various studies (and yours is a typical example) show mainly an older demographic reporting symptoms stretching into months, and include the observation that it was mainly (even if not exclusively) a severe course of the disease that preceded lingering symptoms. But a lot of the attitudes that restrictions must be kept in place to prevent "long COVID" are held by younger people who are very afraid of coming down with the phenomenon, yet they are not significantly at risk of it according to these studies.

[rcpt]

I struggle to see how you reached that interpretation of the paper.

[timr]

Table 3 and Figure 2 make it clear that the hazard ratios for patients with hospitalization and/or encephalopathy are multiples higher for those without hospitalization and/or encephalopathy.

Intracranial haemorrhage is 3-4x more likely in hospitalized patients; ~5x higher in those with encephalopathy. For stroke, 2-3x for both. For first mood disorder, 1.5x/2x more likely.

They don't break down the cross-tabs by age (as they should), but given the patterns here, I would expect to see a strong correlation.

The sicker you are, the sicker you are.

[rcpt]

Yes you are right. I looked into the authors research and found a more recent paper that breaks it down by age

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...

Figure 3 has risk ratios sliced by age+sex

[timr]

Yes, that paper, I am familiar with. It is...quite poor (see below). But it does clearly show the age-dependence of the things they're observing.

There's far too much to get into in a single comment, but the TL;DR is that they bury a lot of important information in the supplemental materials [1] that make a strong argument that what they're observing are spurious correlations with a third factor. At the very least, this kind of statistical fishing expedition has a high risk of bias, because the researchers know the outcomes ahead of time.

Consider supplementary tables 10 & 11: these show that a large number of the "psychiatric sequelae" are correlated with the control conditions, and the effect of Covid is not significantly different (even where they are, the authors have clearly gone on a fishing expedition, which should make you skeptical).

Figures 16-21 show that the risk of a patient developing Covid is 1.5x greater if they've had a recent psychological illness. This is on par with the risk ratios discussed in the text of the paper, and indicates that the association is not necessarily causative (i.e. it's not clear if Covid causes psychiatric problems or vice-versa).

Figure 22 shows a particularly interesting series of plots, where the diagnosis rates of the control illnesses (broken bones, etc.) are plotted over time. Without exception, everything drops but Covid. It is almost inevitable that if you look at this dataset, you will find an increase in diagnosis of X after Covid...because Covid patients are being seen at much higher rates!

Overall, my interpretation of the supplementary figures is that there was an intense focus on "Covid patients" in 2020, and all other groups stayed out of the doctor's office. Covid patients were showing up in the clinic, so covid patients were the ones being diagnosed with other illnesses.

[1] https://www.thelancet.com/cms/10.1016/S2215-0366(20)30462-4/...

[Mediterraneo10]

Average age 40, as you said yourself. And then as the authors of this paper find, "Risks were greatest in, but not limited to, those who had severe COVID-19."

[chc]

Framing an "average age of 40" as "an older demographic" seems a bit misleading, as the average age of human beings in America is 38. We're not talking a few sickly senior citizens here (which, even if we were, I wouldn't feel justified in writing off, but it's not).

[inter_netuser]

That just means America is graying.

Your thymus is very likely to be useless after 40 due to something called thymus involution.

[rcpt]

the "but not limited to" is the important part

[Mediterraneo10]

It doesn’t matter if these longer-term symptoms affect some number of people outside that older, frailer risk group. There are always statistical outliers. If the amount of younger, stronger people affected by these symptoms is small, then that weakens the case for maintaining restrictions after vaccination of the most at-risk groups.

This issue seems to be important to you personally and to others whose concerns may or may not be reasonable, but I don’t believe it will be important to most of society as vaccinations roll out and the Northern Hemisphere spring and summer are upon us.

[orra]

> A lot of the people claiming to have debilitating "long COVID" were never actually tested positive for COVID in the first place.

Worth keeping in mind it was impossible to get a COVID test for a large fraction of the first wave.

[NortySpock]

> A lot of the people claiming to have debilitating "long COVID" were never actually tested positive for COVID in the first place.

Do you have a citation for this claim?

[Mediterraneo10]

I was talking about the innumerable "long COVID" media coverage where some ordinary person is invited to tell the whole story of how they got ill, felt terrible, and still feel terrible, but nowhere did they actually go to the doctor and get a formal positive COVID test. They are just guessing that they had this disease that was going around. And now dedicated Facebook groups etc. are popping up whose membership has complaints and claims that are extremely similar to the "chronic Lyme" groups that flourished just before COVID.

I was obviously not referring to actual scientific studies of long-term COVID effects, but as I said, those studies don’t say quite what the more sensationalistic mass-media coverage is saying.

[wpietri]

There is a big difference between "formal positive COVID test" and "just guessing". For the case I mentioned above, tests were effectively unavailable at time of illness. But later on, multiple doctors said that from the symptoms and the follow-on illness, it was probably COVID.

Your insistence on denying distinctions like this makes you look like a person arguing a case, not somebody trying to jointly get at the truth. Which from my perspective, makes you much worse at arguing your case.