I think it's really a shame that aspirin is not emphasized more as a COVID and COVID-recovery treatment, given that it's known to help reduce clotting which is an important mechanism of COVID etiology. Even Biden's physician had him take it during his case.
I'm in the US, so this advice is only applicable there, but LabCorp will test your blood for you without a doctor's note. I had to route around my doctor because I caught covid in the initial wave and no one knew what was going on. Your doctor may be able to help you more these days. Anyway, so I got my blood tested for all sorts of stuff, fixed deficiencies that came up, then leaned heavily on specialists to get medication to fix my symptoms. Beta blockers/other for my heart palpitations/other issues from a cardiologist, various inhalers for my lung issues from a pulmonologist, a whole slew of medications and treatments from a psychiatrist. And so much help from my friends. At the worst of it, it was exhausting walking from my bedroom to the kitchen, and I live in a small apartment. It did take years, but eventually I got there.
Learning to never push myself, because that would cause me to relapse and spend a week in bed. They have a name for it now, but that's the biggest thing that helped, really.
e: I'm downvoted but this is one of the only treatments with best-in-class evidence for its effectiveness in treating long covid as well as CFS and IBS. The body is a complex organism.
this is one of the only treatments with best-in-class evidence
Firstly, one would expect to see indications of the evidence for cognitive behavioral therapy working for a complex long-term illness with multiple documented physiological issues.
> Firstly, one would expect to see indications of the evidence for cognitive behavioral therapy
There is plenty of evidence if you go looking. It also looks like there is significant overlap between CFS and long covid and the PACE trial demonstrated strong evidence for the effectiveness of CBT in ME/CFS.
"proposed mechanism" != "multiple documented physiological issues" and even the presence of documented physiological issues (such as in IBS) does not preclude the benefit of CBT because the body is complicated and the mind-body duality is not real.
> comparison in the claim you also need to present the lack of evidence for other treatments.
AFAIK - there has not been any other treatment showing this sort of evidence. It is difficult to prove a negative.
”A 2010 meta-analysis of trials that objectively measured physical activity before and after CBT showed that although CBT effectively reduced patients' fatigue questionnaire scores, activity levels were not improved by CBT and changes in physical activity were not related to changes in fatigue questionnaire scores.“
See especially the section on “PACE trial controversy”. It’s easy to see that it’s a poor study.
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The paper I pointed towards describes multiple demonstrated means of neurological injury from SARS-CoV-2 infection. It’s just one single paper selected at random. It shall not be dismissed as “proposed mechanism”.
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The unproven and unprovable negative claim was indeed yours to prove.
> These are politicized by certain patient advocacy groups and associated publishing circles but the evidence is considered pretty strong in the broader medical sphere.
The “critiques” of the PACE study are mostly based around p-hacking the objectives until you get the results you want. PACE participants saw significantly fewer hospitalizations, lower mortality, and better reported questionnaire scores as a bonus.
Because there is a lot of ire against recommending CBT among patient advocacy groups (including threatening to kill the authors and their families), some researchers have critiqued PACE because they have found some metrics in post-analysis that PACE did not improve (classic p-hacking). But that does not represent the broader view of the field.
Described by other scientists: “[The critiques come from a] fairly small, but highly organized, very vocal and very damaging group of individuals who have, I would say, actually hijacked this agenda and distorted the debate so that it actually harms the overwhelming majority of patients.'
> It shall not be dismissed as “proposed mechanism”.
That is literally how the paper self described. I am linking you multiple RCTs demonstrating impact and you are linking speculative causes of a disease that do not yet meet Koch’s postulates. But even if a neurological mechanism holds up (not at all unlikely in my view), this is likely to not be the case for all populations currently diagnosed with long covid - but rather a subset. CBT will likely be helpful for both populations, given the evidence I have linked.
My proof of my claim is that I have researched alternative treatments for long covid and CFS and none of them have these effect sizes :) If you have contrary evidence, that’s on you to prove, but fwiw I am not going to keep replying.
And again, I’ve linked RCT evidence for the effectiveness of CBT in long covid, which I guess you have nothing to say about.
Demonstrated effects of reactive microglia after COVID-19 include a reduction in oligodendrocytes and myelinated axons, highlighting disrupted myelin homeostasis.
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The UK Biobank study discussed above compared magnetic resonance imaging (MRI) data before and after SARS-CoV-2 infection in 401 individuals and 385 matched controls. MRI data obtained an average of 141 days following COVID-19 diagnosis revealed widespread structural abnormalities, including a small but significant global decrease in brain volume, changes throughout the olfactory system, and structural abnormalities in the limbic system, cerebellum, and major white matter tracts (fimbria and superior fronto-occipital fasciculus)
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Concordant findings in an MRI study of individuals with persistent cognitive impairment after COVID-19 found white matter hyperintensities correlating with verbal memory deficits
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Another imaging and neuropsychological assessment of 223 individuals who recovered from mainly mild to moderate SARS-CoV-2 infections and 223 matched healthy controls found that among the 11 MRI markers tested, significant differences between groups were found in global measures of mean diffusivity and extracellular free water, which were both elevated in the white matter of post-SARS-CoV-2 individuals
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And so on and so forth. Those are the first immediately obvious passages describing structural alterations to brain tissue in that one paper.
These are severe physiological issues. This is literal brain damage. This is a paper pointing to craters.
There's even more evidence for CFS - the PACE trial is a notable example. These are politicized by certain patient advocacy groups and associated publishing circles but the evidence is considered pretty strong in the broader medical sphere.
https://jondouglas.dev/long-covid/ (Maybe outdated at this point but tells the full journey)
https://www.reddit.com/r/LongHaulersRecovery/comments/12iv4p... (Probably the most realistic summary)
The most important thing in my opinion that I don't talk about in these posts is to stay informed on the latest research and become study/trial literate. i.e. https://www.science.org/content/article/how-seriously-read-s...
Wishing you the best to recover.