Another look at long covid out in a pre-print, from @mlipsitch&co:
medrxiv.org/content/10.110…
I'm not surprised, but at last someone had the notion to compare folks post-covid to folks post-viral-infection, non-covid.
The headline is "14% had sequelae" but they buried the lede! 1/6
medrxiv.org/content/10.110…
I'm not surprised, but at last someone had the notion to compare folks post-covid to folks post-viral-infection, non-covid.
The headline is "14% had sequelae" but they buried the lede! 1/6
First, the limitations:
1) totally based, not on survey/exam, but on MD-reported ICD-10 codes; so these are "long," possibly random, symptoms bad enough to see an MD and have them code it.
2) retrospective cohort, so all the usual bias & matching concerns.
3) only age 18-65. 2/6
1) totally based, not on survey/exam, but on MD-reported ICD-10 codes; so these are "long," possibly random, symptoms bad enough to see an MD and have them code it.
2) retrospective cohort, so all the usual bias & matching concerns.
3) only age 18-65. 2/6
But it was HUGE (>200K matched cases), which helps;
and fairly well-matched;
and, at last, well-chosen cohorts (2020 no covid, 2019, pre-2020 viral).
WHAT DID THEY FIND???
Post-covid, you had a 14.6% chance of seeing an MD for post-viral problems.
Pre-2020 virus? 13%. 3/6
and fairly well-matched;
and, at last, well-chosen cohorts (2020 no covid, 2019, pre-2020 viral).
WHAT DID THEY FIND???
Post-covid, you had a 14.6% chance of seeing an MD for post-viral problems.
Pre-2020 virus? 13%. 3/6
That said, some problems were strongly associated w/ covid (red) relative to other viruses (grey); others modestly; others about the same.
3 examples here, w/ respiratory failure far worse post-covid (do note the y-axis), clots rather worse, & cardiomyopathy about the same: 4/6
3 examples here, w/ respiratory failure far worse post-covid (do note the y-axis), clots rather worse, & cardiomyopathy about the same: 4/6
Again, this is not a prospective study w/ actual regular exams etc.
But it is suggestive-
namely, that all viral infections can cause substantial health burdens, and it's not clear that SARS-CoV-2 is significantly more likely to cause "long" problems than flu, RSV, HMPV, etc. 5/6
But it is suggestive-
namely, that all viral infections can cause substantial health burdens, and it's not clear that SARS-CoV-2 is significantly more likely to cause "long" problems than flu, RSV, HMPV, etc. 5/6
This has Public Health implications:
1) Let's devote more resources to studying viral infections, as they likely cause an under-appreciated amount of chronic disease.
2) "NPIs are needed to prevent long covid" is only a sound idea if we intend to lock down every flu season. 6/6
1) Let's devote more resources to studying viral infections, as they likely cause an under-appreciated amount of chronic disease.
2) "NPIs are needed to prevent long covid" is only a sound idea if we intend to lock down every flu season. 6/6
Upon finding the authors' v interesting Supp Matls, I'll add:
1) The study's focus on disease codes over symptoms could limit real world value- ie "respiratory arrest" checked, not shortness of breath or chronic cough. Only fatigue, myalgia &anosmia among symptom codes checked.
1) The study's focus on disease codes over symptoms could limit real world value- ie "respiratory arrest" checked, not shortness of breath or chronic cough. Only fatigue, myalgia &anosmia among symptom codes checked.
Data for some of the common complaints of "long-haulers" was not gathered, incl weakness, mild cognitive impairment,& poor exercise tolerance.
On the flip side,2020 MDs are much more likely to code "post-viral fatigue" than 2019 MDs, so some ICDs are prob overstated.
Epi is hard.
On the flip side,2020 MDs are much more likely to code "post-viral fatigue" than 2019 MDs, so some ICDs are prob overstated.
Epi is hard.
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