Thread by @MonicaGandhi9

Was asked if could get long COVID from a mild breakthrough infection with delta? No, likely not from pathophysiology. Persistent symptoms usually occur after a severe viral infection; lot of poor methodology of long COVID studies. Best review here
nature.com/articles/s4159…

And here is one of the best done analyses in terms of methodology which showed that more symptomatic * severe acute illness associated with more prolonged symptoms after (breakthroughs in vax'd generally mild)
ons.gov.uk/peoplepopulati…

This paper shows something similar- again, it is very important to look at the methodology of how analyses are done before taking statistics like 20%, 50%, etc. from insurance ICD-10 codes or other poorly done studies
nature.com/articles/s4159…

And another paper from the VA - having symptoms that last a while after associated with having been in the ICU for COVID-19, then those who are hospitalized with COVID. Those in hospital now with COVID in US mainly unvaccinated, compassionate education
nature.com/articles/s4158….

Kids therefore much less likely to get mild COVID as unlikely to have severe disease. And in adults, with a vax breakthrough, have immune response from vaccine so T cells and antibodies go in to stop viral replication (in nose & elsewhere) - different from infection without vax

And will add this thread from pediatric ID specialist @apsmunro here for specific information on children:

https://twitter.com/apsmunro/status/1396858104290156549