How does being vaccinated impact the risk of #LongCovid?
A thread on 8 studies (I'll add to it as I find more):
1/
The summary: vaccination definitely seems to reduce the risk of #LongCovid, often by 40-50%.
*But* solidly 9.5%-14% of breakthroughs still result in Long Covid.
These figures make sense to me, given the estimated rate of LC in unvaccinated people (~10-30%).
2/
A caveat: many of these studied people who had been vaccinated relatively recently, so as always, we can expect these findings to change a bit as immunity wanes.
3/
Study 1: this is one of two studies rated as high quality by UKHSA.
10,024 breakthrough cases with matched controls, looking 6 months from onset, found vaccination:
-did not reduce overall #LongCovid risk, but did reduce risk of some key symptoms: fatigue, anosmia, hair loss, lung disease, myalgia
-did not reduce risk for other symptoms: abdominal pain, headache
-did reduce severe outcomes (hospitalization, death, respiratory failure)
5/
Study 2: also rated high quality, this found a 7-10x reduced rate of #LongCovid!
Why the difference between Study 1? Not clear, but the number of breakthroughs was smaller (2400) here; it was also pre-Delta, where Study 1 included some Delta cases.
Study 4: 16035 breakthroughs & 3.57 million controls. Found vaccination had specific impacts:
-Reduced risk in cardiovascular, coagulation, metabolic, pulmonary organ systems, & fatigue
-Not reduced in kidney, gastrointestinal, neurologic systems
App-based study, 2370 breakthroughs with matched controls found that *full* vaccination reduced #LongCovid symptoms by roughly half. Notably, one dose resulted in the same Long Covid prevalence as unvaccinated controls.
The next 2 are weird or less comprehensive for different reasons.
11/
Study 7:
This one included a) uninfected controls & b) unvaccinated infected controls, along with vaccinated infected. Some false negatives or sick people were likely in the uninfected controls, because they had high baseline symptom rates (recruited from PCR test sites).
12/
Comparing unvaccinated to vaccinated, this study found some reductions in some symptoms, but not consistently across age groups.
-No reduction in loss of concentration, persistent cough, overall recovery
13/
-Did reduce fatigue, headache, weakness, myalgia, hair loss, dizziness & shortness of breath
-Most reductions higher in people >60 than age 19-35
-11% of vaccinated had fatigue vs 26% unvaccinated
-14% of vaccinated had headache vs 22% unvaccinated
In summary: get vaccinated to reduce your risk of #LongCovid, but be aware that if you get a breakthrough, the risk is still high!
16/
These findings might also suggest reductions in certain types of #LongCovid (respiratory and possibly cardiovascular stick out to me) but not to others (neurologic and gastrointestinal in particular).
17/
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Because this video has caused so much willful misinterpretation, I want to clarify: in the clip I’m countering the myth that #longcovid is lingering symptoms of acute COVID, since many people think it’s just a cough. I should‘ve said “acute COVID”; brain fogged & trying my best.
The interview was an hour long & they edited it to 5 min. I talked their ear off about all hypotheses & the science behind each & it didn’t make it in - the piece was for a general audience. I talked about all the other things COVID can cause, include diabetes & clots, at length.
Anyone who is suggesting I don’t think #longcovid is from COVID (????) or that I don’t think viral persistence is a high priority hypothesis (????) are *actively* ignoring 3.5 yrs of advocacy & that I’ve been highlighting viral persistence since 2020
The most exciting hypotheses in #LongCovid and #pwME are ones that could have cures! This includes viral persistence and others, and also includes the itaconate shunt hypothesis. I'm going to tweet this video as I watch it to try to explain it more 1/
Dr. Ron Davis used to work on the Human Genome Project but switched to ME/CFS when his son got sick. He's the director at the Stanford Genome Center. He is focused on *a cure* for ME/CFS. "I believe it is a curable disease." 2/
He describes the common onsets of ME - usually viral, but can have other causes too, refers to a big parasite onset in Norway from a few years ago 3/
@TheCrankyQueer: highlight the need for trans inclusion in trials, including understanding how different labs may present; biomarker nuance
Oved Amitay: need to create a center of excellence to learn from trials in other diseases 1/
Oved: FDA needs to align on decisions across similar fields, needs cross-talk across similar groups
@Dysautonomia: Most even great researchers don't understand autonomic disorders, which happen in up to 2/3 of LC...is there an opportunity to offer autonomic training? 2/
@Dysautonomia: Also, need to make arms in these trials for pre-Covid POTS/MECFS - this helps learn about LC as well (ie does Paxlovid help pre-covid pts)
"Fatigue turns the most mundane of tasks into an “agonizing cost-benefit analysis,” @turnoftheshrew said. If you do laundry, how long will you need to rest to later make a meal? If you drink water, will you be able to reach the toilet?"
2/
"Only a quarter of long-haulers have symptoms that severely limit their daily activities, but even those with “moderate” cases are profoundly limited. @julialmv still works, but washing her hair, she told me, leaves her as exhausted as the long-distance runs she used to do." 3/
Other factors that correlated with INCREASED likelihood to recover from #LongCovid include:
-being male
-having cardiovascular comorbidities
-lost appetite in acute phase
-had smell/taste alterations (this is often its own subtype that can come with no other symptoms)
3/
Tim Henrich from University of California shows the many, many viruses that have long-term sequelae. 2/
2 years after acute Ebola infection, patients have *higher* rates of markers of tissue damage, T Cell and B cell activation & exhaustion, markers of inflammation 3/