BIG PROBLEMS with framing of new baseline study of NIH intramural #LongCovid #PASC cohort

lack of abnormalities on ROUTINE tests

no objective abnormalities

It ignores #LongCOVID similarities to #MECFS & advances in research on both, including those funded by NIH!

no evidence found

evidence against


Yes, it's a baseline study. But the pivot to discussions of depression and anxiety when abnormalities weren't easily found is jarring.

This follows the HORRIFYING tendency of medicine to psychologize illness, when physiological abnormalities aren't found.


Since #PASC #LongCovid shares much with #MECFS. Why weren't EASILY measured abnormalities evaluated at BASELINE?

There are plenty of reviews of such abnormalities. For ex, 👇🏻 and plenty more recent too
#POTS / #dysautonomia is common w/ #MECFS / post-viral syndromes. #LongHaulers & controls could have been tested with Tilt Table or Nasa Lean testing = Does heart rate 📈 >30bpm from lying to standing?

Such a low-lying fruit. Unpicked.


Many abnormalities found in #MECFS and #LongCovid remain research assays. They aren't routinely available or easily done in every study of #LongCovid.

So lack of performance in this study is reasonable!

Lack of discussion is NOT.


ABNORMAL 2-day cardiopulmonary exercise testing associated with ABNORMAL metabolomics in #MECFS

The authors ignore these & many other abnormalities in #MECFS & #LongCovid.

Instead, they make the epidemiologically FLAWED claim "only female gender... and self-reported history of anxiety disorder... were significantly associated with increased risk for PASC."


These are BASELINE results from a longitudinal study. Association b/w anxiety/gender & #PASC is from a CROSS-SECTIONAL association of those factors amongst people with recent #COVID who were recruited... by SELF-REFERRAL

THESE association could be explained by BIAS...

Ppl w recent #COVID who self-refer into the study already either had #LongCovid or didn't at BASELINE.

Self-referral disparities between ppl w/ vs w/o #LongCovid and w/ vs w/o a history of anxiety, could INDUCE association b/w anxiety & #LongCovid without causation...

Ppl w/ rec #Covid & WITH a history of anxiety might enroll only if having #LongCovid.

But if rec #Covid without #PASC, they might be unlikely to enroll

If ppl WITHOUT Hx anxiety didn't enroll differentially on #PASC status
UNMEANINGFUL association b/w Hx anxiety & #PASC
We should expect more from @NIH intramural studies.

We should expert more from scientific journals like @AnnalsofIM

Need better peer reviewer choice.

Bad science & psychologizing is so dangerous for #LongHaulers #pwME.

Especially when most doctors still don't understand the importance of exertion intolerance #PEM & the importance of pacing



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More from @Steve_Bellan

May 12
2 yrs ago, to raise awareness for the #MillionsMissing due to #MECFS, I started a 🧵 on how tragic chronic illness has consumed my life

But I was too sick to finish, & shortly after uninstalled Twitter. Trapped by illness, unable to advocate.

2 surgeries later... 🧵, 🎬 2

2017: I was Prof of #Epidemiology @PublicHealthUGA, researching #HIVprevention and #vaccine prep for emerging epidemics. I directed an epi training program @ICI3D. I loved my work & my amazing colleagues!

I was healthy & active 🚴🏄‍♂️ 🥁

Then, I bought a 🏡 and had it renovated. Jan 2018 I moved to the newly built master bedroom addition, I became sick.

⏩ 2 years to 2020. Water burst thru walls on 2 sides of my bed. Revealing walls, subfloor, crawl space filled with mold due to construction defects

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