Thread by @Marc_Veld

Long COVID Comes Into the Light

We’re finally starting to see the truth about the vexing condition. It’s not what we thought.

#LongCovid

slate.com/technology/202…

Even before 2020’s first horrific wave of C19 deaths subsided, reports surfaced warning of a brutal second punch: Instead of recovering quickly after a mild infection, some people were suffering from symptoms that lingered or even intensified in the following weeks and months.

The first reports of how COVID seemed to fundamentally change people were scrabbled together from anecdotal accounts and preliminary studies. The picture they painted was frightening: As many as a third of all people who’d tested positive went on to report long COVID.

Few of these people had recovered much, and many were debilitated, unable to work or attend school. Newspapers and magazines ran articles that vividly described the complex litany of suffering endured by patients who weren’t getting any answers from their doctors.

Now, three years later, the research is catching up to the anecdotal reports and the early evidence, and a clearer picture of long COVID has emerged. It turns out that, like COVID-19 itself, a lot of our early guesses about it turned out to be considerably wide of the mark.

Long COVID is neither as common nor as severe as initially feared.

First reports were based on survey-based research, which has confounding factors.

a risk of selection bias; people who feel that they have LC are more likely to want to complete a questionnaire on the topic. Another is that people may report having symptoms post-COVID that they also had pre-COVID, and so their maladies may not actually have been caused by C19.

Retrospective cohort studies are better suited. Comparing two groups from electronic data, filtering out pre-COVID-19 symptoms, matching cohorts by age and sex.

bmj.com/content/380/bm…

Several of this type of studies, that take time, they are retrospective, are coming out, painting a different picture with a much more reduced incidence and severity of COVID-19 long term effects.
thelancet.com/journals/lanps…

Importantly, studies are comparing infection with SARS-CoV-2 with another infection, such as Influenza, to assess what effects may be SARS-COV-2 specific. Here finding symptoms comparable with influenza.

onlinelibrary.wiley.com/doi/10.1002/mp…

The impact on the workforce was estimated to be very considerable in the early COVID-19 days, but this has also not materialised.

theatlantic.com/health/archive…

The best available figures, then, suggest two things: first, that a significant number of patients do experience significant and potentially burdensome symptoms for several months after a SARS-CoV-2 infection, most of which resolve in less than a year;

and second, that a very small percentage experience symptoms that last longer.

i.e. LC is real, dramatically affected many people’s lives, we need to find solutions and take it very serious. But, fortunately, it has not reached the initial feared numbers.

If research funding unleashed by fears of LC ultimately explains why, then that itself would be a significant achievement—an acceleration toward the day when not only LC patients but a lot of other suffering people as well will be able to put their illnesses behind them for good.