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Cont: The One Covid-19 Science and Medicine Thread Part 5

New Long-Covid Study - not of veterans but of young Marines

Preprint:
Results: A total of 197/798 (24.7%) study participants developed PASC. Among these, the most prevalent symptoms were loss of taste and/or smell (n=82; 41.6%), shortness of breath (n=74; 37.6%), and cough (n=45; 22.8%). Those with PASC had higher rates and severity of somatic (p<0.001), general depressive (p<0.001), and anxiety (p<0.005) symptoms. Compared to a historic cohort of Marines, participants with PASC scored worse on their physical fitness assessment due to slower run times (p<0.002). Those with PASC continued to have decreased physical performance one year after completing initial training.

Discussion: In this population of healthy young adult US Marines with mostly either asymptomatic or mild acute COVID-19, one fourth reported physical, cognitive, or psychiatric long-term sequelae of infection.
The Marines affected with PASC/LC showed evidence of long-term decrease in functional performance suggesting that SARS-CoV-2 infection may negatively affect health for a significant proportion of young adults.
Clinical and Functional Assessment of SARS-CoV-2 Sequelae Among Young Marines (SSRN, June 6, 2024)
PASC = Post-acute sequelae of COVID-19.

Graph of self-reported of severity of solicited acute symptoms of COVID-19 among CHARM 2.0 participants in this tweet.


An older study (2021) of (obviously young and fit) soccer players:
Heinrich Heine University Düsseldorf, Düsseldorf Institute for Competition Economics (DICE), Düsseldorf

The COVID-19 pandemic has caused economic shock waves across the globe. Much research addresses direct health implications of an infection, but to date little is known about how this shapes lasting economic effects. This paper estimates the workplace productivity effects of COVID-19 by studying performance of soccer players after an infection. We construct a dataset that encompasses all traceable infections in the elite leagues of Germany and Italy. Relying on a staggered difference-in-differences design, we identify negative short- and longer-run performance effects. Relative to their preinfection outcomes, infected players' performance temporarily drops by more than 6%. Over half a year later, it is still around 5% lower. The negative effects appear to have notable spillovers on team performance. We argue that our results could have important implications for labor markets and public health in general. Countries and firms with more infections might face economic disadvantages that exceed the temporary pandemic shock due to potentially long-lasting reductions in productivity.
The long shadow of an infection: COVID-19 and performance at work (Econstor.eu)
 
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Long Covid (LC)

NASEM news release about Long Covid:
Full Definition
Long COVID (LC) is an infection-associated chronic condition that occurs after SARS-CoV-2 infection and is present for at least three months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems.

LC manifests in multiple ways. A complete enumeration of possible signs, symptoms, and diagnosable conditions of LC would have hundreds of entries. Any organ system can be involved, and LC patients can present with:
* single or multiple symptoms, such as shortness of breath, cough, persistent fatigue, post-exertional malaise, difficulty concentrating, memory changes, recurring headache, lightheadedness, fast heart rate, sleep disturbance, problems with taste or smell, bloating, constipation, and diarrhea.
* Single or multiple diagnosable conditions, such as interstitial lung disease and hypoxemia, cardiovascular disease and arrhythmias, cognitive impairment, mood disorders, anxiety, migraine, stroke, blood clots, chronic kidney disease, postural orthostatic tachycardia syndrome (POTS) and other forms of dysautonomia, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), mast cell activation syndrome (MCAS), fibromyalgia, connective tissue diseases, hyperlipidemia, diabetes, and autoimmune disorders such as lupus, rheumatoid arthritis, and Sjögren’s syndrome.


Important features are:
* LC can follow asymptomatic, mild, or severe SARS-CoV-2 infection. Previous infections may have been recognized or unrecognized.
* LC can be continuous from the time of acute SARS-CoV-2 infection or can be delayed in onset for weeks or months following what had appeared to be full recovery from acute infection.
* LC can affect children and adults, regardless of health, disability, or socioeconomic status, age, sex, gender, sexual orientation, race, ethnicity, or geographic location.
* LC can exacerbate preexisting health conditions or present as new conditions.
* LC can range from mild to severe. It can resolve over a period of months or can persist for months or years.
* LC can be diagnosed on clinical grounds. No biomarker currently available demonstrates conclusively the presence of LC.
* LC can impair an affected individual’s abilities to work, attend school, take care of family, and care for themselves. It can have a profound emotional and physical impact on patients and their families and caregivers.
Federal Government, Clinicians, Employers, and Others Should Adopt New Definition for Long COVID to Aid in Consistent Diagnosis, Documentation, and Treatment (NASEM, June 11, 2024)


The lack of a clear and consistent definition for Long COVID presents challenges for policymakers, researchers, public health professionals, clinicians, support services, and patients. As such, the Administration for Strategic Preparedness and Response and the Office of the Assistant Secretary for Health asked the National Academies to assemble a committee of experts to produce a consensus definition for Long COVID. The resulting report, A Long COVID Definition: A Chronic, Systemic Disease State with Profound Consequences, presents the 2024 NASEM Long COVID Definition, developed based on findings reported in existing literature, as well as stakeholder and patient input.
A Long COVID Definition - A Chronic, Systemic Disease State with Profound Consequences (NASEM, June 2024)

pdf version
 
Long Covid

I am not always impressed by the Washington Post editorial board's opinion pieces, but this one is better than the one it based on 60 Minutes' 'investigation' of the 'Havana syndrome':
Long covid, the symptoms that can linger for months or even years after infection with the pandemic virus, is still a subject of considerable uncertainty. The virus can damage the body in a multitude of ways, leading researchers to list more than 200 symptoms, and there is no single diagnostic test or cure. But even with the unknowns, evidence suggests that long covid could burden millions of people. Its effects — on individuals, but also on society at large — could be protracted and expensive.
This is the implication of two just-published studies from the National Academies of Sciences, Engineering and Medicine. The first study, published on June 5, examined the potential impairment and disability caused by long covid. The second study, published on June 11, provided a much-needed consensus definition — there have been numerous different ones previously — to help patients, doctors, researchers and policymakers work from the same page.
(...)
Based on population surveys, the researchers found, in 2022 approximately 8.9 million adults in the United States reported long covid symptoms. Just recently, a separate study found an estimated 6.9 percent of adults — 17.8 million — had ever had long covid as of early 2023.
(...)
These studies are early warnings in what will probably be a long process. The nation must prepare to cope accurately and compassionately with a wave of illness and impairment that might come.
Opinion: Long covid might presage a wave of disability claims. Get ready. (WaPo, June 17, 2024)


Maybe the nation should prepare to cope with the ongoing pandemic and do something to limit the number of people who are still being infected, hospitalized and killed, with or without prior immunization, but that doesn't appear to be the in the works. :-(
 
Data suggest hybrid immunity protects against long COVID

Interesting analysis of long covid (PCC) and infections, re-infections and vaxxes.

https://www.cidrap.umn.edu/data-suggest-hybrid-immunity-protects-against-long-covid

Virus variant type had the greatest influence on developing long COVID. "Any PCC occurred in around 7% after an infection during the Omicron phase for those with a previous infection and in 47% after initial infection with the Wildtype virus," the authors wrote.

The risk of developing any PCC after a second infection if PCC did not follow a first infection was substantially lower compared to after the first infection, resulting in a long-term risk reduction of around 50%, the authors said.

But the risk of developing long COVID was higher in people who were infected less than 3 months following a vaccination, but approximately 50% compared to those who were infected 4 to 6 months after vaccination.
 
Wow, that's almost a recommendation not to get more vaccines.

It's certainly unexpected. Perhaps it's due to the lack of or disfunctional immunity. The vaccine studies out there show boosters provide about 3-4 months of efficacy against symptomatic infection but rapidly declining after that. So that smaller number that get Covid in the first few months might have gotten long covid vaxxed or not.

In any case researchers need to jump on it. Answers are needed.
 
In any case researchers need to jump on it. Answers are needed.

As we've been saying for 3 years.

The most important thing at this stage is the trend, which are all positive, with lower waves and lower rate of hospitalisation being the standouts. Given research lagging the disease by a couple of years, it's probably just as well.
 
As we've been saying for 3 years.

The most important thing at this stage is the trend, which are all positive, with lower waves and lower rate of hospitalisation being the standouts. Given research lagging the disease by a couple of years, it's probably just as well.

Yep. Trend is good and consistent with broadening immunity to severe disease on re-infection. At least for most. In the USA the 2019-20 flu season killed more people under 50 than Covid-19 during 2023. Big drop (10x) from 2021. Another indication of broadening immunity. Initially from vax, now mostly from infection/re-infection.
 
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From the CIDRAP article:
[SIZE=+2]"Our findings indicate that the risk of developing PCC was strongly reduced for the second SARS-CoV-2 infection"[/SIZE]
"Our findings indicate that the risk of developing PCC was strongly reduced for the second SARS-CoV-2 infection, if the first infection did not result in PCC," the authors concluded. "It is possible that the occurrence of breakthrough infections shortly after vaccination is linked to a specific vulnerability of the individual towards PCC, and the apparent protection actually results from confoundingData suggest hybrid immunity protects against long COVID (CIDRAP, June 18, 2024)


Notice that, for whatever reason, the emphasized quotation leaves out the if-part of the sentence!

What it actually says is that if you didn't get Long Covid (PCC) the first time (and it's possible that you did), you can still get it the second time, but you are less likely to get it the second time if you didn't already get it the first time. The implication is obvious: Any new infection increases your risk of getting Long Covid, but less so if you didn't already get it.
And the reason why you are less likely to get it the second time, may be due to the "specific vulnerability" of individuals, i.e. some individuals are more likely to get it than others, and you may be one of those who isn't, which is indeed confounding.

I recommend that people don't get the second, third, fourth, and fifth infection and, if still feasible, avoid getting the first infection, too.
As quoted yesterday in post 974 of the other thread, COVID-19 infections aren't good for the immune system:
Dr. David Putrino, Dir. of Rehabilitation Innovation of Mt Sinai Health System:
We know that SARS-CoV-2 is affecting the immune system. Our group along with our collaborators from Yale and Stanford University as well as other groups have published multiple times that even mild Covid infections seem to affect the way that your natural killer cells attack infections. It seems to affect the way that our T-cells attack infections and protect us from infections. So I think while the notion is that we actually need challenges for the longest time:
We have told people that, 'You know, if you get an illness and you recover, it just makes you stronger'. What we're seeing over and over again is, that's not the case with Covid. Every time you get a Covid infection, your immune system seems to suffer. It's kind of like a boxer: Every fight takes a little bit more out of them. They're not getting stronger with every fight. They are not getting stronger with every hit they take. Every single time, there's an increased chance that something bad is going to happen to the immune system. And I think that this influx of illness that we are seeing is related to that.
(...)
Putrino: The only thing that we can do to protect ourselves, our families, our immune systems long-term, is to avoid infection.
 
This is the conclusion that The Atheist jumps to:
Wow, that's almost a recommendation not to get more vaccines.


Maybe The Atheist is unaware that the "hybrid immunity" mentioned in the title of the article implies vaccination! Vaccination is mentioned explicitly in the very first sentence:
A study yesterday in the Journal of Infection shows that hybrid immunity from both a fourth vaccination dose and previous COVID-19 illnesses may offer protection against developing long COVID, or post-COVID condition (PCC).
Data suggest hybrid immunity protects against long COVID (CIDRAP, June 18, 2024)

I don't know why marting doesn't point out these things to him.


ETA: From the highlight of the actual study in the Journal of Infection:
A fourth vaccination offers a strong protection against Post-COVID-19 condition

Does this sound like "almost a recommendation not to get more vaccines"?

Minimizers gonna minimize, antivaxxers gonna antivax.
 
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As we've been saying for 3 years.

The most important thing at this stage is the trend, which are all positive, with lower waves and lower rate of hospitalisation being the standouts. Given research lagging the disease by a couple of years, it's probably just as well.


We know what The Atheist has been saying for three years:
I posted this in the science thread yesterday.
... 'Flu deaths here are ~500 a year, and omicron's going to be much lower than that.
Barring a new variant of concern, the pandemic is done and dusted.


And yet the pandemic isn't "done and dusted." The pandemic is still here, it's still maiming and killing far more people than the flu, killing far more people in New Zealand than ~500 a year, and even killing far more people younger than 65.
 
In the USA the 2019-20 flu season killed more people under 50 than Covid-19 during 2023.


And every year since 2020, COVID-19 has killed considerably more people, also far more people under 65, than the flu - including 2023-24.
Or is San Diego an outlier in this respect?!

More interesting data:
In 2023-24, COVID-19 killed 34 0-64-year-olds in San Diego. That is far more 0-64-year-olds than was killed by the flu on average in the years 2007-08 to 2018-19.
See Figure 10. Influenza Deaths by Age and Season (County of San Diego, Influenza Watch)

This under 50 (or under 80 or under whatever) has turned into the favorite goalpost-moving tool for marting and The Atheist, and yet, when you take a closer look, it never really seems to work out to their advantage. Even in the 0-49 age group, there were still more (but just one more!) C19 than flu deaths in the 2023-24 season. There were four times more C19 than flu deaths in 50-64-year-olds and seven times more in the 65+ group.

Done and dusted? I don't think so.
 
And every year since 2020, COVID-19 has killed considerably more people, also far more people under 65, than the flu - including 2023-24.
Or is San Diego an outlier in this respect?!

More interesting data:
In 2023-24, COVID-19 killed 34 0-64-year-olds in San Diego. That is far more 0-64-year-olds than was killed by the flu on average in the years 2007-08 to 2018-19.
See Figure 10. Influenza Deaths by Age and Season (County of San Diego, Influenza Watch)

This under 50 (or under 80 or under whatever) has turned into the favorite goalpost-moving tool for marting and The Atheist, and yet, when you take a closer look, it never really seems to work out to their advantage. Even in the 0-49 age group, there were still more (but just one more!) C19 than flu deaths in the 2023-24 season. There were four times more C19 than flu deaths in 50-64-year-olds and seven times more in the 65+ group.

Done and dusted? I don't think so.

Do you realize that diagnosed flu deaths have been very undercounted in the USA. Not nearly as much as Covid which is regularly tested in all hospitals/urgent care. That ended for Covid last month. And since 2022, most infection tests (case counts) were done at home and not counted. Even when Paxlovid was prescribed. And San Diego, while better than much of the country, is only 1% of the USA's population.

So let's look at the whole USA and compare the last, pre-pandemic flu season with the most recent, full year Covid numbers. In the 2019-20 flu season CDC estimates 25k flu deaths. The CDC also counted 31k covid deaths in 2023. Let's break that down by age.

Sure looks like Flu was worse in every age group under 65 and the 25k total the CDC estimates for Flu is pretty typical of Flu season in the USA.

0-17 Flu: 530, C19: 137
18-49 Flu: 2492, C19: 1444
50-64 Flu: 6200, C19: 4762

And, for those over 65 where Covid is now much more deadly.
65+ Flu:16278, C19:24950

Sources:
https://www.cdc.gov/flu/about/burden/2019-2020.html
https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
 
From Marting's first link to the flu season of 2019-20. (I think most people are aware that COVID-19 didn't make much of an impact until the end of that season, or, if it did, C19 cases might have been misinterpreted as influenza.)
Since then, complete information to estimate the burden of the 2019-2020 flu season has become available. Since testing for flu has increased over time, the adjustment for under-detection of flu was lower and the 2019-2020 burden estimates decreased.

In addition, the death estimates for the 2019-2020 season increased after incorporating information from this season. It is possible that the reason for the increase in the number of deaths is because more deaths were categorized as pneumonia and influenza deaths, despite removing time periods impacted by the emergence of COVID-19. Also, it is possible that the adjustment factors increased because testing for flu decreased during the 2019-2020 season especially as COVID-19 began to surge. Although we excluded data from April 2020 through the end of this season, it is possible that data during the first few months of 2020 could be affected by COVID-19 before it was recognized.

The 2019-2020 season estimates are now considered final. At this time, there are no plans to estimate the flu burden for the 2020-2021 season because there was very little flu activity across the United States.


Marting's bias is conspicuous when he stresses only one side of the equation: "diagnosed flu deaths have been very undercounted in the USA. Not nearly as much as Covid which is regularly tested in all hospitals/urgent care."
Why not quote what the site actually says? Why come up with this biassed summary?

2019-20 when C19 wasn't in the game until the end of the season and testing for it wasn't in place is probably the most idiotic year to use as a comparison of the death toll of the two diseases, flu and C19. The following seasons, when C19 was there from the beginning, show a very different picture: While COVID-19 was killing hundreds of thousands of people, both before and after the mRNA shots, "there was very little flu activity across the United States."
 
Rare cancers

Rare types of cancer are showing up in higher numbers since the Covid-19 pandemic. Doctors suspect that the virus itself may be contributing to the higher cancer rates, despite a solid connection not yet being established. The pandemic may have permanently altered the bodies of those infected, making them more susceptible to cancer. Those affected include people who were otherwise previously healthy.
(...)
What is more alarming is the prevalence of people suffering from more than one type of cancer. "Having multiple forms of cancer at the same time has also become more prevalent. Cancers typically start in one part of the body and spread," the Post said. "It's rare for discrete cancers to begin in different parts of the body during a short window."
Covid might be to blame for an uptick in rare cancers: The virus may be making us more susceptible to certain cancers (TheWeek, June 20, 2024)


Reminiscent of the early 1980s in this respect:
In the early days of the HIV epidemic, some of the first signs of the existence of the virus were incidences of these rare cancers, such as Kaposi sarcoma, in an increasing number of patients.
HIV/AIDS-related cancers (CancerCenter.com, June 2, 2023)


I wonder where C19 minimizers will place the blame this time. On the mRNA vaccines? Immunity debt? Dr. Fauci?

ETA:
A case story - which, of course, serves as illustration only and doesn't prove anything in and of itself:
Then there’s Bob and Bonnie Krall, a couple who in a 14-month stretch endured three types of cancer between them, despite neither having a family history or genetic predisposition.
Cancers typically start in one part of the body and spread. It’s rare for discrete cancers to begin in different parts of the body during a short window of time. Patel said the Kralls and the 78-year-old had coronavirus antibodies “through the roof” in their blood although he’s not sure how that relates to cancer, if at all.
‘Unusual’ cancers emerged after the pandemic. Doctors ask (!) if covid is to blame. (WaPo, June 6, 2024)
Besides, they're also old, so their lives and health don't matter in the minimizer playbook. :mad:
 
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Reminiscent of the early 1980s in this respect:



I wonder where C19 minimizers will place the blame this time. On the mRNA vaccines? Immunity debt? Dr. Fauci?

ETA:
A case story - which, of course, serves as illustration only and doesn't prove anything in and of itself:

Besides, they're also old, so their lives and health don't matter in the minimizer playbook. :mad:

It is surprisingly common to find more than one type of cancer at a time. People now get very intensive investigation when they have a cancer diagnosis this often identifies one or more other early cancers.
 
Reminiscent of the early 1980s in this respect:



I wonder where C19 minimizers will place the blame this time. On the mRNA vaccines? Immunity debt? Dr. Fauci?

ETA:
A case story - which, of course, serves as illustration only and doesn't prove anything in and of itself:

Besides, they're also old, so their lives and health don't matter in the minimizer playbook. :mad:

The mutations causing cancer arise several years before cancers become clinically apparent. Cancers diagnosed now likely started before covid. An alternative explanation might be changes in immune surveillance by the body resulting from infection. The body does respond to cancer, and alterations in immune function can cause cancer to progress faster.
 
From Marting's first link to the flu season of 2019-20. (I think most people are aware that COVID-19 didn't make much of an impact until the end of that season, or, if it did, C19 cases might have been misinterpreted as influenza.)
Yeah. And maybe Flu deaths were misinterpreted asCovid-19 deaths. Bias much? However, I think neither happened to any significant degree. I trust the CDC's Flu mortality burden estimates.

Marting's bias is conspicuous when he stresses only one side of the equation: "diagnosed flu deaths have been very undercounted in the USA. Not nearly as much as Covid which is regularly tested in all hospitals/urgent care."
Why not quote what the site actually says? Why come up with this biassed summary?

Really? I wasn't choosing 2019/2020 to consider Covid at all. It was just the last Flu season that pretty much ended before the Covid-19 pandemic took off in the USA. It was only for getting typical Flu mortality estimates from the official source. Further, the overall Flu mortality burden in that season was about 25k which is pretty typical of Flu mortality burdens in 10 years prior. In what way is that a bias?

2019-20 when C19 wasn't in the game until the end of the season and testing for it wasn't in place is probably the most idiotic year to use as a comparison of the death toll of the two diseases, flu and C19. The following seasons, when C19 was there from the beginning, show a very different picture: While COVID-19 was killing hundreds of thousands of people, both before and after the mRNA shots, "there was very little flu activity across the United States."

Good grief. The Flu 2019/20 season comparison was against the Covid-19 full, 2023 year. By that time Covid hospital testing was pretty universal. And it showed the rapid decrease of Covid-19 deaths from the first 2 years of the pandemic.

There may well be additional deaths ascribed to Covid-19 undercounts or sequelae as time goes on. But that would have to be pretty significant to flip the CDC Covid numbers I posted. Even with some increase, it sure seems like Covid-19 had, in 2023, similar if not less mortality* compared to that of normal influenza years.

*for those under 65. Obviously significantly higher for those over 65.
 
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Meanwhile on the Long Covid front, Eric Topol summarizes new studies here:

https://erictopol.substack.com/p/new-insights-into-acute-and-long

Summing Up
SARS-CoV-2 is still evolving, and by selection will continue to find ways to induce (re-)infections despite global complacency. We’re making progress in elucidating the genesis of Long Covid, with a pair of studies that incriminate autoimmunity as a culprit. At the same time, we’re learning about ways to protect from infection (particularly IFN-1) and how to reduce the chances of central nervous system involvement by vaccination. These are all important steps of progress.
 
Eganelisib

"Targeting an enzyme called phosphatidylinositol 3,4,5-kinase gamma (PI3Kγ) with the small molecule inhibitor eganelisib—a clinical-stage anti-cancer agent developed by Infinity Pharmaceuticals, which declared Chapter 11 bankruptcy in October 2023—reduced the number of myeloid cells in the lungs and improved the survival rate of mice infected with either COVID-19 or MRSA...Stopping PI3Kγ’s activity stops myeloid cell migration, ameliorating tissue damage." Link

It is noteworthy how some drugs get a second chance at becoming commercially successful.
 
ZDoggMD finally gets Covid after 4.5 years.
https://www.youtube.com/watch?v=0t3CqFYeaVo

I like this video because it gives the doctor's perspective on the symptoms and how it differs from other illnesses. Interesting fellow because he is friends with both Dr. Paul Offit and Dr. Vinay Prasad. Very reasonable doc though I'm not into the mediation stuff that seems to fascinate him.


His daughter got Covid at camp a few days earlier, came home, then he got it. She tested positive with a rapid test. Initial rapid test for ZDoggMD was totally negative even though he had strong symptoms then strong positive the next day. Has some distortion in sense of smell/taste. Typical range of symptoms. Is recovering. Says he will report on any long term issues.

His wife hasn't gotten Covid and still is negative. She also had current boosters. ZDoggMD has not had recent boosters.
 
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A study of German youth with presymptomatic type 1 diabetes links COVID-19 infection to accelerated progression to clinical diabetes.
For the study, published yesterday in JAMA, researchers in Munich and Dresden followed up with 509 children aged 1 to 16 years with presymptomatic type 1 diabetes participating in a screening program from February 2015 to October 2023.
(...)
"The incidence of type 1 diabetes increased during the COVID-19 pandemic," the study authors noted, and they sought to determine if COVID-19 contributed to the rise.

Faster progression only among infected youth
Fifty-seven of 358 participants (15.9%) progressed to clinical type 1 diabetes before the pandemic, while 113 of 396 (28.5%) did so after the pandemic began. The incidence of clinical type 1 diabetes was 6.4 per 100 person-years prepandemic and 12.1 per 100 after March 2020.
"The COVID-19 pandemic was associated with an accelerated progression to clinical disease and that this acceleration was confined to those with COVID-19."

COVID tied to faster progression from preclinical to clinical type 1 diabetes in kids (CIDRAP, July 16, 2024)


Notice that it seems to contradict the idea that the accelerated progression of presymptomatic type 1 diabetes to clinical disease could have been due to restrictions, lockdowns, 'immunity debt' or any of the excuses that minimizers come up with when they claim that attempts to mitigate the pandemic are worse than the pandemic, i.e. the infection, itself.
 
Previous research has shown that people with long COVID have elevated levels of IFN-γ, and evidence also suggests that the protein can contribute to injuries in the alveoli3 — the delicate air sacs in the lungs that move gases into and out of the bloodstream. But these studies could not determine whether IFN-γ is a cause of lung damage associated with long COVID or just an indication of another mechanism.
To investigate this, Sun and his colleagues took a two-step approach. First, they recruited people with long COVID and compared samples of cells from their lungs with those of people who had recovered from COVID-19 a few weeks before the study, as well as a controls who hadn’t been infected. They used a technique called single-cell RNA sequencing to analyse the make-up of the lung-cell samples. They discovered that samples from people with long COVID had higher levels of IFN-γ-producing T cells than did samples from people without COVID-19, or those who had recovered from the infection.
Then, the researchers infected mice with SARS-CoV-2. Twenty-one days after infection, the mice had a cellular response in their lungs similar to that seen in people with long COVID, including elevated levels of IFN-γ-producing T cells.
Long COVID lung damage linked to immune system response (Nature, July 18, 2024)
IFN-γ (Wiki)

So much for the idea that Long COVID is psychogenic.
 
President Joe Biden: "The pandemic is over." (Sep 20, 2022)
The pandemic (KP.2.3): "President Joe Biden is over." (July 20, 2024)
Philip K. Dick: "Reality is that which, when you stop believing in it, doesn't go away."

In case anybody is interested in the variant that got Biden.
On July 11, KP.2.3. was just "another variant":
A Yale Medicine expert weighs in on the potential impact of the new strains on the spread of COVID.
(...)
2. What do we know—and not know—about the FLiRT and LB.1 variants?
We know the FLiRT variants have two mutations on their spike proteins (the spike-shaped protrusions on the surface of the virus) that weren’t seen on JN.1 (the previously dominant strain in the U.S.). Some experts say these mutations could make it easier for the virus to evade people’s immunity—from the vaccine or a previous bout of COVID.
While more research is needed, experts suspect that the LB.1 strain and another variant called KP.2.3, which also has the two FLiRT mutations plus an additional one, may be more transmissible as well.
But, the fact that the variants are otherwise genetically similar to JN.1 should be reassuring, Dr. Roberts says. "While JN.1 occurred during the winter months, when people gather indoors and the virus is more likely to spread, its symptoms were milder than those caused by variants in the early years of the pandemic," he says.
There is no conclusive information yet about whether a COVID illness will be more severe with the new variants or how symptoms might change. Because everyone is different, a person’s symptoms and the severity of their COVID disease usually depend less on which variant they are infected with and more on their immunity and overall health, the CDC says.
3 Things to Know About FLiRT and LB.1, the New Coronavirus Strains (Yale Medicine, July 11, 2024)


I think it's a fairly safe bet to say that Biden and those close to him were up to date with their C19 vaccinations, which would confirm that "these mutations could make it easier for the virus to evade people’s immunity—from the vaccine or a previous bout of COVID."
 
Why spread disinformation like this?
There was probably a team of medical specialists lined up to make sure that Biden was fed Paxlovid immediately after he tested positive.
I don't know why The Atheist seems to think that KP.2.3. is more dangerous than previous variants. That is not what the article (or the quotation) says:
"There is no conclusive information yet about whether a COVID illness will be more severe with the new variants or how symptoms might change."
 
Why spread disinformation like this?

Sorry love, there's only one of us panicking about covid.

Hint: it's not me.

Covid is either a deadly disease we must stop at all costs, or it's an endemic disease we have to live with.

Which is it?
 
IFN-γ (Wiki)

So much for the idea that Long COVID is psychogenic.

You make the mistaken assumption that 'psychogenic' conditions are not associated with abnormalities of biochemistry / immunology. Abnormalities of hormones, immunity, cytokines are well described in depression.
 
No, I don't.
psychogenic (adjective): originating in the mind or in mental or emotional conflict
Psychogenic: Definition & Meaning (Merriam-Webster)
Classified as a "conversion disorder" by the DSM-IV, a psychogenic disease is a condition in which mental stressors cause physical symptoms matching other disorders. The manifestation of physical symptoms without biologically identifiable cause results from disruptions in normal brain function due to psychological stress.
Psychogeni disease (Wikipedia)


You are making the mistaken assumption that psychogenic is the same as psychosomatic.
However:
The term psychogenic disease is often used similarly to psychosomatic disease. However, the term psychogenic usually implies that psychological factors played a key causal role in the development of the illness. The term psychosomatic is often used more broadly to describe illnesses with a known medical cause where psychological factors may nonetheless play a role (e.g., asthma as exacerbated by anxiety).
 
Sorry love, there's only one of us panicking about covid.
Hint: it's not me.


Yes, it's none other than The Atheist panicking again.
I think he should get a grip on himself. I don't think anybody here is his love. If somebody is, I am certainly not the one. I am also not his 'mate', another one of those terms he likes to use disparagingly because he has neither facts nor arguments on his side.
He can't let go of those techniques.

Covid is either a deadly disease we must stop at all costs, or it's an endemic disease we have to live with.
Which is it?


It isn't any of them. The Atheist appears to be ignorant of the either-or fallacy (Quillbot, June 26, 2024):
The either-or fallacy, alternatively called false dilemma, false dichotomy, or false binary, leads to oversimplified conclusions that are often misleading and promote a closed-minded outlook.


Indeed!
 
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This is gold. The panic-merchants are going to need something else to panic about.

Conclusions and Relevance In this prospective cohort study, there was no evidence that the proportion of participants with ME/CFS-like illness differed between those infected with SARS-CoV-2 vs those without SARS-CoV-2 infection up to 12 months after infection. A 3% to 4% prevalence of ME/CFS-like illness after an acute infection–like index illness would impose a high societal burden given the millions of persons infected with SARS-CoV-2.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821459#:
 
This is gold! The Long-Covid deniers will love it!

Recruitment occurred in person, by email or telephone, and through electronic advertisement. A secure online platform (Hugo; Hugo Health LLC) facilitated collection of consent and survey distribution. Participants self-enrolled by first completing an online eligibility screener, during which they were asked to self-report COVID-19–like symptoms that they experienced within the past 42 days and provide documentation of their valid COVID-19 test and test result.
(...)
The INSPIRE study included adult participants (aged ≥18 years) who were fluent in English or Spanish, had access to an internet-enabled device to allow for participation, and had self-reported symptoms suggestive of acute SARS-CoV-2 infection at the time of their SARS-CoV-2 test.
(...)
Participants completed surveys at baseline and at 4 quarterly follow-up times. Participants self-reported sociodemographic data, including age, gender (female, male, or transgender, nonbinary, or other gender), race (Asian, Native Hawaiian, or Other Pacific Islander; Black or African American; White; or other
(...)
Because ME/CFS diagnosis requires a full clinical evaluation to identify treatable conditions contributing to symptoms used in diagnosis, the self-reported information in this study only allowed determination of ME/CFS-like illness, hereafter referred to as ME/CFS.


This is what The Atheist thinks of other studies based on self-reported symptoms:
Aside from it being self-reported and therefore irrelevant, the numbers would be expected to increase after a fairly large wave. The only interesting point is it shows 2/3 of alleged long covid sufferers having recovered completely.


This was also interesting:
Our study design required an acute infection prompting COVID-19 testing. While participants testing positive had an identifiable infection (SARS-CoV-2), we were unable to collect data on the specific infection that led to symptoms from those testing negative. Our finding that ME/CFS-like illness was equally likely to occur after SARS-CoV-2 and unknown infection[/hilitte] is similar to findings in a prospective, population-based study of acute respiratory illness in adults in the UK that found symptom burdens to be similar among participants with and without prior SARS-CoV-2 infection.20 In contrast, a large retrospective analysis of electronic health records conducted in the UK in 2020 suggested that SARS-CoV-2 infection resulted in significantly more postacute symptoms than did influenza, although symptoms were also common following influenza.21 However, that study’s definition of ME/CFS was reliant on symptom documentation in electronic health records, which can vary based on clinician expectations and inquiry about postinfectious symptoms in patients with SARS-CoV-2 infection compared with influenza.
I don't think The Atheist has considered the difference between an infectious disease that people may have once every five to ten years, and one they may have several times in the short span of years that SARS-CoV-2 has existed, even if each infection leaves patients with the same number and severity of post acute symptoms.
 
Hearing loss in young adults after C19 infections

We knew about loss of smell and taste with Covid infections.
A nationwide report from S Korea found a 3.5-fold increase in hearing loss among young adultshttps://thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00338-9/fulltext
Eric Topol (X, July 30, 2024)


Background
The association of COVID-19 with hearing loss (HL) is unclear among young adults and needs to be investigated. This study was conducted to determine the association of COVID-19 with HL and sudden sensorineural hearing loss (SSNHL) in young adults.
(...)
During 40,260,757 person-months (PMs) of follow–up, 38,269 cases of HL and 5908 cases of SSNHL were identified.
(...)
Results
In the fully adjusted model, risks of HL (adjusted subdistribution hazard ratio [aSHR], 3.44; 95% CI, 3.33–3.56; P < 0.0001) and SSNHL (aSHR, 3.52; 95% CI, 3.23–3.83; P < 0.0001) were significantly higher in COVID-19 group compared to the non-COVID-19 group.
(...)
During 40,260,757 PMs of follow–up, 38,269 cases of HL were identified. Table 2 presents the association of COVID-19 with the risk of incident HL and SSNHL. The incidence of HL was 11.9/10,000 PMs in the COVID-19 group, which was over 3-fold higher than the non-COVID-19 group. Similarly, the incidence of SSNHL was over 3-fold higher in the COVID-19 group compared to the non-COVID-19 group. In the fully adjusted model, risks of HL (adjusted subdistribution hazard ratio [aSHR], 3.44; 95% CI, 3.33–3.56; P < 0.0001) and SSNHL (aSHR, 3.52; 95% CI, 3.23–3.83; P < 0.0001) were significantly higher in COVID-19 group compared to the non-COVID-19 group.
Incidence of hearing loss following COVID-19 among young adults in South Korea: a nationwide cohort study (The Lancet, July 29, 2024)


The South Korean study looked at young adults specifically, but the problem is probably not limited to them. Why would it be?
In the first quarter of 2022, the US hearing aid market has experienced tailwinds, lifting sales by 7.8 percent. This reflects that there is still demand left from when patients were unable to acquire devices during the pandemic, says an analyst writing for an industry media.
While hearing aid manufacturers can easily describe 2020 as a true annus horribilis, as their primary target customers are elderly people who largely avoided audiologists due to the imposing pandemic, the subsequent year has turned out very differently.
Pent-up demand for hearing aids continues to boost sales in US (MedWatch Hearing Health, April 29, 2022)

A faster growing hearing aid market than ever before and increasing reimbursement for hearing aids have been the hallmarks of the past few years in the U.S.
Focus on strong market and growing reimbursement at US hearing aid show (MedWatch Hearing Health, April 18, 2024)

Summary:
The global hearing aid market is expected to grow by $3.17 billion from 2024-2028, driven by technological advancements and rising demand, despite challenges like battery life concerns.
(...)
Rising Prevalence of Hearing Loss
The growing prevalence of hearing loss, particularly among the elderly, is fueling market growth. Innovations like invisible hearing aids, smart linked hearing aids, and AI-enabled hearing aids are gaining traction for their advanced and discreet solutions.
Hearing Aid Market Size to Grow Significantly Through 2028 (The Hearing Review, July 15, 2024)
See graph of Global Hearing Aid Market 2024-2028 in the linked article.


ETA: It is amusing to see how much the hearing-aid business still stresses how invisible and discreet its hearing aids are.
I had expected this to change nowadays when everybody is walking around with ear pods that are not at all invisible or discreet, but it hasn't happened yet.
 
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The argument against the minimizers' idea that Long Covid is all in the head:
Abstract
Long COVID is a common sequela of SARS-CoV-2 infection. Data from numerous scientific studies indicate that long COVID involves a complex interaction between pathophysiological processes. Long COVID may involve the development of new diagnosable health conditions and exacerbation of pre-existing health conditions. However, despite this rapidly accumulating body of evidence regarding the pathobiology of long COVID, psychogenic and functional interpretations of the illness presentation continue to be endorsed by some healthcare professionals, creating confusion and inappropriate diagnostic and therapeutic pathways for people living with long COVID. The purpose of this perspective is to present a clinical and scientific rationale for why long COVID should not be considered as a functional neurologic disorder. It will begin by discussing the parallel historical development of pathobiological and psychosomatic/sociogenic diagnostic constructs arising from a common root in neurasthenia, which has resulted in the collective understandings of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and functional neurologic disorder (FND), respectively. We will also review the case definition criteria for FND and the distinguishing clinical and neuroimaging findings in FND vs. long COVID. We conclude that considering long COVID as FND is inappropriate based on differentiating pathophysiologic mechanisms and distinguishing clinical findings.
Keywords: post-COVID-19 condition (PCC); post-acute sequalae of COVID-19 (PASC); myalgic encephalomyelitis; chronic fatigue syndrome; neurasthenia; conversion disorder; dysautonomia; neurology; physical examination; imaging

1. Introduction
2. Pathobiological Disease Characterization: From Neurasthenia to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
3. Psychosomatic/Sociogenic Illness Construction: From Neurasthenia to Functional Neurologic Disorder
4. Evidence Refutes That Long COVID Should Be Considered a Functional Neurologic Disorder 4.1. Refutative Evidence from Pathophysiology 4.2. Refutative Evidence from Clinical Presentation 4.2.1. Motor Examination 4.2.2. Sensory Examination 4.2.3. Tremor 4.2.4. Spells and Seizures 4.2.5. Gait Examination 4.2.6. Urinary Functioning 4.2.7. Cognition 4.2.8. Summary 4.3. Refutative Evidence from Neuroimaging5. Conclusions
Author Contributions
Long COVID Is Not a Functional Neurologic Disorder (Journal of Personalized Medicine, July 6/July 23, 2024)
 
C19 and diabetes

Findings
16 669 943 people were included in the pre-vaccination cohort (Jan 1, 2020–Dec 14, 2021), 12 279 669 in the vaccinated cohort, and 3 076 953 in the unvaccinated cohort (both June 1–Dec 14, 2021). In the pre-vaccination cohort, aHRs for the incidence of type 2 diabetes after COVID-19 (compared with before or in the absence of diagnosis) declined from 4·30 (95% CI 4·06–4·55) in weeks 1–4 to 1·24 (1·14–1.35) in weeks 53–102. aHRs were higher in unvaccinated people (8·76 [7·49–10·25]) than in vaccinated people (1·66 [1·50–1·84]) in weeks 1–4 and in patients hospitalised with COVID-19 (pre-vaccination cohort 28·3 [26·2–30·5]) in weeks 1–4 declining to 2·04 [1·72–2·42] in weeks 53–102) than in those who were not hospitalised (1·95 [1·78–2·13] in weeks 1–4 declining to 1·11 [1·01–1·22] in weeks 53–102). Type 2 diabetes persisted for 4 months after COVID-19 in around 60% of those diagnosed. Patterns were similar for type 1 diabetes, although excess incidence did not persist beyond 1 year after a COVID-19 diagnosis.

Interpretation
Elevated incidence of type 2 diabetes after COVID-19 is greater, and persists for longer, in people who were hospitalised with COVID-19 than in those who were not, and is markedly less apparent in people who have been vaccinated against COVID-19. Testing for type 2 diabetes after severe COVID-19 and the promotion of vaccination are important tools in addressing this public health problem.
ncidence of diabetes after SARS-CoV-2 infection in England and the implications of COVID-19 vaccination: a retrospective cohort study of 16 million people (The Lancet: Diabetes & Endocrinology, August 2024)
aHRs = adjusted hazard ratios

Markedly less apparent in those vaccinated, but a considerable elevated incidence of type 2 diabetes after COVID-19 is nevertheless still there in the vaccinated, too.
 
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