4 ms·

I don't think anyone is systematically screening positive COVID cases for this kind of damage. The 662 is the severely affected ones that end up in the ICU, but

I don't think anyone is systematically screening positive COVID cases for this kind of damage. The 662 is the severely affected ones that end up in the ICU, but how many others have inflammatory damage?

irq11 6y ago
You don’t need to systematically screen for it. MIS is obvious and dramatic when it occurs.
SpicyLemonZest 6y ago
Probably a lot, but mild heart inflammation just isn't a very big deal. It's a common complication of viral diseases in general.
- drran 6y ago
  Yep, but this syndrome happens weeks AFTER disease, so it's causes by some kind of damage to tissues, not by virus or toxins directly.
  - nouveaux 6y ago
    Can your sources? This differs from things I have been reading.
    - drran 6y ago
      From linked article: > Case studies also show MIS-C can strike seemingly healthy children without warning three or four weeks after asymptomatic infections, said Alvaro Moreira, MD, MSc, of The University of Texas Health Science Center at San Antonio. Dr. Moreira, a neonatologist, is an assistant professor of pediatrics in the university’s Joe R. and Teresa Lozano Long School of Medicine.
    - vikramkr 6y ago
      You're currently in the comments section of a hacker news post of a source on the syndrome occurring weeks after infection.
  - excalibur 6y ago
    I don't see how the tissue damage taking weeks to accumulate to the point of medical emergency means the virus can't be the cause.
  - SpicyLemonZest 6y ago
    Is that true? It's my understanding that inflammation can persist for weeks after a disease or injury even without permanent damage.
- nouveaux 6y ago
  Can you elaborate on how common is common? Also when does it become problematic?
  - SpicyLemonZest 6y ago
    Conventional wisdom in the literature is that about 10% of flu cases develop it. (one source: https://casereports.bmj.com/content/12/7/e228201?rss=1 https://casereports.bmj.com/content/12/7/e228201?rss=1) I'm not aware of any rigorous data, because it's hard to detect. It becomes problematic when the inflammation is unusually severe, although I believe that in practice it's just never diagnosed unless it's severe enough to impact your quality of life.
hwillis 6y ago
And very few young children have tested positive. People under 18 are in the tens of thousands, iirc- 662 is a LOT.
- arcticbull 6y ago
  Very few young children present any meaningful symptoms meaning testing of them suffers from substantial adverse selection bias. 662 is probably rounding to zero.
altcognito 6y ago
Correct, 15% of athletes who shows some or no symptoms ended up with myocarditis: https://www.nytimes.com/2020/08/23/sports/ncaafootball/college-football-myocarditis-coronavirus.html https://www.nytimes.com/2020/08/23/sports/ncaafootball/colle... If we screened kids who merely tested positive and found 15% had serious longer term reprecussions, how would this change opinion surrounding policy?
- deleted 6y ago
  [deleted]
- PragmaticPulp 6y ago
  Careful, Myocarditis isn’t necessarily indicative of long-term heart damage. Mild myocarditis is not uncommon with any viral infection. Myocarditis should be watched for, but it’s critically important that we discuss severity and relative occurrence rather than reducing the discussion to a binary yes/no. Sadly, whenever you see a news article that omits specific statistics it’s prudent to check the facts. It’s easy to drive clicks by removing critical details to make side effects sound more permanent or more common than they are.
  - adrr 6y ago
    Is it common for Athletes to have to sit out the year because they caught the flu? Flu is so pervasive.
- irq11 6y ago
  FTA: ”But as Daniels’s survey awaits the rigors of peer review, it has received scant attention, in part because Ohio State has refused to make public any testing data about its athletes” So this is an unpublished, un-peer-reviewed paper where the data aren’t available. Basically, someone said something, and the New York Times reported it as fact. That’s simply incredibly irresponsible. So far we’ve seen one of these myocarditis scares debunked completely: https://mobile.twitter.com/ProfDFrancis/status/1298499595056668673 https://mobile.twitter.com/ProfDFrancis/status/1298499595056... and just yesterday, the Penn State doctor had to apologize for admitting that the “30% of all athletes have myocarditis” headline he instigated was essentially hearsay: https://www.google.com/amp/s/www.nj.com/rutgersfootball/2020/09/penn-state-doctor-13rd-of-big-ten-athletes-impacted-by-coronavirus-developed-heart-issue.html%3foutputType=amp https://www.google.com/amp/s/www.nj.com/rutgersfootball/2020... We should be very careful about extrapolating any sort of pre-publication data in this area.

irq11 6y ago

You don’t need to systematically screen for it. MIS is obvious and dramatic when it occurs.

SpicyLemonZest 6y ago

Probably a lot, but mild heart inflammation just isn't a very big deal. It's a common complication of viral diseases in general.

drran 6y ago
Yep, but this syndrome happens weeks AFTER disease, so it's causes by some kind of damage to tissues, not by virus or toxins directly.
- nouveaux 6y ago
  Can your sources? This differs from things I have been reading.
  - drran 6y ago
    From linked article: > Case studies also show MIS-C can strike seemingly healthy children without warning three or four weeks after asymptomatic infections, said Alvaro Moreira, MD, MSc, of The University of Texas Health Science Center at San Antonio. Dr. Moreira, a neonatologist, is an assistant professor of pediatrics in the university’s Joe R. and Teresa Lozano Long School of Medicine.
  - vikramkr 6y ago
    You're currently in the comments section of a hacker news post of a source on the syndrome occurring weeks after infection.
- excalibur 6y ago
  I don't see how the tissue damage taking weeks to accumulate to the point of medical emergency means the virus can't be the cause.
- SpicyLemonZest 6y ago
  Is that true? It's my understanding that inflammation can persist for weeks after a disease or injury even without permanent damage.
nouveaux 6y ago
Can you elaborate on how common is common? Also when does it become problematic?
- SpicyLemonZest 6y ago
  Conventional wisdom in the literature is that about 10% of flu cases develop it. (one source: https://casereports.bmj.com/content/12/7/e228201?rss=1 https://casereports.bmj.com/content/12/7/e228201?rss=1) I'm not aware of any rigorous data, because it's hard to detect. It becomes problematic when the inflammation is unusually severe, although I believe that in practice it's just never diagnosed unless it's severe enough to impact your quality of life.

hwillis 6y ago

And very few young children have tested positive. People under 18 are in the tens of thousands, iirc- 662 is a LOT.

arcticbull 6y ago
Very few young children present any meaningful symptoms meaning testing of them suffers from substantial adverse selection bias. 662 is probably rounding to zero.

altcognito 6y ago

Correct, 15% of athletes who shows some or no symptoms ended up with myocarditis: https://www.nytimes.com/2020/08/23/sports/ncaafootball/college-football-myocarditis-coronavirus.html https://www.nytimes.com/2020/08/23/sports/ncaafootball/colle... If we screened kids who merely tested positive and found 15% had serious longer term reprecussions, how would this change opinion surrounding policy?

deleted 6y ago
[deleted]
PragmaticPulp 6y ago
Careful, Myocarditis isn’t necessarily indicative of long-term heart damage. Mild myocarditis is not uncommon with any viral infection. Myocarditis should be watched for, but it’s critically important that we discuss severity and relative occurrence rather than reducing the discussion to a binary yes/no. Sadly, whenever you see a news article that omits specific statistics it’s prudent to check the facts. It’s easy to drive clicks by removing critical details to make side effects sound more permanent or more common than they are.
- adrr 6y ago
  Is it common for Athletes to have to sit out the year because they caught the flu? Flu is so pervasive.
irq11 6y ago
FTA: ”But as Daniels’s survey awaits the rigors of peer review, it has received scant attention, in part because Ohio State has refused to make public any testing data about its athletes” So this is an unpublished, un-peer-reviewed paper where the data aren’t available. Basically, someone said something, and the New York Times reported it as fact. That’s simply incredibly irresponsible. So far we’ve seen one of these myocarditis scares debunked completely: https://mobile.twitter.com/ProfDFrancis/status/1298499595056668673 https://mobile.twitter.com/ProfDFrancis/status/1298499595056... and just yesterday, the Penn State doctor had to apologize for admitting that the “30% of all athletes have myocarditis” headline he instigated was essentially hearsay: https://www.google.com/amp/s/www.nj.com/rutgersfootball/2020/09/penn-state-doctor-13rd-of-big-ten-athletes-impacted-by-coronavirus-developed-heart-issue.html%3foutputType=amp https://www.google.com/amp/s/www.nj.com/rutgersfootball/2020... We should be very careful about extrapolating any sort of pre-publication data in this area.