9 ms·

Into the looking glass: Post-viral syndrome post COVID-19

91 points by lend000 6y ago

throwmeaway_pls 6y ago
That is not at all the title of the linked article. What is going on?
- qualitydrew 6y ago
  Broken link? That is exactly the title of the linked article on my end.
  - rjsw 6y ago
    The title has been changed since this was submitted.
salmon30salmon 6y ago
It is very interesting that the reported lingering long-term symptoms of SARS-CoV-2 align almost perfectly with major depressive disorder and generalized anxiety disorder. Clinical depression and anxiety levels are through the roof right now. Shouldn’t that be considered an explanation for these post-viral symptoms?
- tru3_power 6y ago
  Sure, but I think it’s just as plausible that right now is simply a very anxiety inducing time for a lot of people.
  - salmon30salmon 6y ago
    That’s my point. What if it isn’t long term Covid for most people but rather anxiety and depression
    - ljf 6y ago
      I can only talk personally, and I have seen people with anxiety and depression before, and that isn't what my wife has (she has long covid). She is part of the coverscan.com trial and has uncovered potential heart damage - which links to the way she's been feeling - heart rate all over the place, tachycardia etc. exhaustion, alongside breathing issues and physical issues such as numbness. She's 40 and before this incredibly active, working out a few days a week, running our house and looking after the kids plus involved in loads of other activities and groups. Since she got ill it can take all her energy to get downstairs to sit on the sofa - with her heart rate peaking at over 180 just walking to get a drink. Her old resting heart rate was around 62. Similar medical responses have been seen with other viruses before. I understand why people want to disbelieve/find alternative ideas, but it is medically understood that viruses can cause serious responses like this. The question is why covid appears to cause more long cases than other viruses (SARS excepted). That all said, I wouldn't be surprised if long covid sufferers END UP with anxiety and depression had 6 months plus of an unknown pathway through a new illness.
      - salmon30salmon 6y ago
        Hey, I am sorry to hear of this and I hope your wife (and you!) find answers and see improvement. I want to be very clear that I am not dismissing long COVID. In fact, I am hoping that via a more accurate diagnostic environment (which it seems like you went through) we can better identify true long Covid vs. anxiety/depression. The better we can (and forgive my terrible analogy) separate the wheat from the chaff and identify true long Covid patients the better we can help true sufferers
- elchief 6y ago
  If it leads to systemic inflation, then anxiety and depression are likely to follow https://www.nature.com/articles/tp201327 https://www.nature.com/articles/tp201327 https://www.nature.com/articles/nrn2297 https://www.nature.com/articles/nrn2297
drcross 6y ago
N=1 in this study. No mention of race, vitamin D levels or BMI, all of which are very useful data to have in the context of Covid-19. All viral respiratory infections have the potential to have some side effects to varying degrees but I can't help but feel that this letter will be used to support the concept of "long covid" on an unsuspecting public. Yes, covid is terrible but it's a different strain of a coronavirus (of which 20% of common colds are too), it's not something mystical. There's a strong chance we have substantial cross immunity to it though T-Cells defence. The literature is saying that if you're under 48 the flu has a higher mortality rate. We've mostly passed through the gompertz curve of the virus mortality as described by initial research by Hope Simpson regarding the seasonality of influenza viruses. We can't base national health policy on individual health outcomes. Covid has been turned into a religion completely lacking any scientific rigour and I feel this paper will be used as a tool to add to the fear.
- triyambakam 6y ago
  > Covid has been turned into a religion completely lacking any scientific rigour Yeah, many people are just using the virus to animate some other message for their own goals. One example of this seems to be power and control that governments are exploiting this time to increase, more so than is warranted for the situation.
  - peter422 6y ago
    Examples where you think governments are exploiting this? Governments just love reducing tax dollars by shutting stuff down!
    - ddeck 6y ago
      Numerous authoritarian goverments have used the pandemic as an excuse to expand powers and suppress dissent, often invoking emergency powers to bypass the usual law making process. Look at Hungary, Hong Kong, Cambodia, Venezuela etc. A quick search will bring up many examples.
  - dboreham 6y ago
bryan0 6y ago
Not a doctor, but the treatment for "adverse effects resembling Chronic Fatigue Syndrome/Myalgic Encephalomyelitis" that was successful (N=1?) is surprising to me: > Manual treatment was provided to aid central lymphatic drainage, improve mechanics and reduce the inflammation of the spine and reduce the allostatic load by improving the sympathetic tone. > ... and the patient followed a self-massage routine to aid lymph drainage along with gentle exercises to improve thoracic spinal mobility.
- oxymoran 6y ago
  I never understood why osteopaths aren’t in the same ballpark as chiropractors. Seems like the type of woo-ish stuff that doctors hate.
  - erentz 6y ago
    It sounds like maybe osteopaths are something different overseas but in the US both a DO and MD degree are 99% the same now. There is a schedule for smoothing out the remaining differences and essentially they’ll become identical. The history of osteopathy as a branch of medicine is kooky, but a lot of mainstream allopathic medicine was just as kooky when osteopathy started too. Today I have absolutely no issues whether my doctor got a DO or MD and wouldn’t even know without looking at the initials after their name. Chiropractors on the other hand are indeed completely dangerous quacks that routinely give people severe injuries. I know two people that have been disabled by chiropractors manipulating their necks and damaging the tissues and causes stenosis of the veins which has ruined their lives.
- dm319 6y ago
  As a doctor, this looks like quackery to me.
blakesterz 6y ago
Maybe also important to note, this is a "Letter to the Editor"... which I assume means it's not a real study?
throwawaytired 6y ago
Throwaway due to worry about comment being linked back professionally. Early COVID case mid February. Took 5 weeks to recover but the acuity wasn’t too bad. After just never really felt the same. Assumed adderall “wasn’t working”. Couldn’t explain the lethargy or sharp uptick in anxiety and general inability to work. Luckily with the world it’s been easier to lay low, but the symptoms generally track even the muscle piece. Is there more research on this? Where does one get this “Fatigue Scale” test? The linked article suggests they tested at an osteopathic clinic but that doesn’t really make sense.
- jupp0r 6y ago
  Anecdotal evidence about cases like yours have made me really weary about getting infected since February. I wish there was more scientific investigation into how often there are long term consequences of Covid disease so the public could make more informed decisions. In any case, thanks for sharing and hope you get better soon.
  - fossuser 6y ago
    As someone who deals with pretty intense anxiety often, it’s worth just waiting for more general data. Physical symptoms from anxiety are real and hard to separate from non-anxiety related symptoms. The current covid/election/general global craziness sets anxiety levels high. I haven’t caught covid, but if I had I imagine I’d be similarly freaking out over every anxious feeling via hypervigilance. None of this means that there aren’t real long term effects, but it’s worth being skeptical in context of anecdotes. You can find anxious people going down rabbit holes of vague symptoms for basically every possible disease. People are not able to adequately assess themselves.
  - deleted 6y ago
    [deleted]
  - ljf 6y ago
    My wife has long covid, 6 months later and she's only recently able to look after our kids alone - she's just been too tired before. I've dipped in to the groups she's part of and my very rough guess from the numbers is that it is something like 1 in 1000 covid sufferers get long covid. That figure though could be totally out either way as the number of cases was unlikely to have been correctly reported back when she got ill, and the new long cases coming through now won't be 'long' for months yet.
dm319 6y ago
There's something a bit weird about this article. I totally buy post-viral fatigue syndrome, and that there's certainly a possibility of it occurring post COVID-19, particularly since it is a virus. But alarm bells started ringing with the description of the lymphatic drainage, and the way the examination section is written is odd. You don't find mid thoracic spine inflammation on examination - an MRI would be used for that. They mention a conflict of interest in that the treatment for this condition is some kind of lymphatic drainage and is a technique devised by one of the authors. That author is an osteopath not a medical doctor. That in itself would not mean I'd automatically discount research, but as others have mentioned it really is n of 1, and I'd be surprised if these clinical signs and techniques have been validated in any large trial.
mensetmanusman 6y ago
Assume there are small molecules left in the brain resulting in long covid, how would you flush it out, drinking lots of water? Exercise?

91 points by lend000 6y ago

throwmeaway_pls 6y ago

That is not at all the title of the linked article. What is going on?

qualitydrew 6y ago
Broken link? That is exactly the title of the linked article on my end.
- rjsw 6y ago
  The title has been changed since this was submitted.

salmon30salmon 6y ago

It is very interesting that the reported lingering long-term symptoms of SARS-CoV-2 align almost perfectly with major depressive disorder and generalized anxiety disorder. Clinical depression and anxiety levels are through the roof right now. Shouldn’t that be considered an explanation for these post-viral symptoms?

tru3_power 6y ago
Sure, but I think it’s just as plausible that right now is simply a very anxiety inducing time for a lot of people.
- salmon30salmon 6y ago
  That’s my point. What if it isn’t long term Covid for most people but rather anxiety and depression
  - ljf 6y ago
    I can only talk personally, and I have seen people with anxiety and depression before, and that isn't what my wife has (she has long covid). She is part of the coverscan.com trial and has uncovered potential heart damage - which links to the way she's been feeling - heart rate all over the place, tachycardia etc. exhaustion, alongside breathing issues and physical issues such as numbness. She's 40 and before this incredibly active, working out a few days a week, running our house and looking after the kids plus involved in loads of other activities and groups. Since she got ill it can take all her energy to get downstairs to sit on the sofa - with her heart rate peaking at over 180 just walking to get a drink. Her old resting heart rate was around 62. Similar medical responses have been seen with other viruses before. I understand why people want to disbelieve/find alternative ideas, but it is medically understood that viruses can cause serious responses like this. The question is why covid appears to cause more long cases than other viruses (SARS excepted). That all said, I wouldn't be surprised if long covid sufferers END UP with anxiety and depression had 6 months plus of an unknown pathway through a new illness.
    - salmon30salmon 6y ago
      Hey, I am sorry to hear of this and I hope your wife (and you!) find answers and see improvement. I want to be very clear that I am not dismissing long COVID. In fact, I am hoping that via a more accurate diagnostic environment (which it seems like you went through) we can better identify true long Covid vs. anxiety/depression. The better we can (and forgive my terrible analogy) separate the wheat from the chaff and identify true long Covid patients the better we can help true sufferers
elchief 6y ago
If it leads to systemic inflation, then anxiety and depression are likely to follow https://www.nature.com/articles/tp201327 https://www.nature.com/articles/tp201327 https://www.nature.com/articles/nrn2297 https://www.nature.com/articles/nrn2297

drcross 6y ago

N=1 in this study. No mention of race, vitamin D levels or BMI, all of which are very useful data to have in the context of Covid-19. All viral respiratory infections have the potential to have some side effects to varying degrees but I can't help but feel that this letter will be used to support the concept of "long covid" on an unsuspecting public. Yes, covid is terrible but it's a different strain of a coronavirus (of which 20% of common colds are too), it's not something mystical. There's a strong chance we have substantial cross immunity to it though T-Cells defence. The literature is saying that if you're under 48 the flu has a higher mortality rate. We've mostly passed through the gompertz curve of the virus mortality as described by initial research by Hope Simpson regarding the seasonality of influenza viruses. We can't base national health policy on individual health outcomes. Covid has been turned into a religion completely lacking any scientific rigour and I feel this paper will be used as a tool to add to the fear.

triyambakam 6y ago
> Covid has been turned into a religion completely lacking any scientific rigour Yeah, many people are just using the virus to animate some other message for their own goals. One example of this seems to be power and control that governments are exploiting this time to increase, more so than is warranted for the situation.
- peter422 6y ago
  Examples where you think governments are exploiting this? Governments just love reducing tax dollars by shutting stuff down!
  - ddeck 6y ago
    Numerous authoritarian goverments have used the pandemic as an excuse to expand powers and suppress dissent, often invoking emergency powers to bypass the usual law making process. Look at Hungary, Hong Kong, Cambodia, Venezuela etc. A quick search will bring up many examples.
- dboreham 6y ago

bryan0 6y ago

Not a doctor, but the treatment for "adverse effects resembling Chronic Fatigue Syndrome/Myalgic Encephalomyelitis" that was successful (N=1?) is surprising to me: > Manual treatment was provided to aid central lymphatic drainage, improve mechanics and reduce the inflammation of the spine and reduce the allostatic load by improving the sympathetic tone. > ... and the patient followed a self-massage routine to aid lymph drainage along with gentle exercises to improve thoracic spinal mobility.

oxymoran 6y ago
I never understood why osteopaths aren’t in the same ballpark as chiropractors. Seems like the type of woo-ish stuff that doctors hate.
- erentz 6y ago
  It sounds like maybe osteopaths are something different overseas but in the US both a DO and MD degree are 99% the same now. There is a schedule for smoothing out the remaining differences and essentially they’ll become identical. The history of osteopathy as a branch of medicine is kooky, but a lot of mainstream allopathic medicine was just as kooky when osteopathy started too. Today I have absolutely no issues whether my doctor got a DO or MD and wouldn’t even know without looking at the initials after their name. Chiropractors on the other hand are indeed completely dangerous quacks that routinely give people severe injuries. I know two people that have been disabled by chiropractors manipulating their necks and damaging the tissues and causes stenosis of the veins which has ruined their lives.
dm319 6y ago
As a doctor, this looks like quackery to me.

blakesterz 6y ago

Maybe also important to note, this is a "Letter to the Editor"... which I assume means it's not a real study?

throwawaytired 6y ago

Throwaway due to worry about comment being linked back professionally. Early COVID case mid February. Took 5 weeks to recover but the acuity wasn’t too bad. After just never really felt the same. Assumed adderall “wasn’t working”. Couldn’t explain the lethargy or sharp uptick in anxiety and general inability to work. Luckily with the world it’s been easier to lay low, but the symptoms generally track even the muscle piece. Is there more research on this? Where does one get this “Fatigue Scale” test? The linked article suggests they tested at an osteopathic clinic but that doesn’t really make sense.

jupp0r 6y ago
Anecdotal evidence about cases like yours have made me really weary about getting infected since February. I wish there was more scientific investigation into how often there are long term consequences of Covid disease so the public could make more informed decisions. In any case, thanks for sharing and hope you get better soon.
- fossuser 6y ago
  As someone who deals with pretty intense anxiety often, it’s worth just waiting for more general data. Physical symptoms from anxiety are real and hard to separate from non-anxiety related symptoms. The current covid/election/general global craziness sets anxiety levels high. I haven’t caught covid, but if I had I imagine I’d be similarly freaking out over every anxious feeling via hypervigilance. None of this means that there aren’t real long term effects, but it’s worth being skeptical in context of anecdotes. You can find anxious people going down rabbit holes of vague symptoms for basically every possible disease. People are not able to adequately assess themselves.
- deleted 6y ago
  [deleted]
- ljf 6y ago
  My wife has long covid, 6 months later and she's only recently able to look after our kids alone - she's just been too tired before. I've dipped in to the groups she's part of and my very rough guess from the numbers is that it is something like 1 in 1000 covid sufferers get long covid. That figure though could be totally out either way as the number of cases was unlikely to have been correctly reported back when she got ill, and the new long cases coming through now won't be 'long' for months yet.

dm319 6y ago

There's something a bit weird about this article. I totally buy post-viral fatigue syndrome, and that there's certainly a possibility of it occurring post COVID-19, particularly since it is a virus. But alarm bells started ringing with the description of the lymphatic drainage, and the way the examination section is written is odd. You don't find mid thoracic spine inflammation on examination - an MRI would be used for that. They mention a conflict of interest in that the treatment for this condition is some kind of lymphatic drainage and is a technique devised by one of the authors. That author is an osteopath not a medical doctor. That in itself would not mean I'd automatically discount research, but as others have mentioned it really is n of 1, and I'd be surprised if these clinical signs and techniques have been validated in any large trial.

mensetmanusman 6y ago

Assume there are small molecules left in the brain resulting in long covid, how would you flush it out, drinking lots of water? Exercise?