40 ms·

Almost third of UK Covid hospital patients readmitted within four months

226 points by curmudgeon22 6y ago

roenxi 6y ago
The article doesn't give us quite enough information - what percentage of hospitalised Covid patients are over 70? 70 year olds are getting to the point where they spend a lot of time in hospital. The "hospitalised for Covid" part of the sample group is introducing a lot of bias. Fit, young and healthy people are much less likely to end up in hospital. So it makes sense from the first that the group is suffering more problems than a general population control group.
- DanBC 6y ago
  The ICNARC reports give more information. It's only for ICU. https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports Page 29 has a chart for spread of age. Most people (88%) live without any assistance in day to day activity.
  - azakai 6y ago
    The full article says it is not only for the ICU, and most were not in the ICU: > 47,780 patients with covid-19 (4,745 admitted to the intensive care unit and 43,035 not requiring admission to the intensive care unit) were included in the analysis https://www.bmj.com/content/372/bmj.n693 https://www.bmj.com/content/372/bmj.n693
- morsch 6y ago
  Four times more often than the control group. Over a mean follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14 060 of 47 780) and more than 1 in 10 (5875) died after discharge, with these events occurring at rates four and eight times greater, respectively, than in the matched control group. Rates of respiratory disease (P<0.001), diabetes (P<0.001), and cardiovascular disease (P<0.001) were also significantly raised in patients with covid-19, with 770 (95% confidence interval 758 to 783), 127 (122 to 132), and 126 (121 to 131) diagnoses per 1000 person years, respectively. Rate ratios were greater for individuals aged less than 70 than for those aged 70 or older, and in ethnic minority groups compared with the white population, with the largest differences seen for respiratory disease (10.5 (95% confidence interval 9.7 to 11.4) for age less than 70 years v 4.6 (4.3 to 4.8) for age ≥70, and 11.4 (9.8 to 13.3) for non-white v 5.2 (5.0 to 5.5) for white individuals).
  - peytn 6y ago
    Worth mentioning that the control group wasn’t matched for hospital admission status, while the study group was solely people who ended up in the hospital. I’m guessing that the authors likely could have acquired the data to match a control group of people who had been admitted to the hospital, so I’d be curious to see what the results would’ve been there. According to the paper, this control group was picked because, essentially, that’s what the authors wanted to choose: > We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
    - azakai 6y ago
      Yes, but that seems like a very relevant type of control group. If a person got COVID and ended up in the hospital, and that person wants to know what possible long-term harm that could cause them (that is, compared to had they not gotten COVID and not been hospitalized), then the article focused on exactly that.
      - makomk 6y ago
        Not really. The UK has been testing pretty much everyone who's admitted to hospital for COVID since the start of the outbreak regardless of why they were admitted, which means there's going to be quite a few people in the COVID and in hospital group who were actually admitted due to other, unrelated conditions. Particularly if they were being admitted to hospital regularly...
        azakai 6y ago
        Good question to ask, but no, they didn't look at people who tested positive but were admitted for something else: > Individuals were included if they had a hospital episode from 1 January to 31 August 2020 with a primary diagnosis of covid-19 (from the full paper)
        6y ago
- deleted 6y ago
  [deleted]
surfpel 6y ago
Link to the study: https://www.bmj.com/content/372/bmj.n693 https://www.bmj.com/content/372/bmj.n693 From the study: > At baseline, individuals with covid-19 had a mean age of 64.5 (standard deviation 19.2) and 54.9% were men. Compared with the general population, individuals in hospital with covid-19 were more likely to be: male, aged 50 or more, living in a deprived area, a former smoker, and overweight or obese (table 1). Individuals with covid-19 were also more likely to be comorbid than the general population, with a higher prevalence of previous admission to hospital and of all measured pre-existing conditions (most notably hypertension, major adverse cardiovascular event, respiratory disease, and diabetes). > Individuals discharged from hospital after acute covid-19 had increased rates of multiorgan dysfunction (particularly respiratory and cardiometabolic) compared with a matched control group from the general population > The rate ratio of multiorgan dysfunction (comparing individuals with covid-19 and matched controls) after discharge was greater in those aged less than 70 than in those aged 70 or more, and in ethnic minority groups than in the white population > Our findings suggest that the diagnosis, treatment, and prevention of post-covid syndrome requires integrated rather than organ or disease specific approaches
- noodlenotes 6y ago
  I remember at the beginning of the pandemic, it seemed as though few current smokers were getting seriously ill, although former smokers were at high risk. Did anything come of that?
  - deleted 6y ago
    [deleted]
  - SturgeonsLaw 6y ago
    That has been observed, and nicotine proposed as a potential therapeutic aid. The mechanism could be because the SARS-CoV-2 spike protein binds to the same nicotinic acetylcholine receptors that nicotine binds to. > A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0–3.4%) to 12.6% (95% CI 10.6–14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9–8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7–8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210099/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210099/ > Based on the early observations of the lower than expected smoking prevalence in hospitalised COVID-19 patients, Changeux and colleagues suggested a role for nicotinic acetylcholine receptors (nAChRs) in the pathophysiology of COVID-19 via a direct interaction between these receptors and the viral spike (S) glycoprotein.11 This suggestion was based in the fact that the S protein from SARS-CoV-2 contains a sequence motif similar to known nAChR antagonists11 (Figure S1), such as α-bungarotoxin from Bungarus multicinctus and glycoprotein from Rabies lyssavirus (formerly Rabies virus). Changeux et al. also proposed that COVID-19 might be controlled or mitigated by the use of nicotine, if the latter can sterically or allosterically compete with the virus for binding to these receptors.9,11 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386492/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386492/
Tarsul 6y ago
what I find to be even more astonishing: "and about one in eight had died", so 1/8 of those who were in hospital for covid AND discharged afterwards, died within 4 months. We also had another article in the guardian that said that 1 million of people in the UK suffer from long covid ("Symptoms vary but include fatigue, muscle pain and difficulty concentrating."): https://www.theguardian.com/society/2021/apr/01/long-covid-snapshot-poll-finds-million-people-symptoms-uk https://www.theguardian.com/society/2021/apr/01/long-covid-s...
- gxqoz 6y ago
  I've seen some pushback that a lot of hard-to-diagnose chronic syndromes are now being deemed "long covid." My assumption is that at least some of this is happening as it's the trendiest disease of the moment. Not to say there aren't a lot of people with clear-cut long covid syndromes.
  - JulianMorrison 6y ago
    It looks like there's an overlap with post-viral syndromes and chronic fatigue syndrome, pointing to a common etiology under the hood.
    - sprkwd 6y ago
      It would be nice if this helped research in to chronic fatigue conditions.
      - JulianMorrison 6y ago
        I strongly suspect it will.
    - gnabgib 6y ago
      There is some overlap and some similarities.. if long covid doesn't end perhaps it'll even be considered M.E[0]. Myalgic Encephalomyelitis sufferers have been ignored by mainstream medicine, maybe this will bring change. [0]: https://valerieeliotsmith.com/2021/02/19/a-short-post-on-long-covid-media-exposure/ https://valerieeliotsmith.com/2021/02/19/a-short-post-on-lon...
bedhead 6y ago
There is a ton of selection bias here, these are already generally speaking very unhealthy people.
- azakai 6y ago
  That's why the study looked at a control group, to try to account for that bias (as the abstract says, the control group was chosen to match "personal and clinical characteristics"). It's always possible they missed a factor, that's always a risk in such research, but they worked hard to address that possibility.
  - peytn 6y ago
    Not matching for hospital admission status is a pretty big factor given the bold, highly publicized top-line numbers: > We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
    - azakai 6y ago
      (I disagree, see discussion above: https://news.ycombinator.com/item?id=26672461 https://news.ycombinator.com/item?id=26672461 )
      - peytn 6y ago
        Essentially any contact with a hospital in that population produces eye-popping statistics. Having worked in this area, I’m of the opinion that the presentation of this work is misleading.
        mlyle 6y ago
        But the opposite would be misleading, too, in that the hospital contact was induced by COVID. It's all confounded. If you compare to other hospital admits, you're finding an even-less-healthy population (because they had a reason to show up to the hospital -without- COVID). If you compare to the general populace, you risk inadequately controlling the comparison. But if you want to know the increased risk people have subsequent to COVID hospitalization, perhaps the latter makes the most sense to measure.
LatteLazy 6y ago
What's the usually figure for (1) patients of flu admitted to hospital, (2) patients of flu with this sort of age breakdown? Are their unusual or particular symptoms compared to other people with long term issues after viral infections? I full believe "long covid" is a thing. But so much of covid news has been shitty "studies" that get a lot of press despite shedding very little light and go on to be rapidly disproven but still repeated (Vit D, Chloroquinine etc).
- incrudible 6y ago
  Vitamin D supplementation has been "disproven" as an emergency treatment, not for prevention. I still think it's worthwhile, with or without COVID. https://news.harvard.edu/gazette/story/2017/02/study-confirms-vitamin-d-protects-against-cold-and-flu/ https://news.harvard.edu/gazette/story/2017/02/study-confirm...
randomopining 6y ago
I had both vaccines shots and prob got covid last week. Had no nasal congestion, 100F low fever coming and going, little fatigue, night sweats. After I felt more normal, developed a little cough that I still have.
- incrudible 6y ago
  Those symptoms are consistent with the dozens of common cold viruses that haven't diseappeared. Consider that many people get COVID tests because they are symptomatic, yet most of them are negative.
  - alacombe 6y ago
    According to https://www.canada.ca/en/public-health/services/diseases/flu-influenza/influenza-surveillance/weekly-reports-2020-2021-season.html https://www.canada.ca/en/public-health/services/diseases/flu..., there has been pretty much no flu season this year compared to ~any other year (which in itself is highly suspect). Last week of January reported 55 vs 23,972 on average any other season.
    - lostlogin 6y ago
      I’m missing your angle - why is it suspect that there are so few cases?
      - Izkata 6y ago
        Because the symptoms are so similar, it's possible it's still spreading but to the same people getting covid and people are only being diagnosed with covid.
    - DanBC 6y ago
      You might want to check how they count flu in normal years.
    - incrudible 6y ago
      Influenza is not the same as the common cold, which is also sometimes referred to as "the flu". Besides influenza-types, there are a couple of viruses that cause the common cold, among them the aptly named rhinoviruses but also other coronaviruses. Indeed there's a suspicious drop in influenza-type cases, likely caused by all the social distancing and perhaps by SarS-COV-2 simply out-competing influenza-types in knocking people out.
jaybrendansmith 6y ago
Long Covid is real. I had a mild case back in August, but it took around 5 months to feel 'normal' again. Lots of inexplicable things: Minor heart palpitations, feeling of 'heaviness' behind my breastbone. When I exercised, even moderately like running a half mile, I would feel strangely exhausted for many hours later. All of this has gone away now, but I can easily see how someone who is hospitalized could have a relapse, either by overdoing it because they think they should be fully recovered, or through some other mysterious after-effect. Personally I believe it is caused by an immune system that is on 'high alert' after being attacked in every organ for multiple weeks (this is how Covid feels). It is logical to me that it might take multiple months for an immune system to gain back its equilibrium. Just guesses, I am not a doctor.
- anoncake 6y ago
  > Long Covid is real. But temporary -- and not all that long compared to the hell we've all had to endure for more than a year now -- except in extremely rare cases. Evidence to the contrary is welcome, after more than a year there should be some.
  - itake 6y ago
    > surveys conducted by patient groups indicate that 50% to 80% of patients continue to have bothersome symptoms three months after the onset of COVID-19 — even after tests no longer detect virus in their body. https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173 https://www.health.harvard.edu/blog/the-tragedy-of-the-post-... Search for the term "covid long haulers" to get more information.
    - anoncake 6y ago
      Avoiding three months of suffering for some people is hardly a reason to make everyone suffer for 15 months and counting. > Search for the term "covid long haulers" to get more information. No. https://thelogicofscience.com/2016/09/27/dont-tell-people-to-google-it-thats-your-job-not-theirs/ https://thelogicofscience.com/2016/09/27/dont-tell-people-to...
mjfl 6y ago
There needs to be some kind of analysis to determine whether they have causality flipped- do they have these long term health problems because of severe COVID or did they get severe COVID due to these long term health problems?
- benjaminwootton 6y ago
  Or are they both getting seriously ill with Covid and long term health problems because they are typically aged 70+ with comorbidities
mdoms 6y ago
The only reason you've had to endure this for over a year is because you never once tried to do it properly. 6 weeks of hard (proper) lockdown followed by sensible plans to manage outbreaks and boom you'd have been done. But no, Americans absolutely refuse to work together, to pull in the same direction, to achieve something.
- rorykoehler 6y ago
  Europeans were no different. It’s changed my perspective on who we are and not in a good way.
  - spookthesunset 6y ago
    If your plan requires 100% compliance to succeed, it failed before you even started. Good plans operate within the realities of human nature and respect people's inalienable human rights.
- emptysongglass 6y ago
  I'm not sure this is true. We did it right in Denmark and we're still in what is starting to feel like one long lockdown with no end in sight. Our vaccination numbers are terrible: at the rate we are vaccinating all Danes will have started their first vaccination round by July 21st, 2022. [1] We've had the Moderna vaccine since January 13th [2] of the previous year. This is not people failing, these are our leaders failing. I was so gung ho about us coming together to make the sacrifices and beat this thing but now a year and a half later I'm done with the colossal failures of our leadership and the promulgation of fear everywhere. [1] https://hvorlangtervi.dk/english https://hvorlangtervi.dk/english [2] https://nymag.com/intelligencer/2020/12/moderna-covid-19-vaccine-design.html https://nymag.com/intelligencer/2020/12/moderna-covid-19-vac...
- amscanne 6y ago
  Are you saying that an Wuhan-style lockdown would have been a better or even feasible approach? I don't think humans anywhere are able to "pull in the same direction" to the extent that such a lockdown is possible without an authoritarian government. Italy imposed pretty draconian rules for at least six weeks, and has still had to deal with a second wave and additional lockdowns. Personally, I think that the principles of personal freedom (that such an authoritarian government is largely incompatible with) are much more valuable in the long run. Working through the disease has been messier in the last year, but the economic system largely based on these principles was also able to produce novel vaccines. While the last year has been rough, I'm much happier overall that I don't live in a place where an authoritarian lockdown is even possible.
legerdemain 6y ago
> one in eight of patients dies in the same period Another nuanced and striking peculiarity of the English language that writers for this international paper may not have mastered yet! "Eight of them" is grammatically unremarkable. "Eight of the patients" and "eight patients" are also unremarkable, although slightly different in meaning. "Eight of patients" is jarring. It sounds like "four of clubs."
stretchwithme 6y ago
All the more reason to make sure you're getting enough Vitamins D and K2. Here's an interesting explanation of how Vitamin D helps the immune system. https://www.youtube.com/watch?v=cT1CaTv5-e4 https://www.youtube.com/watch?v=cT1CaTv5-e4 Vitamin D improves your uptake of calcium. Vitamin K2 makes sure calcium goes where it's supposed to go. You want your BONES calcified, not your arteries.
godmode2019 6y ago
In my opinion the 'long covid' was a line thrust into the spotlight from the media to justify continued restrictions. Person A: 'We should open up' Person B: 'Have you not heard most people have serious health problems after covid?' When we talk about proportional reporting I think of the book 'Thinking fast and slow'.
- Mediterraneo10 6y ago
  You are not wrong. Yes, scientific studies speak of some subset of patients experiencing symptoms weeks or months (but not necessarily longer) after COVID. However, the actual studies emphasize that severity of long-term symptoms strongly correlates with severity of illness. That means that young people are at very low risk (not zero, of course, but as low as with many other common illnesses). When the media has taken these research findings up, however, they typically leave out all the nuance, because that way it sounds like more dramatic, attention-catching news. Also, last year some newspapers irresponsibly allowed some people to share their claims that they were dealing with tough long-term COVID symptoms even when they had never even tested positive for the disease in the first place. It was no different than giving a megaphone to the people who, before COVID, experienced some distress and, without any actual medical verification, were sure they were cases of "chronic Lyme disease". Health officials in several countries have plainly fudged the truth or left out details when speaking to the public, for what they see as the greater good of maintaining restrictions for long enough to reach their public-health goals. One naturally suspects that they found the panic about long COVID useful for this.
- tim333 6y ago
  There could be elements of that as well as it being a real thing.
dukeofdoom 6y ago
I once had pneumonia, early 30s. It took months to feel 100% again. Its just your lungs get damaged, and takes time to heal. But if you have other health problems, its a spiral. One bad thing leads to the next. Hence, I feel that life is like a bumpy pothole filled road. For the most part, if you get past one, you will keep rolling down. The key is to avoid the big potholes. Some people in terrible physical shape get lucky, and missed a few. When reality is anyone of those previous ones could have taken them out. I learned this on a road from the airport to a hotel in Dominican Republic.
rdkbo 6y ago
https://www.rdkbo.id/ https://www.rdkbo.id/
JoeAltmaier 6y ago
What is the control? Folks admitted for (any other disease)? What was their readmission rate? Folks needing hospitalization are pretty sick. If they're older, this seems a normal result. I'd have to see some statistics to call it remarkable.

226 points by curmudgeon22 6y ago

The article doesn't give us quite enough information - what percentage of hospitalised Covid patients are over 70? 70 year olds are getting to the point where they spend a lot of time in hospital. The "hospitalised for Covid" part of the sample group is introducing a lot of bias. Fit, young and healthy people are much less likely to end up in hospital. So it makes sense from the first that the group is suffering more problems than a general population control group.

DanBC 6y ago
The ICNARC reports give more information. It's only for ICU. https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports Page 29 has a chart for spread of age. Most people (88%) live without any assistance in day to day activity.
- azakai 6y ago
  The full article says it is not only for the ICU, and most were not in the ICU: > 47,780 patients with covid-19 (4,745 admitted to the intensive care unit and 43,035 not requiring admission to the intensive care unit) were included in the analysis https://www.bmj.com/content/372/bmj.n693 https://www.bmj.com/content/372/bmj.n693
morsch 6y ago
Four times more often than the control group. Over a mean follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14 060 of 47 780) and more than 1 in 10 (5875) died after discharge, with these events occurring at rates four and eight times greater, respectively, than in the matched control group. Rates of respiratory disease (P<0.001), diabetes (P<0.001), and cardiovascular disease (P<0.001) were also significantly raised in patients with covid-19, with 770 (95% confidence interval 758 to 783), 127 (122 to 132), and 126 (121 to 131) diagnoses per 1000 person years, respectively. Rate ratios were greater for individuals aged less than 70 than for those aged 70 or older, and in ethnic minority groups compared with the white population, with the largest differences seen for respiratory disease (10.5 (95% confidence interval 9.7 to 11.4) for age less than 70 years v 4.6 (4.3 to 4.8) for age ≥70, and 11.4 (9.8 to 13.3) for non-white v 5.2 (5.0 to 5.5) for white individuals).
- peytn 6y ago
  Worth mentioning that the control group wasn’t matched for hospital admission status, while the study group was solely people who ended up in the hospital. I’m guessing that the authors likely could have acquired the data to match a control group of people who had been admitted to the hospital, so I’d be curious to see what the results would’ve been there. According to the paper, this control group was picked because, essentially, that’s what the authors wanted to choose: > We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
  - azakai 6y ago
    Yes, but that seems like a very relevant type of control group. If a person got COVID and ended up in the hospital, and that person wants to know what possible long-term harm that could cause them (that is, compared to had they not gotten COVID and not been hospitalized), then the article focused on exactly that.
    - makomk 6y ago
      Not really. The UK has been testing pretty much everyone who's admitted to hospital for COVID since the start of the outbreak regardless of why they were admitted, which means there's going to be quite a few people in the COVID and in hospital group who were actually admitted due to other, unrelated conditions. Particularly if they were being admitted to hospital regularly...
      - azakai 6y ago
        Good question to ask, but no, they didn't look at people who tested positive but were admitted for something else: > Individuals were included if they had a hospital episode from 1 January to 31 August 2020 with a primary diagnosis of covid-19 (from the full paper)
      - 6y ago
deleted 6y ago
[deleted]

surfpel 6y ago

Link to the study: https://www.bmj.com/content/372/bmj.n693 https://www.bmj.com/content/372/bmj.n693 From the study: > At baseline, individuals with covid-19 had a mean age of 64.5 (standard deviation 19.2) and 54.9% were men. Compared with the general population, individuals in hospital with covid-19 were more likely to be: male, aged 50 or more, living in a deprived area, a former smoker, and overweight or obese (table 1). Individuals with covid-19 were also more likely to be comorbid than the general population, with a higher prevalence of previous admission to hospital and of all measured pre-existing conditions (most notably hypertension, major adverse cardiovascular event, respiratory disease, and diabetes). > Individuals discharged from hospital after acute covid-19 had increased rates of multiorgan dysfunction (particularly respiratory and cardiometabolic) compared with a matched control group from the general population > The rate ratio of multiorgan dysfunction (comparing individuals with covid-19 and matched controls) after discharge was greater in those aged less than 70 than in those aged 70 or more, and in ethnic minority groups than in the white population > Our findings suggest that the diagnosis, treatment, and prevention of post-covid syndrome requires integrated rather than organ or disease specific approaches

noodlenotes 6y ago
I remember at the beginning of the pandemic, it seemed as though few current smokers were getting seriously ill, although former smokers were at high risk. Did anything come of that?
- deleted 6y ago
  [deleted]
- SturgeonsLaw 6y ago
  That has been observed, and nicotine proposed as a potential therapeutic aid. The mechanism could be because the SARS-CoV-2 spike protein binds to the same nicotinic acetylcholine receptors that nicotine binds to. > A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0–3.4%) to 12.6% (95% CI 10.6–14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9–8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7–8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210099/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210099/ > Based on the early observations of the lower than expected smoking prevalence in hospitalised COVID-19 patients, Changeux and colleagues suggested a role for nicotinic acetylcholine receptors (nAChRs) in the pathophysiology of COVID-19 via a direct interaction between these receptors and the viral spike (S) glycoprotein.11 This suggestion was based in the fact that the S protein from SARS-CoV-2 contains a sequence motif similar to known nAChR antagonists11 (Figure S1), such as α-bungarotoxin from Bungarus multicinctus and glycoprotein from Rabies lyssavirus (formerly Rabies virus). Changeux et al. also proposed that COVID-19 might be controlled or mitigated by the use of nicotine, if the latter can sterically or allosterically compete with the virus for binding to these receptors.9,11 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386492/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386492/

Tarsul 6y ago

what I find to be even more astonishing: "and about one in eight had died", so 1/8 of those who were in hospital for covid AND discharged afterwards, died within 4 months. We also had another article in the guardian that said that 1 million of people in the UK suffer from long covid ("Symptoms vary but include fatigue, muscle pain and difficulty concentrating."): https://www.theguardian.com/society/2021/apr/01/long-covid-snapshot-poll-finds-million-people-symptoms-uk https://www.theguardian.com/society/2021/apr/01/long-covid-s...

gxqoz 6y ago
I've seen some pushback that a lot of hard-to-diagnose chronic syndromes are now being deemed "long covid." My assumption is that at least some of this is happening as it's the trendiest disease of the moment. Not to say there aren't a lot of people with clear-cut long covid syndromes.
- JulianMorrison 6y ago
  It looks like there's an overlap with post-viral syndromes and chronic fatigue syndrome, pointing to a common etiology under the hood.
  - sprkwd 6y ago
    It would be nice if this helped research in to chronic fatigue conditions.
    - JulianMorrison 6y ago
      I strongly suspect it will.
  - gnabgib 6y ago
    There is some overlap and some similarities.. if long covid doesn't end perhaps it'll even be considered M.E[0]. Myalgic Encephalomyelitis sufferers have been ignored by mainstream medicine, maybe this will bring change. [0]: https://valerieeliotsmith.com/2021/02/19/a-short-post-on-long-covid-media-exposure/ https://valerieeliotsmith.com/2021/02/19/a-short-post-on-lon...

bedhead 6y ago

There is a ton of selection bias here, these are already generally speaking very unhealthy people.

azakai 6y ago
That's why the study looked at a control group, to try to account for that bias (as the abstract says, the control group was chosen to match "personal and clinical characteristics"). It's always possible they missed a factor, that's always a risk in such research, but they worked hard to address that possibility.
- peytn 6y ago
  Not matching for hospital admission status is a pretty big factor given the bold, highly publicized top-line numbers: > We selected controls from the general population rather than matching to non-covid hospital admissions to determine the increased risk after hospital admission for covid-19 versus no hospital admission for covid-19 (that is, compared with the expected risk for people with similar personal and clinical characteristics in the general population).
  - azakai 6y ago
    (I disagree, see discussion above: https://news.ycombinator.com/item?id=26672461 https://news.ycombinator.com/item?id=26672461 )
    - peytn 6y ago
      Essentially any contact with a hospital in that population produces eye-popping statistics. Having worked in this area, I’m of the opinion that the presentation of this work is misleading.
      - mlyle 6y ago
        But the opposite would be misleading, too, in that the hospital contact was induced by COVID. It's all confounded. If you compare to other hospital admits, you're finding an even-less-healthy population (because they had a reason to show up to the hospital -without- COVID). If you compare to the general populace, you risk inadequately controlling the comparison. But if you want to know the increased risk people have subsequent to COVID hospitalization, perhaps the latter makes the most sense to measure.

LatteLazy 6y ago

What's the usually figure for (1) patients of flu admitted to hospital, (2) patients of flu with this sort of age breakdown? Are their unusual or particular symptoms compared to other people with long term issues after viral infections? I full believe "long covid" is a thing. But so much of covid news has been shitty "studies" that get a lot of press despite shedding very little light and go on to be rapidly disproven but still repeated (Vit D, Chloroquinine etc).

incrudible 6y ago
Vitamin D supplementation has been "disproven" as an emergency treatment, not for prevention. I still think it's worthwhile, with or without COVID. https://news.harvard.edu/gazette/story/2017/02/study-confirms-vitamin-d-protects-against-cold-and-flu/ https://news.harvard.edu/gazette/story/2017/02/study-confirm...

randomopining 6y ago

I had both vaccines shots and prob got covid last week. Had no nasal congestion, 100F low fever coming and going, little fatigue, night sweats. After I felt more normal, developed a little cough that I still have.

incrudible 6y ago
Those symptoms are consistent with the dozens of common cold viruses that haven't diseappeared. Consider that many people get COVID tests because they are symptomatic, yet most of them are negative.
- alacombe 6y ago
  According to https://www.canada.ca/en/public-health/services/diseases/flu-influenza/influenza-surveillance/weekly-reports-2020-2021-season.html https://www.canada.ca/en/public-health/services/diseases/flu..., there has been pretty much no flu season this year compared to ~any other year (which in itself is highly suspect). Last week of January reported 55 vs 23,972 on average any other season.
  - lostlogin 6y ago
    I’m missing your angle - why is it suspect that there are so few cases?
    - Izkata 6y ago
      Because the symptoms are so similar, it's possible it's still spreading but to the same people getting covid and people are only being diagnosed with covid.
  - DanBC 6y ago
    You might want to check how they count flu in normal years.
  - incrudible 6y ago
    Influenza is not the same as the common cold, which is also sometimes referred to as "the flu". Besides influenza-types, there are a couple of viruses that cause the common cold, among them the aptly named rhinoviruses but also other coronaviruses. Indeed there's a suspicious drop in influenza-type cases, likely caused by all the social distancing and perhaps by SarS-COV-2 simply out-competing influenza-types in knocking people out.

jaybrendansmith 6y ago

Long Covid is real. I had a mild case back in August, but it took around 5 months to feel 'normal' again. Lots of inexplicable things: Minor heart palpitations, feeling of 'heaviness' behind my breastbone. When I exercised, even moderately like running a half mile, I would feel strangely exhausted for many hours later. All of this has gone away now, but I can easily see how someone who is hospitalized could have a relapse, either by overdoing it because they think they should be fully recovered, or through some other mysterious after-effect. Personally I believe it is caused by an immune system that is on 'high alert' after being attacked in every organ for multiple weeks (this is how Covid feels). It is logical to me that it might take multiple months for an immune system to gain back its equilibrium. Just guesses, I am not a doctor.

anoncake 6y ago
> Long Covid is real. But temporary -- and not all that long compared to the hell we've all had to endure for more than a year now -- except in extremely rare cases. Evidence to the contrary is welcome, after more than a year there should be some.
- itake 6y ago
  > surveys conducted by patient groups indicate that 50% to 80% of patients continue to have bothersome symptoms three months after the onset of COVID-19 — even after tests no longer detect virus in their body. https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173 https://www.health.harvard.edu/blog/the-tragedy-of-the-post-... Search for the term "covid long haulers" to get more information.
  - anoncake 6y ago
    Avoiding three months of suffering for some people is hardly a reason to make everyone suffer for 15 months and counting. > Search for the term "covid long haulers" to get more information. No. https://thelogicofscience.com/2016/09/27/dont-tell-people-to-google-it-thats-your-job-not-theirs/ https://thelogicofscience.com/2016/09/27/dont-tell-people-to...

mjfl 6y ago

There needs to be some kind of analysis to determine whether they have causality flipped- do they have these long term health problems because of severe COVID or did they get severe COVID due to these long term health problems?

benjaminwootton 6y ago
Or are they both getting seriously ill with Covid and long term health problems because they are typically aged 70+ with comorbidities

mdoms 6y ago

The only reason you've had to endure this for over a year is because you never once tried to do it properly. 6 weeks of hard (proper) lockdown followed by sensible plans to manage outbreaks and boom you'd have been done. But no, Americans absolutely refuse to work together, to pull in the same direction, to achieve something.

rorykoehler 6y ago
Europeans were no different. It’s changed my perspective on who we are and not in a good way.
- spookthesunset 6y ago
  If your plan requires 100% compliance to succeed, it failed before you even started. Good plans operate within the realities of human nature and respect people's inalienable human rights.
emptysongglass 6y ago
I'm not sure this is true. We did it right in Denmark and we're still in what is starting to feel like one long lockdown with no end in sight. Our vaccination numbers are terrible: at the rate we are vaccinating all Danes will have started their first vaccination round by July 21st, 2022. [1] We've had the Moderna vaccine since January 13th [2] of the previous year. This is not people failing, these are our leaders failing. I was so gung ho about us coming together to make the sacrifices and beat this thing but now a year and a half later I'm done with the colossal failures of our leadership and the promulgation of fear everywhere. [1] https://hvorlangtervi.dk/english https://hvorlangtervi.dk/english [2] https://nymag.com/intelligencer/2020/12/moderna-covid-19-vaccine-design.html https://nymag.com/intelligencer/2020/12/moderna-covid-19-vac...
amscanne 6y ago
Are you saying that an Wuhan-style lockdown would have been a better or even feasible approach? I don't think humans anywhere are able to "pull in the same direction" to the extent that such a lockdown is possible without an authoritarian government. Italy imposed pretty draconian rules for at least six weeks, and has still had to deal with a second wave and additional lockdowns. Personally, I think that the principles of personal freedom (that such an authoritarian government is largely incompatible with) are much more valuable in the long run. Working through the disease has been messier in the last year, but the economic system largely based on these principles was also able to produce novel vaccines. While the last year has been rough, I'm much happier overall that I don't live in a place where an authoritarian lockdown is even possible.

legerdemain 6y ago

> one in eight of patients dies in the same period Another nuanced and striking peculiarity of the English language that writers for this international paper may not have mastered yet! "Eight of them" is grammatically unremarkable. "Eight of the patients" and "eight patients" are also unremarkable, although slightly different in meaning. "Eight of patients" is jarring. It sounds like "four of clubs."

stretchwithme 6y ago

All the more reason to make sure you're getting enough Vitamins D and K2. Here's an interesting explanation of how Vitamin D helps the immune system. https://www.youtube.com/watch?v=cT1CaTv5-e4 https://www.youtube.com/watch?v=cT1CaTv5-e4 Vitamin D improves your uptake of calcium. Vitamin K2 makes sure calcium goes where it's supposed to go. You want your BONES calcified, not your arteries.

godmode2019 6y ago

In my opinion the 'long covid' was a line thrust into the spotlight from the media to justify continued restrictions. Person A: 'We should open up' Person B: 'Have you not heard most people have serious health problems after covid?' When we talk about proportional reporting I think of the book 'Thinking fast and slow'.

Mediterraneo10 6y ago
You are not wrong. Yes, scientific studies speak of some subset of patients experiencing symptoms weeks or months (but not necessarily longer) after COVID. However, the actual studies emphasize that severity of long-term symptoms strongly correlates with severity of illness. That means that young people are at very low risk (not zero, of course, but as low as with many other common illnesses). When the media has taken these research findings up, however, they typically leave out all the nuance, because that way it sounds like more dramatic, attention-catching news. Also, last year some newspapers irresponsibly allowed some people to share their claims that they were dealing with tough long-term COVID symptoms even when they had never even tested positive for the disease in the first place. It was no different than giving a megaphone to the people who, before COVID, experienced some distress and, without any actual medical verification, were sure they were cases of "chronic Lyme disease". Health officials in several countries have plainly fudged the truth or left out details when speaking to the public, for what they see as the greater good of maintaining restrictions for long enough to reach their public-health goals. One naturally suspects that they found the panic about long COVID useful for this.
tim333 6y ago
There could be elements of that as well as it being a real thing.

dukeofdoom 6y ago

I once had pneumonia, early 30s. It took months to feel 100% again. Its just your lungs get damaged, and takes time to heal. But if you have other health problems, its a spiral. One bad thing leads to the next. Hence, I feel that life is like a bumpy pothole filled road. For the most part, if you get past one, you will keep rolling down. The key is to avoid the big potholes. Some people in terrible physical shape get lucky, and missed a few. When reality is anyone of those previous ones could have taken them out. I learned this on a road from the airport to a hotel in Dominican Republic.

rdkbo 6y ago

https://www.rdkbo.id/ https://www.rdkbo.id/

JoeAltmaier 6y ago

What is the control? Folks admitted for (any other disease)? What was their readmission rate? Folks needing hospitalization are pretty sick. If they're older, this seems a normal result. I'd have to see some statistics to call it remarkable.