14 ms·

Long-term cardiovascular outcomes of Covid-19

136 points by dv_dt 5y ago

avalys 5y ago
Would love to see these results broken down by vaccine status as well.
- gchokov 5y ago
- Daishiman 5y ago
  Because vaccination reduces the severity of the disease in a known fashion, the vaccination status is going to be proportionate to that.
  - TrevorJ 5y ago
    That's not how science works.
    - Daishiman 5y ago
      So? The risk profile of vaccines has been researched to death as well as the effects of disease severity. Part of doing science also means having looked at enough papers and conclusions to know which questions merit further research and which questions are of little relevance to public health. It is extremely unlikely that you'll find any surprises here, and considering the open questions of long covid and long-term health effects on the population on COVID, I'd much rather the focus be on the more important questions.
      - avalys 5y ago
        We don’t understand nearly enough about Covid, long Covid, or breakthrough cases to draw any conclusion about how much the vaccine mitigates the severity of long-term outcomes in breakthrough cases. We have enough information to form an educated guess. But your attitude here is exactly why public health authorities have damaged their credibility and that of science itself in the past two years. They have repeatedly misrepresented their educated guesses as scientific fact - and then turned out to be wrong.
        skrbjc 5y ago
        They're not "breakthrough" cases since the vaccine was never intended to stop transmission and very clearly does not stop transmission. They're just cases amongst people who took the vaccine.
        lamontcg 5y ago
        Vaccines reduce transmission. https://www.medrxiv.org/content/10.1101/2021.12.27.21268278v1 https://www.medrxiv.org/content/10.1101/2021.12.27.21268278v... > We found an increased transmission for unvaccinated individuals, and a reduced transmission for booster-vaccinated individuals, compared to fully vaccinated individuals. And their definition of unvaccinated includes partially vaccinated (1-shot) and probably includes recovered individuals. See table 2 for their results which finds that boosters do significantly reduce transmissibility and susceptibility, but it is just very far from the perfect effect everyone would have hoped and wished for. Vaccines are probably still more effective than masking in preventing transmission (given the average person's adherence to masking guidelines) and the effect would intuitively (to me anyway) seem likely to stack.
        Daishiman 5y ago
        > But your attitude here is exactly why public health authorities have damaged their credibility and that of science itself in the past two years. They have repeatedly misrepresented their educated guesses as scientific fact - and then turned out to be wrong. Where has that happened for this? Every study that has shown disease severity correlated with vaccine usage has shown the same results, over and over, for each variant: vaccination correlates with symptomatic disease severity which correlates linearly with long-term effects, in every observed metric. This has appeared again and again and again in dozens of studies, to the point where it is the null hypothesis; you'd need to make a real case with novel, contradictory evidence to show that this is not the case. In every domain of medicine there is some degree of guessing and basing off of historical data for a cohort; you can't test every patient for every possible thing that could ever affect them. Instead you pick and choose the most significant factors and use that as your guidelines. Research efforts for COVID are very large, but also limited; there is no evidence to contradict this and it's not worth researching. If you actually kept up with domain experts during the pandemic, you'll see that there were many open questions over which they kept interest, and many open questions where they did not care much. The reason for that has to do with the acquired knowledge of having studied hundreds of other diseases and similar cases; they tell you how to explore the domain, seeing where things are likely to be different, and where they are not.
    - asveikau 5y ago
      It could be exactly how science works! You start out proposing that, perhaps based on intuition, then you do a study to confirm or deny it.
- robbiep 5y ago
  It appears the study date only moves up to the start of vaccine release. We’ll probably be waiting another 12 months to get that data
- michalu 5y ago
  At least one study (very small) seems to show that covid alone doesn't cause cardiovascular abnormalities 6 months after the disease. https://www.sciencedirect.com/science/article/pii/S1936878X21003569/ https://www.sciencedirect.com/science/article/pii/S1936878X2...
SommaRaikkonen 5y ago
- colonelxc 5y ago
  This study is about people who got Covid and now have issues, not issues with vaccines.
- FeteCommuniste 5y ago
  The article isn't about the risks of vaccination but of covid infection. The only mention of vaccines is in a section where it discusses controlling for vaccination status and concludes that the risk of myocarditis from infection is present even in the unvaccinated.
- pstuart 5y ago
  One thing I've wondered about with issues from vaccine side effects is if they are in any way related to how the body would respond if the actual disease was contracted. This is not to discount the effects or concerns about it -- just curiosity.
  - sojournerc 5y ago
    My understanding is that the likelihood of adverse vaccine side-effects is greater after a previous COVID infection than in a "naive" immune system. This study shows >2x risk for previously infected healthcare workers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313055/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313055/
    - _s 5y ago
      Adverse sounds serious, but really: About 105 vaccine recipients reported at least one AEFI symptoms following COVID-19 vaccination (incidence proportion 6.4%, 95% CI: 5.3%, 7.7%). All AEFI reported were minor which were managed by tablet paracetamol and subsided after 1–2 days. Fever (65, 3.98%) was the most commonly reported AEFI followed by myalgia (54, 3.30%) (Fig. 1). About 48 (2.94%) study participants reported 2 or more AEFI, most common being fever with myalgia (19, 1.16%) and fever with headache (18, 1.10%). No severe or serious AEFI was reported among vaccine recipients.
throwaway22032 5y ago
The meat of this seems to be in confirming that if you're not hospitalized the long-term effects are minimal. Not _zero_, but very small. The abstract states that "These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection", but I'd urge attention to the data as this implies only that there is a detectable change, it's not a judgement on the size of the risk. The worst cases are in intubated patients that basically lost proper oxygen flow for extended periods of time.
- wwweston 5y ago
  I'd guess you're being downvoted because the article describes a different conclusion: "[long term] risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection." Though it does seem to make a distinction in grade ("these risks increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care)"), it doesn't seem to support the idea that the impacts are limited to the hospitalized.
  - throwaway22032 5y ago
    Yes, it's evident in the scientific sense of the word - the risks exist. They're just very small. If you look at the data, the risk ratios are in the range of 1.0x-2.0x, on outcomes which in healthy individuals are extremely rare to begin with. Same with the excess figures. The logical conclusion given the rest of the data is that these outcomes would be concentrated in those who were very ill but below the threshold of hospitalization. The study itself doesn't bin the groups far enough to show the implication for the asymptomatic or those with very minor symptoms, but there's a clear exponential trend that associates acute severity with long-term severity supra-linearly.
    - dekhn 5y ago
      replying just to emphasize that relative risks always sound huge until you find out they're relative to a very small baseline.
ProAm 5y ago
My heart had wild palpitations for several days in the midst of having covid and post covid my resting heart rate is ~20bpm higher during the day and ~30 bpm higher during the night.
- arghnoname 5y ago
  I had a very similar reaction that correlates to getting the vaccine. It took months for my resting heart rate to return to pre-vaccination levels. Maybe this means I would have died had I caught covid, maybe not, no way to know. It's scary how much this spike protein / immune response / etc seems to provoke adverse cardiovascular responses, even if there is full recovery in most of us.
  - dv_dt 5y ago
    The vaccine is the safer controlled introduction to it in comparison to getting a full covid exposure. In a full covid case w/o being vaccinated would introduce more spike protein as well as a exposure to the sequences of the rest of the virus which could cause all sorts of other issues.
  - nwiswell 5y ago
    > It's scary how much this spike protein / immune response / etc seems to provoke adverse cardiovascular responses, even if there is full recovery in most of us. Honestly I am wondering if this is sampling bias. Have we ever paid this much concentrated attention to a disease? When you consider what a virus does to the body, it seems likely that many other viruses that have been endemic for millennia have been wreaking pernicious havoc on our bodies and we just... shrugged it off. Anyplace the body heals from a significant physical injury, there is a scar. It's never a perfect restoration. It seems almost intuitive that the damage from a virus would be similar, and there is documented evidence that COVID will attack neurons.
    - deleted 5y ago
      [deleted]
    - 5y ago
noipv4 5y ago
After a bout of Covid and Moderna vaccines, I am now on a beta blocker, a Ca channel blocker and an ACE inhibitor along with a diuretic. I had never seen such high BP 180/140 in my arms. The virus and the S1 protein messed with my heart.
- likeabbas 5y ago
  That sucks man :/ my anecdotal experience after having the original Covid strain and 3 full Moderna shots is that my heart is fine. BP is back to 105/60, resting heart rate is 50. I had long Covid for 8 months that fucked with my ability to workout and play tennis but now my stamina is fine.
- techsin101 5y ago
  my BP is also out of whack and it's been 5 months since i had covid so i dont think it's getting better
xiphias2 5y ago
It’s interesting to see less obese and younger people more affected. Maybe it’s either because of vaccine status that another commenter asked for, or more deaths in those cohorts.
throw3838 5y ago
I got high cholesterol, and I am in risk of hearth attack. Never had covid, just poor health due to prolonged lockdowns and closed gyms.
- nhance 5y ago
  Maybe you should start habits that change this? You can try to blame this on someone else, but it's your own choices that put you here.
  - throw3838 5y ago
    My own choice? I followed legally mandated lockdown. But I ensure you I learned my lesson!
    - ChrisClark 5y ago
      You chose not to exercise. It's is completely on you.
    - ganbatekudasai 5y ago
      Lockdown made my work out more: Since I have no commute time anymore, I took up regular running (3x a week). Very significant increase in fitness.
      - throw3838 5y ago
        Not everyone want to run with mask around dirty city block. It is really interesting to see this mental gymnastics, if someone is fat, gets virus and dies, it is "the plague". But here we have dozen people talking about "personal responsibility".
        threeseed 5y ago
        a) Never seen a single city mandate masks for exercising outside. Especially since it’s quite dangerous to limit your oxygen flow. So you should have been fine to run outside. b) Some of the toughest workouts I’ve done were inside. You need to stop being so close minded.
dv_dt 5y ago
Aside from the study being interesting topic, I love the inclusion of Fig 1 the cohort construction diagram. I wish more papers would include that as a standard item.
dijit 5y ago
I had an awful experience running for the first time after contracting COVID.. Unsure what strain I had but it was recent and I was careful so it's likely the "milder" omicron variant. At the Gym, 3 weeks after testing positive the first time, I ran for 60s at 11km/h on the treadmill and my heart rate was 180bpm by the end. For context, a 60s jog at that same speed prior to being afflicted would have resulted in a 130bpm heart rate. Normally it would take running for 45 minutes to get to 180bpm.. But I got there (and felt awful) in 60s. I had to stop running.
- dv_dt 5y ago
  Be careful returning to a full exercise schedule, esp after seeing effects like that. I see a running twitter group anecdotally observing a risk of a hard backlash of symptoms for runners trying to get back to their regular schedule too soon after even a mild covid bout.
  - el_benhameen 5y ago
    Neat, I just recovered last week and was planning on a trial run this afternoon. Do you happen to have any links to the discussion in the twitter group?
    - dv_dt 5y ago
      Not my regular crowd, I fell into a thread last week and read through it, but can't find it now. There was a lot of side sniping from the sort of covid optimism denialist crowd - so they might have deleted parts of it and went to some other venue.
    - femto 5y ago
      Not twitter, but the same topic: https://www.abc.net.au/news/2022-01-18/returning-to-exercise-post-covid-19/100750992 https://www.abc.net.au/news/2022-01-18/returning-to-exercise...
- Jcampuzano2 5y ago
  I don't do much running, mostly just weightlifting and a whole lot of walking but after I caught what I believe is the omicron variant relatively recently, I tried to go back to the gym and do a typical hard session. I felt like my heart/lungs were going to burst out of my chest after a heavy set that I normally might just be breathing mildy-heavy after. I've definitely learned to take it a little easy for a while.
EMM_386 5y ago
I have been noticeably short of breath since getting a pretty bad case of Covid (hospitalized), and that was months ago. Even things like climbing stairs has become a chore. One top of that, I was experiencing syncope on standing which they sent me to a cardiologist for. I couldn't complete the treadmill test to anyone's satisfaction so now we have to explore this further. None of this existed prior to getting Covid, and it's far past the point of "it's all in my head". With the fainting on standing, I would literally drop to my knees as the world faded to black. I've never experienced anything like that in my life. The shortness of breath is just another one to add to a list of problems now. Note I was double-vaxxed when I caught Covid. I'll have to assume Omnicron although I have no actual data on that. It was a breakthrough case and I had a 104 fever, cough, and shortness of breath (that's why they admitted me). It's been downhill since then.
- xxpor 5y ago
  I really hope they figure out what's going on :\ Do you happen to know if your resting blood pressure has changed?
  - nopenopenopeno 5y ago
    >I really hope they figure out what's going on :\ COVID-19
- TylerE 5y ago
  Lungs are no joke. I had a bad case of pneumonia that put me in the hospital for a couple days a few years back (early 30s at the time) - and it was year plus before my lungs were back to "normal"... I'm asthmatic so even my normal isn't that great. Was having to do nebulizer treatments basically every day for months.
- hughrr 5y ago
  Interesting. I didn't get hospitalized but I had what appeared to have been covid in April 2020. Before that I was running 10k quite happily but couldn't manage round the park for 2 months afterwards even though I just had a temperature and fatigue for a couple of weeks as symptoms. It took me 9 months to get over it completely.
dorchadas 5y ago
I had heart palpitations randomly for over 8 months after Covid. I still find that my extremities tend to go to sleep and start tingling regardless of what I do (even them hanging by my side). It's extremely noticeable when I wake up from sleep. Even sleeping on my back with hands to the sides all night wakes up with them completely asleep and tingling, and other parts of the body seem to go to sleep easier than they did pre-Covid. Thankfully, even though I likely had an early variant(Dec 2020), mine was not very extreme. I was constantly cold (like 45 minutes hot showers to get warm) and lost taste/smell, but I felt decent enough to run a 5k with it (probably stupidly, but at least it warmed me up), but the after effects have got me worried, especially the tingling in extremities which doesn't show any sign of going away.
- sjg007 5y ago
  Did you get vaccinated as well? Apparently the vaccine helps people with long covid.
  - tasty_freeze 5y ago
    It helps some people. But there are people for whom it makes things worse. I know one of them. She had covid early in the spring of 2020 and made very slow progress to getting better. The vaccine put her back six months at least. I'm not saying someone should not get it, but find some statistics about the likelihood it will make you better vs worse.
    - legutierr 5y ago
      Why is this getting downvoted? I’ve seen the same thing. People have very different experiences.
    - deleted 5y ago
      [deleted]
  - dorchadas 5y ago
    Yes I'm vaccinated and boosted. It didn't really help. Got my second shot March 2021 (teacher), and symptoms didn't really go away until September, and I still have some as I said.
thenerdhead 5y ago
Took me a little over 12 months to recover and feel back to normal. My heart still feels somewhat weird depending on the day, but my cardiologist told me that there's nothing to be concerned about and showed me proof that everything is working as expected. Difficulty breathing, heart palpitations, dizziness, muscle twitches, and the brain fog throughout the last year has had its toll on my mental health. Covid has brought upon one of the most depressive/anxious periods of my life. I don't know if it was because of Covid, the damage it caused along the way out, or if I had a huge panic/anxiety attack because of the symptoms. Whatever it is, I have really been working on reducing stress, focusing on my mental health, and many of these symptoms have faded away and only return when I'm a bit on edge. It has somewhat unlocked a superpower of knowing when to slow down at work, be in the present with my kids, and take a deep breath. I never had this ability before it.
nawgz 5y ago
With the supposed cardiovascular and brain dangers of COVID, I have still been working pretty hard to avoid infection, which is definitely getting to be old news. My apartment isn't that nice. Glad to see some science putting numbers on what the odds we're all against in terms of long-term damage.
- TameAntelope 5y ago
  Same, my wife and I have been more or less holed up the past month or so, waiting for our area's death rates and hospitalizations to normalize, but honestly I'd like even the case count to drop more before I venture back into the world. Yes, I could get COVID and yes, I'd probably be fine, but the more information coming out around lingering effects give me serious pause about the "everyone will get it eventually" route. I'd rather never get it, if that's possible, and honestly if the numbers continue to drop as they have been, I'm a few weeks away from that being actually possible in my area again.
  - nradov 5y ago
    The virus will never disappear. Regardless of your area's death rates, you will be exposed eventually (unless you spend the rest of your life quarantined). https://www.businessinsider.com/delta-variant-made-herd-immunity-not-possible-astrazeneca-developer-2021-8 https://www.businessinsider.com/delta-variant-made-herd-immu... https://www.medpagetoday.com/opinion/vinay-prasad/94646 https://www.medpagetoday.com/opinion/vinay-prasad/94646
    - TameAntelope 5y ago
      Yes, but eventually is not today, and a) there may be a better treatment for long COVID by then, b) hospitals in my area will hopefully be less overwhelmed, c) vaccinated, healthy people can still die to COVID-19 and, d) maybe I can skip Omicron and get some other, even less severe, variant instead. The trendline is heading towards Fall 2021 levels, which weren't great but still at my personal acceptable levels of risk. A few more weeks, hopefully. [0] https://newrepublic.com/article/163186/youll-probably-get-covid-eventually-avoid-long-can https://newrepublic.com/article/163186/youll-probably-get-co... [1] https://time.com/6133419/should-i-try-to-get-omicron/ https://time.com/6133419/should-i-try-to-get-omicron/ [2] https://www.reuters.com/business/healthcare-pharmaceuticals/why-you-should-still-try-avoid-catching-omicron-2022-01-12/ https://www.reuters.com/business/healthcare-pharmaceuticals/...
Eric_WVGG 5y ago
If anyone here has an Apple Watch and knows or suspects that they got COVID in the past year, open the Health app on your phone and look up your "v02 Max" figure on the Watch. This is a machine-learning guesstimate of how efficiently your lungs process oxygen. Here's a quick look at my measurements over the past six months, would you like to guess when I tested positive for COVID? http://whiskyvangoghgo.com/images/v02max.jpeg http://whiskyvangoghgo.com/images/v02max.jpeg (this was a huge letdown, back in September I had started a jumprope program in hopes of driving this number up, despite reading that v02-max is nearly hard-wired to a individual’s physiology)
- bamboozled 5y ago
  Do you think you think it might be worth getting assessed by medical professionals before getting too disappointed ? I have a Garmin watch and it does some pretty weird thing. My heart rate is super high apparently sometimes, it can tell me it's 180 during warmup when I'm hardly breaking a sweat, then go back down to 100 out of nowhere. Maybe my heart is not working properly but I tend to think it's the "smart watch" doing funny things. The chest HRM seems more accurate but definitely not perfect because it relies on sweat for good conductivity.
  - Eric_WVGG 5y ago
    Yeah, of course Apple and everyone else is always reminding us "this is not FDA-approved medical blah blah" I'm aware that none of this is medical-grade, but every chance I get, I'll compare the data to actual clinical measurements and I've never seen anything more than a fraction of a percent off. Furthermore, the numbers from the Watch show clear trends; if the data was scattered or random, I would think that's "doing funny things." A clear change in data mere days after a COVID diagnosis… that's not a coincidence, c'mon.
NoImmatureAdHom 5y ago
Overall a skim makes this seem like a good effort to me and potentially informative. However, I want people to understand a couple things: 1) This article is not an experiment and doesn't establish that COVID-19 is the causative agent here. They do a variety of statistical tricks to get a little closer to causality. I am particularly worried about this part: "To adjust for the difference in baseline characteristics ... variables were selected based on prior knowledge1,7,24,25. The pre-defined covariates included age, race (White, Black and Other), sex, ADI, body mass index, smoking status (current, former and never) and healthcare use parameters, including the use number of outpatient and inpatient encounters and use of long-term care. We additionally specified..." That's nice, but it involves a lot of experimenter degrees of freedom and doesn't control for the main thing that strikes me as relevant here: behavior. It's not like people were randomly selected to get COVID or not, they were getting COVID or not largely as a function of their behavior. People who are more risk-tolerant and / or less norm-compliant are going to have different health outcomes. EDIT: point 2 is wrong, I misread the data 2) The effects aren't large. For individual cardio conditions, max 1% increase. Overall, max 5% (many of which aren't serious). EDIT: begin the part I still believe again: I'd like to see an analysis that looks at these outcomes merely on the basis of care setting. I.e., if you end up in the ICU for anything at all, how does your increased risk of $CARDIO_PROBLEM change relative to COVID specifically? It's fun to talk anecdotes, but the data isn't ever as exciting as people would like to believe. I think it's very important to work against the hype machine because that's the only way we'll build real evidence-based progress.
- azeirah 5y ago
  Where do you get those effect sizes from? I'm reading the graphs in the results section with the hazard ratios. All hazard ratios are above 1.5, which if I understand hazard ratio correctly means at least a 50% higher risk compared to regular population? Am I misunderstanding hazard ratios? Or do you get the stats from elsewhere in the paper?
  - NoImmatureAdHom 5y ago
    No, I think you're right. I screwed up and was interpreting excess burden as in excess of existing burden, not excess burden per capita. I will edit. And thank you!
the_grue 5y ago
Can anyone explain the findings? A quick google of 'excess burden' term didn't yield a clear definition, there is a similar term in taxation, but that seems unrelated.
- sfteus 5y ago
  I believe that 'excess burden' is essentially how many more people than expected would show these outcomes. IE, if normally you'd expect to see 5/1000 people in a control group experience a stroke, but observe stokes in 15/1000 people in your non-control group, the excess burden would be 10/1000. HR appears to be 'hazard ratio' which is simply a ratio between the two groups. The above example would have a hazard ratio of 3, as three times as many people presented with the outcome than expected.
zjyeung 5y ago
I got Covid in December and it took me roughly around 2~3 weeks to recover. Basically my symptoms were on the light side (minor cough and lots of phlegm. Luckily I didn't have a fever but on the worst day I had a headache and fatigue. Most of the recovery period, I was just resting and not really doing any intense physical activities. It was only in January that I started running or exercising intensely and noticed only a slight decrease in performance. Mainly that was due to not exercising for a month or so. However, overall I didn't notice that running/working out was significantly (>10%) harder but In my case, I took a very longer break than other. Just some food for thought
- clairity 5y ago
  i also had a recent bout, probably omicron. 2 days of fever and fatigue, and then a couple days of light coughing to get all the resultant phlegm out. the kicker is that i feel better afterwards, due to the fever (i'm guessing) also clearing out a lingering cardiopulmonary issue (perhaps from a pneumonia bout a few years prior) that had gotten progressively worse during lockdowns (when gyms were closed for months). getting covid was a net gain for me.
jamieridely15 5y ago
jamieridely15 5y ago

136 points by dv_dt 5y ago

avalys 5y ago

Would love to see these results broken down by vaccine status as well.

gchokov 5y ago
Daishiman 5y ago
Because vaccination reduces the severity of the disease in a known fashion, the vaccination status is going to be proportionate to that.
- TrevorJ 5y ago
  That's not how science works.
  - Daishiman 5y ago
    So? The risk profile of vaccines has been researched to death as well as the effects of disease severity. Part of doing science also means having looked at enough papers and conclusions to know which questions merit further research and which questions are of little relevance to public health. It is extremely unlikely that you'll find any surprises here, and considering the open questions of long covid and long-term health effects on the population on COVID, I'd much rather the focus be on the more important questions.
    - avalys 5y ago
      We don’t understand nearly enough about Covid, long Covid, or breakthrough cases to draw any conclusion about how much the vaccine mitigates the severity of long-term outcomes in breakthrough cases. We have enough information to form an educated guess. But your attitude here is exactly why public health authorities have damaged their credibility and that of science itself in the past two years. They have repeatedly misrepresented their educated guesses as scientific fact - and then turned out to be wrong.
      - skrbjc 5y ago
        They're not "breakthrough" cases since the vaccine was never intended to stop transmission and very clearly does not stop transmission. They're just cases amongst people who took the vaccine.
        lamontcg 5y ago
        Vaccines reduce transmission. https://www.medrxiv.org/content/10.1101/2021.12.27.21268278v1 https://www.medrxiv.org/content/10.1101/2021.12.27.21268278v... > We found an increased transmission for unvaccinated individuals, and a reduced transmission for booster-vaccinated individuals, compared to fully vaccinated individuals. And their definition of unvaccinated includes partially vaccinated (1-shot) and probably includes recovered individuals. See table 2 for their results which finds that boosters do significantly reduce transmissibility and susceptibility, but it is just very far from the perfect effect everyone would have hoped and wished for. Vaccines are probably still more effective than masking in preventing transmission (given the average person's adherence to masking guidelines) and the effect would intuitively (to me anyway) seem likely to stack.
      - Daishiman 5y ago
        > But your attitude here is exactly why public health authorities have damaged their credibility and that of science itself in the past two years. They have repeatedly misrepresented their educated guesses as scientific fact - and then turned out to be wrong. Where has that happened for this? Every study that has shown disease severity correlated with vaccine usage has shown the same results, over and over, for each variant: vaccination correlates with symptomatic disease severity which correlates linearly with long-term effects, in every observed metric. This has appeared again and again and again in dozens of studies, to the point where it is the null hypothesis; you'd need to make a real case with novel, contradictory evidence to show that this is not the case. In every domain of medicine there is some degree of guessing and basing off of historical data for a cohort; you can't test every patient for every possible thing that could ever affect them. Instead you pick and choose the most significant factors and use that as your guidelines. Research efforts for COVID are very large, but also limited; there is no evidence to contradict this and it's not worth researching. If you actually kept up with domain experts during the pandemic, you'll see that there were many open questions over which they kept interest, and many open questions where they did not care much. The reason for that has to do with the acquired knowledge of having studied hundreds of other diseases and similar cases; they tell you how to explore the domain, seeing where things are likely to be different, and where they are not.
  - asveikau 5y ago
    It could be exactly how science works! You start out proposing that, perhaps based on intuition, then you do a study to confirm or deny it.
robbiep 5y ago
It appears the study date only moves up to the start of vaccine release. We’ll probably be waiting another 12 months to get that data
michalu 5y ago
At least one study (very small) seems to show that covid alone doesn't cause cardiovascular abnormalities 6 months after the disease. https://www.sciencedirect.com/science/article/pii/S1936878X21003569/ https://www.sciencedirect.com/science/article/pii/S1936878X2...

SommaRaikkonen 5y ago

colonelxc 5y ago
This study is about people who got Covid and now have issues, not issues with vaccines.
FeteCommuniste 5y ago
The article isn't about the risks of vaccination but of covid infection. The only mention of vaccines is in a section where it discusses controlling for vaccination status and concludes that the risk of myocarditis from infection is present even in the unvaccinated.
pstuart 5y ago
One thing I've wondered about with issues from vaccine side effects is if they are in any way related to how the body would respond if the actual disease was contracted. This is not to discount the effects or concerns about it -- just curiosity.
- sojournerc 5y ago
  My understanding is that the likelihood of adverse vaccine side-effects is greater after a previous COVID infection than in a "naive" immune system. This study shows >2x risk for previously infected healthcare workers. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313055/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313055/
  - _s 5y ago
    Adverse sounds serious, but really: About 105 vaccine recipients reported at least one AEFI symptoms following COVID-19 vaccination (incidence proportion 6.4%, 95% CI: 5.3%, 7.7%). All AEFI reported were minor which were managed by tablet paracetamol and subsided after 1–2 days. Fever (65, 3.98%) was the most commonly reported AEFI followed by myalgia (54, 3.30%) (Fig. 1). About 48 (2.94%) study participants reported 2 or more AEFI, most common being fever with myalgia (19, 1.16%) and fever with headache (18, 1.10%). No severe or serious AEFI was reported among vaccine recipients.

throwaway22032 5y ago

The meat of this seems to be in confirming that if you're not hospitalized the long-term effects are minimal. Not _zero_, but very small. The abstract states that "These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection", but I'd urge attention to the data as this implies only that there is a detectable change, it's not a judgement on the size of the risk. The worst cases are in intubated patients that basically lost proper oxygen flow for extended periods of time.

wwweston 5y ago
I'd guess you're being downvoted because the article describes a different conclusion: "[long term] risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection." Though it does seem to make a distinction in grade ("these risks increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care)"), it doesn't seem to support the idea that the impacts are limited to the hospitalized.
- throwaway22032 5y ago
  Yes, it's evident in the scientific sense of the word - the risks exist. They're just very small. If you look at the data, the risk ratios are in the range of 1.0x-2.0x, on outcomes which in healthy individuals are extremely rare to begin with. Same with the excess figures. The logical conclusion given the rest of the data is that these outcomes would be concentrated in those who were very ill but below the threshold of hospitalization. The study itself doesn't bin the groups far enough to show the implication for the asymptomatic or those with very minor symptoms, but there's a clear exponential trend that associates acute severity with long-term severity supra-linearly.
  - dekhn 5y ago
    replying just to emphasize that relative risks always sound huge until you find out they're relative to a very small baseline.

ProAm 5y ago

My heart had wild palpitations for several days in the midst of having covid and post covid my resting heart rate is ~20bpm higher during the day and ~30 bpm higher during the night.

arghnoname 5y ago
I had a very similar reaction that correlates to getting the vaccine. It took months for my resting heart rate to return to pre-vaccination levels. Maybe this means I would have died had I caught covid, maybe not, no way to know. It's scary how much this spike protein / immune response / etc seems to provoke adverse cardiovascular responses, even if there is full recovery in most of us.
- dv_dt 5y ago
  The vaccine is the safer controlled introduction to it in comparison to getting a full covid exposure. In a full covid case w/o being vaccinated would introduce more spike protein as well as a exposure to the sequences of the rest of the virus which could cause all sorts of other issues.
- nwiswell 5y ago
  > It's scary how much this spike protein / immune response / etc seems to provoke adverse cardiovascular responses, even if there is full recovery in most of us. Honestly I am wondering if this is sampling bias. Have we ever paid this much concentrated attention to a disease? When you consider what a virus does to the body, it seems likely that many other viruses that have been endemic for millennia have been wreaking pernicious havoc on our bodies and we just... shrugged it off. Anyplace the body heals from a significant physical injury, there is a scar. It's never a perfect restoration. It seems almost intuitive that the damage from a virus would be similar, and there is documented evidence that COVID will attack neurons.
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noipv4 5y ago

After a bout of Covid and Moderna vaccines, I am now on a beta blocker, a Ca channel blocker and an ACE inhibitor along with a diuretic. I had never seen such high BP 180/140 in my arms. The virus and the S1 protein messed with my heart.

likeabbas 5y ago
That sucks man :/ my anecdotal experience after having the original Covid strain and 3 full Moderna shots is that my heart is fine. BP is back to 105/60, resting heart rate is 50. I had long Covid for 8 months that fucked with my ability to workout and play tennis but now my stamina is fine.
techsin101 5y ago
my BP is also out of whack and it's been 5 months since i had covid so i dont think it's getting better

xiphias2 5y ago

It’s interesting to see less obese and younger people more affected. Maybe it’s either because of vaccine status that another commenter asked for, or more deaths in those cohorts.

throw3838 5y ago

I got high cholesterol, and I am in risk of hearth attack. Never had covid, just poor health due to prolonged lockdowns and closed gyms.

nhance 5y ago
Maybe you should start habits that change this? You can try to blame this on someone else, but it's your own choices that put you here.
- throw3838 5y ago
  My own choice? I followed legally mandated lockdown. But I ensure you I learned my lesson!
  - ChrisClark 5y ago
    You chose not to exercise. It's is completely on you.
  - ganbatekudasai 5y ago
    Lockdown made my work out more: Since I have no commute time anymore, I took up regular running (3x a week). Very significant increase in fitness.
    - throw3838 5y ago
      Not everyone want to run with mask around dirty city block. It is really interesting to see this mental gymnastics, if someone is fat, gets virus and dies, it is "the plague". But here we have dozen people talking about "personal responsibility".
      - threeseed 5y ago
        a) Never seen a single city mandate masks for exercising outside. Especially since it’s quite dangerous to limit your oxygen flow. So you should have been fine to run outside. b) Some of the toughest workouts I’ve done were inside. You need to stop being so close minded.

dv_dt 5y ago

Aside from the study being interesting topic, I love the inclusion of Fig 1 the cohort construction diagram. I wish more papers would include that as a standard item.

dijit 5y ago

I had an awful experience running for the first time after contracting COVID.. Unsure what strain I had but it was recent and I was careful so it's likely the "milder" omicron variant. At the Gym, 3 weeks after testing positive the first time, I ran for 60s at 11km/h on the treadmill and my heart rate was 180bpm by the end. For context, a 60s jog at that same speed prior to being afflicted would have resulted in a 130bpm heart rate. Normally it would take running for 45 minutes to get to 180bpm.. But I got there (and felt awful) in 60s. I had to stop running.

dv_dt 5y ago
Be careful returning to a full exercise schedule, esp after seeing effects like that. I see a running twitter group anecdotally observing a risk of a hard backlash of symptoms for runners trying to get back to their regular schedule too soon after even a mild covid bout.
- el_benhameen 5y ago
  Neat, I just recovered last week and was planning on a trial run this afternoon. Do you happen to have any links to the discussion in the twitter group?
  - dv_dt 5y ago
    Not my regular crowd, I fell into a thread last week and read through it, but can't find it now. There was a lot of side sniping from the sort of covid optimism denialist crowd - so they might have deleted parts of it and went to some other venue.
  - femto 5y ago
    Not twitter, but the same topic: https://www.abc.net.au/news/2022-01-18/returning-to-exercise-post-covid-19/100750992 https://www.abc.net.au/news/2022-01-18/returning-to-exercise...
Jcampuzano2 5y ago
I don't do much running, mostly just weightlifting and a whole lot of walking but after I caught what I believe is the omicron variant relatively recently, I tried to go back to the gym and do a typical hard session. I felt like my heart/lungs were going to burst out of my chest after a heavy set that I normally might just be breathing mildy-heavy after. I've definitely learned to take it a little easy for a while.

EMM_386 5y ago

I have been noticeably short of breath since getting a pretty bad case of Covid (hospitalized), and that was months ago. Even things like climbing stairs has become a chore. One top of that, I was experiencing syncope on standing which they sent me to a cardiologist for. I couldn't complete the treadmill test to anyone's satisfaction so now we have to explore this further. None of this existed prior to getting Covid, and it's far past the point of "it's all in my head". With the fainting on standing, I would literally drop to my knees as the world faded to black. I've never experienced anything like that in my life. The shortness of breath is just another one to add to a list of problems now. Note I was double-vaxxed when I caught Covid. I'll have to assume Omnicron although I have no actual data on that. It was a breakthrough case and I had a 104 fever, cough, and shortness of breath (that's why they admitted me). It's been downhill since then.

xxpor 5y ago
I really hope they figure out what's going on :\ Do you happen to know if your resting blood pressure has changed?
- nopenopenopeno 5y ago
  >I really hope they figure out what's going on :\ COVID-19
TylerE 5y ago
Lungs are no joke. I had a bad case of pneumonia that put me in the hospital for a couple days a few years back (early 30s at the time) - and it was year plus before my lungs were back to "normal"... I'm asthmatic so even my normal isn't that great. Was having to do nebulizer treatments basically every day for months.
hughrr 5y ago
Interesting. I didn't get hospitalized but I had what appeared to have been covid in April 2020. Before that I was running 10k quite happily but couldn't manage round the park for 2 months afterwards even though I just had a temperature and fatigue for a couple of weeks as symptoms. It took me 9 months to get over it completely.

dorchadas 5y ago

I had heart palpitations randomly for over 8 months after Covid. I still find that my extremities tend to go to sleep and start tingling regardless of what I do (even them hanging by my side). It's extremely noticeable when I wake up from sleep. Even sleeping on my back with hands to the sides all night wakes up with them completely asleep and tingling, and other parts of the body seem to go to sleep easier than they did pre-Covid. Thankfully, even though I likely had an early variant(Dec 2020), mine was not very extreme. I was constantly cold (like 45 minutes hot showers to get warm) and lost taste/smell, but I felt decent enough to run a 5k with it (probably stupidly, but at least it warmed me up), but the after effects have got me worried, especially the tingling in extremities which doesn't show any sign of going away.

sjg007 5y ago
Did you get vaccinated as well? Apparently the vaccine helps people with long covid.
- tasty_freeze 5y ago
  It helps some people. But there are people for whom it makes things worse. I know one of them. She had covid early in the spring of 2020 and made very slow progress to getting better. The vaccine put her back six months at least. I'm not saying someone should not get it, but find some statistics about the likelihood it will make you better vs worse.
  - legutierr 5y ago
    Why is this getting downvoted? I’ve seen the same thing. People have very different experiences.
  - deleted 5y ago
    [deleted]
- dorchadas 5y ago
  Yes I'm vaccinated and boosted. It didn't really help. Got my second shot March 2021 (teacher), and symptoms didn't really go away until September, and I still have some as I said.

thenerdhead 5y ago

Took me a little over 12 months to recover and feel back to normal. My heart still feels somewhat weird depending on the day, but my cardiologist told me that there's nothing to be concerned about and showed me proof that everything is working as expected. Difficulty breathing, heart palpitations, dizziness, muscle twitches, and the brain fog throughout the last year has had its toll on my mental health. Covid has brought upon one of the most depressive/anxious periods of my life. I don't know if it was because of Covid, the damage it caused along the way out, or if I had a huge panic/anxiety attack because of the symptoms. Whatever it is, I have really been working on reducing stress, focusing on my mental health, and many of these symptoms have faded away and only return when I'm a bit on edge. It has somewhat unlocked a superpower of knowing when to slow down at work, be in the present with my kids, and take a deep breath. I never had this ability before it.

nawgz 5y ago

With the supposed cardiovascular and brain dangers of COVID, I have still been working pretty hard to avoid infection, which is definitely getting to be old news. My apartment isn't that nice. Glad to see some science putting numbers on what the odds we're all against in terms of long-term damage.

TameAntelope 5y ago
Same, my wife and I have been more or less holed up the past month or so, waiting for our area's death rates and hospitalizations to normalize, but honestly I'd like even the case count to drop more before I venture back into the world. Yes, I could get COVID and yes, I'd probably be fine, but the more information coming out around lingering effects give me serious pause about the "everyone will get it eventually" route. I'd rather never get it, if that's possible, and honestly if the numbers continue to drop as they have been, I'm a few weeks away from that being actually possible in my area again.
- nradov 5y ago
  The virus will never disappear. Regardless of your area's death rates, you will be exposed eventually (unless you spend the rest of your life quarantined). https://www.businessinsider.com/delta-variant-made-herd-immunity-not-possible-astrazeneca-developer-2021-8 https://www.businessinsider.com/delta-variant-made-herd-immu... https://www.medpagetoday.com/opinion/vinay-prasad/94646 https://www.medpagetoday.com/opinion/vinay-prasad/94646
  - TameAntelope 5y ago
    Yes, but eventually is not today, and a) there may be a better treatment for long COVID by then, b) hospitals in my area will hopefully be less overwhelmed, c) vaccinated, healthy people can still die to COVID-19 and, d) maybe I can skip Omicron and get some other, even less severe, variant instead. The trendline is heading towards Fall 2021 levels, which weren't great but still at my personal acceptable levels of risk. A few more weeks, hopefully. [0] https://newrepublic.com/article/163186/youll-probably-get-covid-eventually-avoid-long-can https://newrepublic.com/article/163186/youll-probably-get-co... [1] https://time.com/6133419/should-i-try-to-get-omicron/ https://time.com/6133419/should-i-try-to-get-omicron/ [2] https://www.reuters.com/business/healthcare-pharmaceuticals/why-you-should-still-try-avoid-catching-omicron-2022-01-12/ https://www.reuters.com/business/healthcare-pharmaceuticals/...

Eric_WVGG 5y ago

If anyone here has an Apple Watch and knows or suspects that they got COVID in the past year, open the Health app on your phone and look up your "v02 Max" figure on the Watch. This is a machine-learning guesstimate of how efficiently your lungs process oxygen. Here's a quick look at my measurements over the past six months, would you like to guess when I tested positive for COVID? http://whiskyvangoghgo.com/images/v02max.jpeg http://whiskyvangoghgo.com/images/v02max.jpeg (this was a huge letdown, back in September I had started a jumprope program in hopes of driving this number up, despite reading that v02-max is nearly hard-wired to a individual’s physiology)

bamboozled 5y ago
Do you think you think it might be worth getting assessed by medical professionals before getting too disappointed ? I have a Garmin watch and it does some pretty weird thing. My heart rate is super high apparently sometimes, it can tell me it's 180 during warmup when I'm hardly breaking a sweat, then go back down to 100 out of nowhere. Maybe my heart is not working properly but I tend to think it's the "smart watch" doing funny things. The chest HRM seems more accurate but definitely not perfect because it relies on sweat for good conductivity.
- Eric_WVGG 5y ago
  Yeah, of course Apple and everyone else is always reminding us "this is not FDA-approved medical blah blah" I'm aware that none of this is medical-grade, but every chance I get, I'll compare the data to actual clinical measurements and I've never seen anything more than a fraction of a percent off. Furthermore, the numbers from the Watch show clear trends; if the data was scattered or random, I would think that's "doing funny things." A clear change in data mere days after a COVID diagnosis… that's not a coincidence, c'mon.

NoImmatureAdHom 5y ago

Overall a skim makes this seem like a good effort to me and potentially informative. However, I want people to understand a couple things: 1) This article is not an experiment and doesn't establish that COVID-19 is the causative agent here. They do a variety of statistical tricks to get a little closer to causality. I am particularly worried about this part: "To adjust for the difference in baseline characteristics ... variables were selected based on prior knowledge1,7,24,25. The pre-defined covariates included age, race (White, Black and Other), sex, ADI, body mass index, smoking status (current, former and never) and healthcare use parameters, including the use number of outpatient and inpatient encounters and use of long-term care. We additionally specified..." That's nice, but it involves a lot of experimenter degrees of freedom and doesn't control for the main thing that strikes me as relevant here: behavior. It's not like people were randomly selected to get COVID or not, they were getting COVID or not largely as a function of their behavior. People who are more risk-tolerant and / or less norm-compliant are going to have different health outcomes. EDIT: point 2 is wrong, I misread the data 2) The effects aren't large. For individual cardio conditions, max 1% increase. Overall, max 5% (many of which aren't serious). EDIT: begin the part I still believe again: I'd like to see an analysis that looks at these outcomes merely on the basis of care setting. I.e., if you end up in the ICU for anything at all, how does your increased risk of $CARDIO_PROBLEM change relative to COVID specifically? It's fun to talk anecdotes, but the data isn't ever as exciting as people would like to believe. I think it's very important to work against the hype machine because that's the only way we'll build real evidence-based progress.

azeirah 5y ago
Where do you get those effect sizes from? I'm reading the graphs in the results section with the hazard ratios. All hazard ratios are above 1.5, which if I understand hazard ratio correctly means at least a 50% higher risk compared to regular population? Am I misunderstanding hazard ratios? Or do you get the stats from elsewhere in the paper?
- NoImmatureAdHom 5y ago
  No, I think you're right. I screwed up and was interpreting excess burden as in excess of existing burden, not excess burden per capita. I will edit. And thank you!

the_grue 5y ago

Can anyone explain the findings? A quick google of 'excess burden' term didn't yield a clear definition, there is a similar term in taxation, but that seems unrelated.

sfteus 5y ago
I believe that 'excess burden' is essentially how many more people than expected would show these outcomes. IE, if normally you'd expect to see 5/1000 people in a control group experience a stroke, but observe stokes in 15/1000 people in your non-control group, the excess burden would be 10/1000. HR appears to be 'hazard ratio' which is simply a ratio between the two groups. The above example would have a hazard ratio of 3, as three times as many people presented with the outcome than expected.

zjyeung 5y ago

I got Covid in December and it took me roughly around 2~3 weeks to recover. Basically my symptoms were on the light side (minor cough and lots of phlegm. Luckily I didn't have a fever but on the worst day I had a headache and fatigue. Most of the recovery period, I was just resting and not really doing any intense physical activities. It was only in January that I started running or exercising intensely and noticed only a slight decrease in performance. Mainly that was due to not exercising for a month or so. However, overall I didn't notice that running/working out was significantly (>10%) harder but In my case, I took a very longer break than other. Just some food for thought

clairity 5y ago
i also had a recent bout, probably omicron. 2 days of fever and fatigue, and then a couple days of light coughing to get all the resultant phlegm out. the kicker is that i feel better afterwards, due to the fever (i'm guessing) also clearing out a lingering cardiopulmonary issue (perhaps from a pneumonia bout a few years prior) that had gotten progressively worse during lockdowns (when gyms were closed for months). getting covid was a net gain for me.

jamieridely15 5y ago