6 ms·

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 w

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.
  - robrorcroptrer 5y ago
    Sorry I genuinely do not understand what this means. Could it be explained in some other wording?
    - npinsker 5y ago
      This means that expressing changes in a tiny value relative to its baseline (e.g. "3x as likely") sounds more impactful than expressing the same changes in absolute terms (e.g. "from 0.01% to 0.03%").
    - mvcalder 5y ago
      I bought one lottery ticket. Then I went back and bought two more, now I have 3-times the chance to win $100 million!
- dTal 5y ago
  You have moved the goalposts from "not hospitalized" to "asymptomatic or very minor symptoms". About half the people I know who got covid (and knew about it) had, or are currently having, a very unpleasant time.
  - throwaway22032 5y ago
    The study itself states that in patients that are not hospitalized the risks of various heart conditions increase on average by ~1.5-2x. That's for the entire cohort of non-hospitalized individuals, it's an average. If you assume that they're uniformly distributed (e.g. if you assume that the relative risk of future myocarditis is identical for someone who has no symptoms, and for someone who's bedridden for a week with breathing difficulties but non-hospitalized), the figures show that if you're not hospitalized your risk of myocarditis and other heart issues is multiplied by about 2. If the study were binned more finely I think you'd see a 5x multiplier if you have mild illness (mild in the clinical sense which simply means non-hospitalized but exhibiting symptoms) or no discernable effect if asymptomatic. I agree that there is no specific data for this, I'm extrapolating the curve. > About half the people I know who got covid (and knew about it) had, or are currently having, a very unpleasant time. We're not debating this point, this is a paper showing the correlation between the short term and long term effects of the disease.
    - dTal 5y ago
      You say "only" a doubling of the risk of rare heart related issues, over the course of a single year. I say gee, it sure sounds like the virus massively fucked with their system. Large statistical anomalies are measurable an entire year later. Whether the baseline risk of such issues is high or low is irrelevant, since the main takeaway is that everyone basically gets Long Covid, to a greater or lesser extent. Remember that this isn't the only measurable effect either - it's just the one this paper is talking about, and it fits into a wider pattern of research indicating systemic damage even in so-called "minor" cases. Again, speaking from both personal anecdata and the wider scientific consensus - if you have symptomatic covid, it takes you a long time to feel "normal" again.
- dv_dt 5y ago
  Individually maybe small (I actually am not sure 1-2x seem like a minimization of the impact but I'd leave it to further reading and discussion to settle that), but in a public health sense it might mean a doubling of cardio treatment resources in a system where growing those resources is not a fast response and could have follow on effects on quality and availability of treatments.
  - deleted 5y ago
    [deleted]

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.
- robrorcroptrer 5y ago
  Sorry I genuinely do not understand what this means. Could it be explained in some other wording?
  - npinsker 5y ago
    This means that expressing changes in a tiny value relative to its baseline (e.g. "3x as likely") sounds more impactful than expressing the same changes in absolute terms (e.g. "from 0.01% to 0.03%").
  - mvcalder 5y ago
    I bought one lottery ticket. Then I went back and bought two more, now I have 3-times the chance to win $100 million!
dTal 5y ago
You have moved the goalposts from "not hospitalized" to "asymptomatic or very minor symptoms". About half the people I know who got covid (and knew about it) had, or are currently having, a very unpleasant time.
- throwaway22032 5y ago
  The study itself states that in patients that are not hospitalized the risks of various heart conditions increase on average by ~1.5-2x. That's for the entire cohort of non-hospitalized individuals, it's an average. If you assume that they're uniformly distributed (e.g. if you assume that the relative risk of future myocarditis is identical for someone who has no symptoms, and for someone who's bedridden for a week with breathing difficulties but non-hospitalized), the figures show that if you're not hospitalized your risk of myocarditis and other heart issues is multiplied by about 2. If the study were binned more finely I think you'd see a 5x multiplier if you have mild illness (mild in the clinical sense which simply means non-hospitalized but exhibiting symptoms) or no discernable effect if asymptomatic. I agree that there is no specific data for this, I'm extrapolating the curve. > About half the people I know who got covid (and knew about it) had, or are currently having, a very unpleasant time. We're not debating this point, this is a paper showing the correlation between the short term and long term effects of the disease.
  - dTal 5y ago
    You say "only" a doubling of the risk of rare heart related issues, over the course of a single year. I say gee, it sure sounds like the virus massively fucked with their system. Large statistical anomalies are measurable an entire year later. Whether the baseline risk of such issues is high or low is irrelevant, since the main takeaway is that everyone basically gets Long Covid, to a greater or lesser extent. Remember that this isn't the only measurable effect either - it's just the one this paper is talking about, and it fits into a wider pattern of research indicating systemic damage even in so-called "minor" cases. Again, speaking from both personal anecdata and the wider scientific consensus - if you have symptomatic covid, it takes you a long time to feel "normal" again.
dv_dt 5y ago
Individually maybe small (I actually am not sure 1-2x seem like a minimization of the impact but I'd leave it to further reading and discussion to settle that), but in a public health sense it might mean a doubling of cardio treatment resources in a system where growing those resources is not a fast response and could have follow on effects on quality and availability of treatments.
- deleted 5y ago
  [deleted]