12 ms·

Covid and the Heart: It Spares No One – Johns Hopkins

192 points by alwillis 5y ago

Dharmat55 5y ago
smitty1110 5y ago
Dr. Al-Aly's paper is here: https://www.nature.com/articles/s41591-022-01689-3?s=08 https://www.nature.com/articles/s41591-022-01689-3?s=08
- yamrzou 5y ago
  Previous discussion: https://news.ycombinator.com/item?id=30249618 https://news.ycombinator.com/item?id=30249618
azth 5y ago
What about those that took the vaccine?
- blueline 5y ago
  > This study was done before vaccination was widely available. Is there any indication that, for example, breakthrough infections would have a different result long term? > Yes. We are [studying] this, but I think the jury is still out. We're certainly very interested in addressing that publicly as soon as we can.
  - smegsicle 5y ago
    neat! that first quoted line has css text-transform:uppercase in the article, so firefox copies as original, lowercase text, but chromium copies as all caps!
- lapetitejort 5y ago
  > THIS STUDY WAS DONE BEFORE VACCINATION WAS WIDELY AVAILABLE. IS THERE ANY INDICATION THAT, FOR EXAMPLE, BREAKTHROUGH INFECTIONS WOULD HAVE A DIFFERENT RESULT LONG TERM? > Yes. We are [studying] this, but I think the jury is still out. We're certainly very interested in addressing that publicly as soon as we can.
- exo-pla-net 5y ago
  If you're referring to cases of myocarditis caused by vaccination itself, the cases are negligible: 2.3 per 100,000 [1]. Compare that with the apparent near-certainty of heart damage (and likely brain damage) if you contract COVID while being unvaccinated, and the decision to not get vaccinated is not just selfish but self-destructive. [1] https://www.nejm.org/doi/full/10.1056/NEJMoa2110737 https://www.nejm.org/doi/full/10.1056/NEJMoa2110737
  - vikingerik 5y ago
    Heart damage from Covid is nothing like a "near-certainty". The vast majority don't experience it, upwards of 95% depending on the study. Framing this as "near-certainty" or "spares no one" is irresponsible fear-mongering.
    - pdonis 5y ago
      The study is not saying that 95% of people who get COVID do not experience heart damage. It is only saying that 95% of people who get COVID did not have a heart-related acute event in the time period examined. That doesn't mean they had no heart damage at all. Their hearts were not directly examined. The point of this study was to assess whether people who have had COVID are at increased risk for heart-related problems (and the conclusion was that yes, they are), not to assess what percentage of them had actual heart damage.
    - Daishiman 5y ago
      95% is not a "vast majority"; that's 5% of the population with quantifiable degradation in heart function. I fear for the catastrophe it will cause 20 years down the line in increased disease burden.
    - exo-pla-net 5y ago
      Near-certainty is literally the finding of the linked article. You're confusing your numbers. Heart damage != heart attacks.
    - runako 5y ago
      This claim really requires a citation of some sort. In particular, > don't experience it is reckless, given that we know the vast majority of heart disease is undiagnosed until there are symptoms.
darzu 5y ago
What’s the effect size? Didn’t see this anywhere in the article and seems pretty important to know.
rkk3 5y ago
What was the methodology around asymptomatic covid cases and cardiac outcomes? This seems like a sensationalist claim.
mmaunder 5y ago
Don’t obsess over this. It’ll distract you and stress you out, which comes with its own health risks. None of us get out alive anyway. Go live as healthy a life as you can, find happiness, and help others when the opportunity presents.
- vkou 5y ago
  You don't need to obsess over this, but you do need to remember that there has been, and continues to be a large pro-COVID faction that insists that getting everyone sick with it will be no big deal, because it only kills <0.X%> of people in <particular age range>. They were, of course, speaking from a position of ignorance of long-term side effects, because the data wasn't yet in. It's been two years, and in many ways, the data is still not in yet. We'll have another go-around[1] on the COVID rodeo next holiday season, if another dangerous variant emerges. [1] Just because the news has forgotten about the virus, doesn't mean that the virus has forgotten about us. There are more daily worldwide cases right now, then there have been at any point prior to November 2021. That's a lot of opportunity for variants to mutate.
  - mwint 5y ago
    > It's been two years, and in many ways, the data is still not in yet. But we hopefully aren’t expected to hide until the data are in?
    - vkou 5y ago
      You're expected to take simple, cheap precautions, proportionate to the expected consequences. You're also expected to not take what you think is the best case scenario, and extrapolate that it's the scenario that we are actually in.
      - bamboozled 5y ago
        One cannot live in 2022 without catching covid, the level of precautions I would have to take to avoid it would be extreme and damage my quality of life and probably my mental health. I've definitely had it once, likely twice, just doing basic things exposes me to it now, so what can I do?
kragen 5y ago
A more accurate headline would be "it spares 93%–97% of people," though the interview meticulously omitted almost all quantifiable information. The hazard ratios in the paper smitty1110 cited https://www.nature.com/articles/s41591-022-01689-3?s=08 https://www.nature.com/articles/s41591-022-01689-3?s=08 are mostly 1.49–1.85, which as I understand it means that people with covid were 1½–2 times as likely to experience the condition, pericarditis or stroke or whatever, than thr control group. The exceptions are things that normally happen only once in a lifetime, like cardiac arrest (HR=2.45), so we're still talking about a tiny fraction of people. This justifies the statement in the paper's abstract, "Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial," but (unless I'm misunderstanding the paper) shows that the interview headline is an irresponsible, sensationalist lie.
- exo-pla-net 5y ago
  False. > We went into it thinking that [the risk] was going to be most pronounced and evident in people who smoked a lot or had diabetes, heart disease, kidney disease, or some [other] risk factors. What we found is that even in people who did not have any heart problems start with, were athletic, did not have a high BMI, were not obese, did not smoke, did not have kidney disease or diabetes—even in people who were previously healthy and had no risk factors or problems with the heart—COVID-19 affected them in such a way that manifested the higher risk of heart problems than people who did not get COVID-19. They found that even mild COVID damaged otherwise healthy people's hearts so badly that their risk for heart problems are now comparable to those of obese people. In other words, it does damage your heart. That damage might result in a heart attack, reflected in the increased hazard ratio.
  - bigfudge 5y ago
    No, there's not enough data to be sure either way, but given that some/most people experience absolutely no lingering symptoms the simplest explanation is that even mild disease cases damage in some people. EDIT: to be clear. We have no idea if the outcome-generating process is continuous or discontinuous. You seem to think it's continuous, analogous to risks from smoking or obesity, but others would assume not.
quadrifoliate 5y ago
Looking at the title, I am sad to see the discourse in research sink to this level over the last few years (well, I think so – perhaps it was already at this level before?). Honestly, it's hard to blame the author(s) for using such a clickbait title when Governments across the world have done precisely the same thing by trivializing the effects of a largely unknown disease, banning public health measures, or declaring the lifting of public health restrictions as a "Freedom Day". I don't have a great solution for this – perhaps just that we should all tend towards discourse that is a bit more dry and phrased in terms of data; and steer it back to that phrasing when required.
- EricE 5y ago
  The experiences of countries that didn't lock down proves that the "restrictions" were ineffective at best and more and more it looks like they caused and are continuing to cause more harm. Lockdowns in cities was particularly dumb. Let's lock everyone indoor, in apartment buildings with shared air systems - yup, brilliant strategy for a highly contagious respiratory virus. If the weather is nice enough for people to be outside, the more that are outside the better! The selective enforcement driven by non-medial reasoning was even more egregious. For example, forcing small businesses to close while allowing big box stores to remain open - either the virus is deadly enough to warrant the prohibition of ALL public contact or it isn't. Same with the ridiculous posturing during the "summer of love" as if the virus was smart enough to avoid spreading at BLM protests, but deadly everywhere else outdoors. All the lockdowns did was foster the greatest transfer of wealth from the little guys to the big guys in all of human history :p Even the definition of "emergency" is now hopelessly devalued. The best analogy to demonstrate this that I have heard: If someone asks to borrow your car for two weeks and after two years they still haven't brought it back, they are no longer borrowing your car. How many people ended up in the hospital on a ventilator and potentially died needlessly while the government panned ivermectin and HCQ and the media/big tech demonized, banned and flat out declared war on anyone talking about anything other than complying with ridiculous mandates and vaccination as the only solution? Going on a ventilator was a 50/50 death sentence. ANYTHING that could have POSSIBLY prevented ANYONE from ever having to go into the hospital should have been thrown at anyone willing to try it. Ivermectin and HCQ are DECADES old, given to millions if not billions of people and even if they were 100% ineffective they certainly were not going to do harm to the VAST majority of people. But here we are. People still make fun of Ivermectin with the "horse dewormer" slur. It's very common for drugs to have human and animal uses and anyone who implies otherwise is either grossly ignorant or the most evil kind of person out there deliberately distorting actual science for political/tribal reasons. I could go on, but the parameters of the disease were well known by the March after the December the virus really broke on our consciousness. The real problem is politics and money took over. Big pharma had a risk free gravy train as long as the "restrictions" and vaccine mandates were underway. Politicians got to boss people around and make themselves even more important. The government, media and big tech blatantly collaborated in flogging the messaging in ways never before seen in human history. Trust in government, the media and big tech is at an all time low for very, very good reasons. What's going to be really tragic - there may be a future biological incident where there are legitimate reasons for dramatic and long term restrictions; good luck getting everyone to cooperate after the ridiculous way COVID was handled. The more evidence that keeps coming out that much of the response and overreaction to it was utterly unwarranted, the more trust is going to be eroded. The most egregious that I am just dumbfounded that here is ongoing controversy over: it's beyond criminal that ANY kids are being forced to still wear face masks. It's flat out child abuse mainly to pleasure the teacher unions. That you seem to be implying that governments didn't take COVID seriously enough when it's beyond obvious now that the opposite is true - the vast majority of governments dramatically overreacted and probably made things FAR worse with their policies shows just how big of a disconnect remains, unfortunately.
etaioinshrdlu 5y ago
I had chest pains for the first time in my life in 2021 and I’m in late 20’s. Doctor couldn’t find anything. Felt much better after a month. But it came back after getting a booster. I had COVID confirmed in 2020 with no such issues. For me, as far as i can tell, the chest pains are more correlated with the vaccinations. I’m rather grumpy at the idea of getting additional boosters.
- abhishekjha 5y ago
  Surprisingly I am having the same symptoms. Like I can feel chest pain during cycling and hours after I am done. This was not the case earlier. I haven't got it checked yet. I am gonna do that soon.
- brianwawok 5y ago
  It's possible they are related, or also possible just coincidence. When I was 31 or 32 I had a bout of crazy chest pains. Did all the tests, got all the EKGs... end result was Dr told me I was fine, lay off the stress. Has not come back, so I think it was just a reminder to take care of my flesh bag a big better.
- yosito 5y ago
  I'm sorry you had that experience with vaccines. I know it won't make much difference to you personally, but the truth is that these sorts of chest pains and heart problems are far more common in immune-naive people who are infected with covid than in people who get vaccines.
  - andrew_ 5y ago
    Could you drop a link to some research for side effects of immune-naive infection versus vaccine? I've read the latest on the Pfizer side effects but have nothing to compare it to for immune-naive infection effects and rate of those kinds of symptoms.
  - EricE 5y ago
    Citation needed! In fact, there is more and more data every day the EXACT opposite is true.
anamax 5y ago
Do we know whether Covid-19 is different wrt heart and other effects than other corona viruses or even flu viruses in general? For example, how is Covid-19/SARS-CoV-2 different from 2002-4's SARS-CoV-1 in this respect? I ask because the reports of mental sluggishness for a couple of months after Covid-19 reminded me of how I felt after some previous flus.
- andrew_ 5y ago
  New studies are suggesting links to nerve damage as a cause for long-covid symptoms https://www.nbcnews.com/health/health-news/long-covid-symptoms-may-linked-nerve-damage-small-study-rcna18145 https://www.nbcnews.com/health/health-news/long-covid-sympto...
  - anamax 5y ago
    My question is how different covid-19 is. One of the things that has come out of Covid-19 is how little was actually known about flus, despite the fact that flus have been killing 30-70k Americans each year for decades. This ignorance is "interesting" because "we need to be ready for the next Spanish flu" has been at the core of the "give us more money for research" argument for decades. For example, it looks like we still don't understand transmission in any useful sense. There was some reasonable research in the late 40s but we've learned more in the last two years than in the intervening 80 years. Yes, some of the tools used in the last two years weren't available 20 years ago but they were available 10 years ago. That said, many of the tools have been available, albeit unused, for 80+ years.
    - avgDev 5y ago
      I think going forward we are going to learn a lot more about these long term issues. Before COVID, getting chronic fatigue from flu was mostly ignored by the medical community. Now, with popularity of covid a lot more doctors are aware of some possible neurological issues. There have been case studies, research and support groups for these things for many years. However, handful of physicians treating patients. I am now seeing more doctors seeing patients with odd symptoms at clinics all over the US, some even have ads targeting long covid. I think we are going to make some major advancements in the next 10 years, and I'm happy many suffering quietly will be heard.
throwawaycities 5y ago
There was a lot of information coming out of college athletics early on consistent with the research in this article. Young, healthy athletes that were asymptomatic showed signs of inflammation in the heart. Since then there were follow up studies which were split in their findings. The early studies used MRI testing and suggested “high-risk” of heart damage/myocarditis in the athletes. Follow up studies tended not to use MRI, opting for testing for certain proteins associated with heart inflammation and ultra sounds and those studies found heart damage to be uncommon in the athletes.
- thelettere 5y ago
  If there's been such heart damage to athletes that caught it, how come they all are invariably coming back to the same exact performance they had previously? Is there such a thing as damage to the heart that has no effect on performance, particularly the incredibly demanding kinds of performances that sports like professional basketball require?
  - reggedtorespond 5y ago
    They haven't all. Look up Asia Durr if you want an anecdote. #2 draft pick for WBNA and hasn't played since her rookie season due to long haul covid effects. I am not aware of any study on covid in athletes in particular, though.
    - thelettere 5y ago
      Huh, you've got to reach to the WNBA to find someone. Kinda proves my point. Edit: And to all the wonderful people who no doubt checked themselves to make sure they had expertise on the subject before they downvoted my question (!), here's some food for thought: A 2021 study of 789 professional athletes found that only 5 (0.6%) had heart inflammation. https://jamanetwork.com/journals/jamacardiology/fullarticle/2777308 https://jamanetwork.com/journals/jamacardiology/fullarticle/... Another study found that COVID in athletes was rarely serious: "The severity of COVID-19 in elite athletes is predominantly mild and without complications. Athletes can return to sport after two symptom-free weeks and additional heart screening is usually not required." https://www.sciencedirect.com/science/article/pii/S1440244021001791 https://www.sciencedirect.com/science/article/pii/S144024402... 2021 review of 12 studies: "Athletes have an overall low risk of SARS-CoV-2 pericardial/myocardial involvement, arrhythmias and SCA/SCD." https://bmjopensem.bmj.com/content/7/4/e001164.abstract https://bmjopensem.bmj.com/content/7/4/e001164.abstract 2022 editorial review: "Most importantly, to date, there have been no acute adverse cardiac events reported as a direct consequence of COVID-19 infection in the athletes included in these large registries" and noted that the few smaller studies that deviated from these findings were badly designed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8730531/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8730531/ 2022 study: "These data add to the growing body of the literature and agree with larger cohorts that the risk of cardiac involvement post-infection appears to be low among elite athletic and semi-professional athletic populations." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8791243/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8791243/ 2022 letter: "Several elite professional athletes tested positive for SARS-CoV-2. A few reports of persistent and residual symptoms of infections emerged. However, peak athletic performance in elite athletes did not seem to be affected, with some athletes recording historical performances both in the weeks following as well as several months after contracting the novel coronavirus.... These findings raise further awareness about the importance of performing regular physical activity and maintaining a favourable body composition and overall fitness, and emphasise the need for public health initiatives and actions to promote a healthy lifestyle on a population level." https://www.sciencedirect.com/science/article/abs/pii/S144024402100205X https://www.sciencedirect.com/science/article/abs/pii/S14402... The idea - however appealing to Americans and apparently hackers - that everyone is on an equal playing field of risk is absolute nonsense.
deleted 5y ago
[deleted]
timr 5y ago
It's worth saying that all of Al-Aly's papers so far have had the same basic structure, and the same basic problems: they take a population of older, sicker people (veteran's administration data), compare to some synthetic, non-randomized control group (this is where the "study of 15M" comes from), then extrapolate from that comparison to everyone. This is problematic for a few reasons: * the older, sicker population is simply not representative of the population at large. No amount of normalization or adjustment can truly fix this. * Moreover, the normalization process creates a "modeling problem" -- it's too easy for the researcher to find whatever outcome he's seeking by mucking with the weightings. With methods like this, you have to be very careful interpreting the results, because tiny details in the methods matter a lot. * the signals in the data often are smaller in magnitude than the covariates in the study population (e.g. finding an X% difference in thing Y, when the population is more than X% sicker, overall) * Use of ICD (medical billing) codes for a study like this is fraught. Choice of codes can create/remove a small signal in the data, and yet, it's not always clear that certain codes should be used (basic example: do you use the ICD code for a bypass graft as a "cardiac event" in a study like this? Almost certainly, a heart bypass surgery reflects a life-long problem, not an acute event due to Covid.) Again, methods matter a great deal here. * Al-Aly is...less than transparent...about the size of the observed effect and its dependence on age and health. Often these details are buried in supplemental materials, and then he goes in the news media and makes bombastic claims about something "even happening in younger populations", based on a relatively weak effect size extrapolated in younger, healthy people. * Relatively strong claims are made about small differences in outcome. For example, I just saw one last night from Al-Aly that turned a 13 per 1000 difference in outcome (1.3%), into a breathless claim of "over 40% increased risk". Mathematically true, perhaps, but utterly misleading (also, the difference was observed primarily in the oldest people, so the citing mean difference was simply wrong). I could go on. Point is, please don't take this study as definitive. This is one paper, and Al-Aly has an agenda.
SnowProblem 5y ago
We should expect some heart damage because it happens after the flu too, but this study is flawed. If you had covid but weren't tested, you were put into the control group, meaning the conclusions they draw (ie. 5% increase in heart problems after a year) are going to be higher than in reality.
fallingknife 5y ago
This chart from the actual paper contains much more useful information than the linked article. https://www.nature.com/articles/s41591-022-01689-3/figures/5 https://www.nature.com/articles/s41591-022-01689-3/figures/5 Basically, don't worry about this if you were not hospitalized with covid. Whole paper: https://www.nature.com/articles/s41591-022-01689-3 https://www.nature.com/articles/s41591-022-01689-3
zuminator 5y ago
I'd be curious to know how the numbers compare other infections generally. This page [0] leads me to conclude that all types of infections, even the common cold, often affect the heart adversely. Are Covid's effects on the heart more severe than other studied viruses, or is this really just business as usual, the main difference being the comparatively widespread nature of the Covid virus? [0] https://www.mayoclinic.org/diseases-conditions/myocarditis/symptoms-causes/syc-20352539# https://www.mayoclinic.org/diseases-conditions/myocarditis/s...
EricE 5y ago
It will be interesting to see the long term numbers for this on the vaxxed vs. unvaxxed.
wlakjlkjkerg 5y ago
Fargoan 5y ago
My friend died 2 days ago. Heart attack at 31 years old. He had some unhealthy eating habits, but nothing out of the ordinary and he was at most slightly overweight. I wouldn't be surprised if him having covid a couple months ago was a major factor in his death.
- melling 5y ago
  Was the person vaccinated? This was done before people were vaccinated so it’s unclear if being vaccinated helped: “THIS STUDY WAS DONE BEFORE VACCINATION WAS WIDELY AVAILABLE.”
  - bsdetector 5y ago
    The study, if I found the right one, has tables where they compare myocarditis in Covid patients to non-vaccinated by excluding data after vaccination, 62% of Covid patients and 56% of non-covid group excluded, to show that Covid itself caused damage. I would hardly call half of data coming from vaccinated people "before widely available". https://www.nature.com/articles/s41591-022-01689-3 https://www.nature.com/articles/s41591-022-01689-3 Also an interesting bit, myocarditis hazard ratio for covid-infected by non-hospital / hospital / ICU vs: Contemporary: 3.47 / 12.13 / 35.57 Historical: 5.67 / 19.82 / 58.11 The other outcomes were basically identical between contemporary and historical. I wonder what caused higher levels of mycarditis in half-vaccinated, uninfected contemporary group? That is a tough one.
  - Fargoan 5y ago
    He was vaccinated. Pfizer iirc. Not sure if he got a booster
- stjohnswarts 5y ago
  Seems unlikely. Usually something as drastic as a heart attack at a young age like that is linked to genetics.
- parrellel 5y ago
  Very possible, there was a teen girl who was recovering from Covid around here a month ago that just hemorrhaged to death. Cardiovascular damage continues to be no joke.
johndfsgdgdfg 5y ago
- elevenoh 5y ago
temptemptemp111 5y ago
tucosan 5y ago
Has anyone found a quantification of the HR for vaccinated vs non-vaccinated patients in the study?
phendrenad2 5y ago
So basically everyone who has had COVID (presumably even the "milder" Omicron variant family, although we seem to be permanently stuck on the name Omicron, so the association with "mildness" probably won't last forever) has heart damage, that could last for a year or more? Oh boy.

192 points by alwillis 5y ago

Dr. Al-Aly's paper is here: https://www.nature.com/articles/s41591-022-01689-3?s=08 https://www.nature.com/articles/s41591-022-01689-3?s=08

yamrzou 5y ago
Previous discussion: https://news.ycombinator.com/item?id=30249618 https://news.ycombinator.com/item?id=30249618

azth 5y ago

What about those that took the vaccine?

blueline 5y ago
> This study was done before vaccination was widely available. Is there any indication that, for example, breakthrough infections would have a different result long term? > Yes. We are [studying] this, but I think the jury is still out. We're certainly very interested in addressing that publicly as soon as we can.
- smegsicle 5y ago
  neat! that first quoted line has css text-transform:uppercase in the article, so firefox copies as original, lowercase text, but chromium copies as all caps!
lapetitejort 5y ago
> THIS STUDY WAS DONE BEFORE VACCINATION WAS WIDELY AVAILABLE. IS THERE ANY INDICATION THAT, FOR EXAMPLE, BREAKTHROUGH INFECTIONS WOULD HAVE A DIFFERENT RESULT LONG TERM? > Yes. We are [studying] this, but I think the jury is still out. We're certainly very interested in addressing that publicly as soon as we can.
exo-pla-net 5y ago
If you're referring to cases of myocarditis caused by vaccination itself, the cases are negligible: 2.3 per 100,000 [1]. Compare that with the apparent near-certainty of heart damage (and likely brain damage) if you contract COVID while being unvaccinated, and the decision to not get vaccinated is not just selfish but self-destructive. [1] https://www.nejm.org/doi/full/10.1056/NEJMoa2110737 https://www.nejm.org/doi/full/10.1056/NEJMoa2110737
- vikingerik 5y ago
  Heart damage from Covid is nothing like a "near-certainty". The vast majority don't experience it, upwards of 95% depending on the study. Framing this as "near-certainty" or "spares no one" is irresponsible fear-mongering.
  - pdonis 5y ago
    The study is not saying that 95% of people who get COVID do not experience heart damage. It is only saying that 95% of people who get COVID did not have a heart-related acute event in the time period examined. That doesn't mean they had no heart damage at all. Their hearts were not directly examined. The point of this study was to assess whether people who have had COVID are at increased risk for heart-related problems (and the conclusion was that yes, they are), not to assess what percentage of them had actual heart damage.
  - Daishiman 5y ago
    95% is not a "vast majority"; that's 5% of the population with quantifiable degradation in heart function. I fear for the catastrophe it will cause 20 years down the line in increased disease burden.
  - exo-pla-net 5y ago
    Near-certainty is literally the finding of the linked article. You're confusing your numbers. Heart damage != heart attacks.
  - runako 5y ago
    This claim really requires a citation of some sort. In particular, > don't experience it is reckless, given that we know the vast majority of heart disease is undiagnosed until there are symptoms.

darzu 5y ago

What’s the effect size? Didn’t see this anywhere in the article and seems pretty important to know.

rkk3 5y ago

What was the methodology around asymptomatic covid cases and cardiac outcomes? This seems like a sensationalist claim.

mmaunder 5y ago

Don’t obsess over this. It’ll distract you and stress you out, which comes with its own health risks. None of us get out alive anyway. Go live as healthy a life as you can, find happiness, and help others when the opportunity presents.

vkou 5y ago
You don't need to obsess over this, but you do need to remember that there has been, and continues to be a large pro-COVID faction that insists that getting everyone sick with it will be no big deal, because it only kills <0.X%> of people in <particular age range>. They were, of course, speaking from a position of ignorance of long-term side effects, because the data wasn't yet in. It's been two years, and in many ways, the data is still not in yet. We'll have another go-around[1] on the COVID rodeo next holiday season, if another dangerous variant emerges. [1] Just because the news has forgotten about the virus, doesn't mean that the virus has forgotten about us. There are more daily worldwide cases right now, then there have been at any point prior to November 2021. That's a lot of opportunity for variants to mutate.
- mwint 5y ago
  > It's been two years, and in many ways, the data is still not in yet. But we hopefully aren’t expected to hide until the data are in?
  - vkou 5y ago
    You're expected to take simple, cheap precautions, proportionate to the expected consequences. You're also expected to not take what you think is the best case scenario, and extrapolate that it's the scenario that we are actually in.
    - bamboozled 5y ago
      One cannot live in 2022 without catching covid, the level of precautions I would have to take to avoid it would be extreme and damage my quality of life and probably my mental health. I've definitely had it once, likely twice, just doing basic things exposes me to it now, so what can I do?

kragen 5y ago

A more accurate headline would be "it spares 93%–97% of people," though the interview meticulously omitted almost all quantifiable information. The hazard ratios in the paper smitty1110 cited https://www.nature.com/articles/s41591-022-01689-3?s=08 https://www.nature.com/articles/s41591-022-01689-3?s=08 are mostly 1.49–1.85, which as I understand it means that people with covid were 1½–2 times as likely to experience the condition, pericarditis or stroke or whatever, than thr control group. The exceptions are things that normally happen only once in a lifetime, like cardiac arrest (HR=2.45), so we're still talking about a tiny fraction of people. This justifies the statement in the paper's abstract, "Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial," but (unless I'm misunderstanding the paper) shows that the interview headline is an irresponsible, sensationalist lie.

exo-pla-net 5y ago
False. > We went into it thinking that [the risk] was going to be most pronounced and evident in people who smoked a lot or had diabetes, heart disease, kidney disease, or some [other] risk factors. What we found is that even in people who did not have any heart problems start with, were athletic, did not have a high BMI, were not obese, did not smoke, did not have kidney disease or diabetes—even in people who were previously healthy and had no risk factors or problems with the heart—COVID-19 affected them in such a way that manifested the higher risk of heart problems than people who did not get COVID-19. They found that even mild COVID damaged otherwise healthy people's hearts so badly that their risk for heart problems are now comparable to those of obese people. In other words, it does damage your heart. That damage might result in a heart attack, reflected in the increased hazard ratio.
- bigfudge 5y ago
  No, there's not enough data to be sure either way, but given that some/most people experience absolutely no lingering symptoms the simplest explanation is that even mild disease cases damage in some people. EDIT: to be clear. We have no idea if the outcome-generating process is continuous or discontinuous. You seem to think it's continuous, analogous to risks from smoking or obesity, but others would assume not.

quadrifoliate 5y ago

Looking at the title, I am sad to see the discourse in research sink to this level over the last few years (well, I think so – perhaps it was already at this level before?). Honestly, it's hard to blame the author(s) for using such a clickbait title when Governments across the world have done precisely the same thing by trivializing the effects of a largely unknown disease, banning public health measures, or declaring the lifting of public health restrictions as a "Freedom Day". I don't have a great solution for this – perhaps just that we should all tend towards discourse that is a bit more dry and phrased in terms of data; and steer it back to that phrasing when required.

EricE 5y ago
The experiences of countries that didn't lock down proves that the "restrictions" were ineffective at best and more and more it looks like they caused and are continuing to cause more harm. Lockdowns in cities was particularly dumb. Let's lock everyone indoor, in apartment buildings with shared air systems - yup, brilliant strategy for a highly contagious respiratory virus. If the weather is nice enough for people to be outside, the more that are outside the better! The selective enforcement driven by non-medial reasoning was even more egregious. For example, forcing small businesses to close while allowing big box stores to remain open - either the virus is deadly enough to warrant the prohibition of ALL public contact or it isn't. Same with the ridiculous posturing during the "summer of love" as if the virus was smart enough to avoid spreading at BLM protests, but deadly everywhere else outdoors. All the lockdowns did was foster the greatest transfer of wealth from the little guys to the big guys in all of human history :p Even the definition of "emergency" is now hopelessly devalued. The best analogy to demonstrate this that I have heard: If someone asks to borrow your car for two weeks and after two years they still haven't brought it back, they are no longer borrowing your car. How many people ended up in the hospital on a ventilator and potentially died needlessly while the government panned ivermectin and HCQ and the media/big tech demonized, banned and flat out declared war on anyone talking about anything other than complying with ridiculous mandates and vaccination as the only solution? Going on a ventilator was a 50/50 death sentence. ANYTHING that could have POSSIBLY prevented ANYONE from ever having to go into the hospital should have been thrown at anyone willing to try it. Ivermectin and HCQ are DECADES old, given to millions if not billions of people and even if they were 100% ineffective they certainly were not going to do harm to the VAST majority of people. But here we are. People still make fun of Ivermectin with the "horse dewormer" slur. It's very common for drugs to have human and animal uses and anyone who implies otherwise is either grossly ignorant or the most evil kind of person out there deliberately distorting actual science for political/tribal reasons. I could go on, but the parameters of the disease were well known by the March after the December the virus really broke on our consciousness. The real problem is politics and money took over. Big pharma had a risk free gravy train as long as the "restrictions" and vaccine mandates were underway. Politicians got to boss people around and make themselves even more important. The government, media and big tech blatantly collaborated in flogging the messaging in ways never before seen in human history. Trust in government, the media and big tech is at an all time low for very, very good reasons. What's going to be really tragic - there may be a future biological incident where there are legitimate reasons for dramatic and long term restrictions; good luck getting everyone to cooperate after the ridiculous way COVID was handled. The more evidence that keeps coming out that much of the response and overreaction to it was utterly unwarranted, the more trust is going to be eroded. The most egregious that I am just dumbfounded that here is ongoing controversy over: it's beyond criminal that ANY kids are being forced to still wear face masks. It's flat out child abuse mainly to pleasure the teacher unions. That you seem to be implying that governments didn't take COVID seriously enough when it's beyond obvious now that the opposite is true - the vast majority of governments dramatically overreacted and probably made things FAR worse with their policies shows just how big of a disconnect remains, unfortunately.

etaioinshrdlu 5y ago

I had chest pains for the first time in my life in 2021 and I’m in late 20’s. Doctor couldn’t find anything. Felt much better after a month. But it came back after getting a booster. I had COVID confirmed in 2020 with no such issues. For me, as far as i can tell, the chest pains are more correlated with the vaccinations. I’m rather grumpy at the idea of getting additional boosters.

abhishekjha 5y ago
Surprisingly I am having the same symptoms. Like I can feel chest pain during cycling and hours after I am done. This was not the case earlier. I haven't got it checked yet. I am gonna do that soon.
brianwawok 5y ago
It's possible they are related, or also possible just coincidence. When I was 31 or 32 I had a bout of crazy chest pains. Did all the tests, got all the EKGs... end result was Dr told me I was fine, lay off the stress. Has not come back, so I think it was just a reminder to take care of my flesh bag a big better.
yosito 5y ago
I'm sorry you had that experience with vaccines. I know it won't make much difference to you personally, but the truth is that these sorts of chest pains and heart problems are far more common in immune-naive people who are infected with covid than in people who get vaccines.
- andrew_ 5y ago
  Could you drop a link to some research for side effects of immune-naive infection versus vaccine? I've read the latest on the Pfizer side effects but have nothing to compare it to for immune-naive infection effects and rate of those kinds of symptoms.
- EricE 5y ago
  Citation needed! In fact, there is more and more data every day the EXACT opposite is true.

anamax 5y ago

Do we know whether Covid-19 is different wrt heart and other effects than other corona viruses or even flu viruses in general? For example, how is Covid-19/SARS-CoV-2 different from 2002-4's SARS-CoV-1 in this respect? I ask because the reports of mental sluggishness for a couple of months after Covid-19 reminded me of how I felt after some previous flus.

andrew_ 5y ago
New studies are suggesting links to nerve damage as a cause for long-covid symptoms https://www.nbcnews.com/health/health-news/long-covid-symptoms-may-linked-nerve-damage-small-study-rcna18145 https://www.nbcnews.com/health/health-news/long-covid-sympto...
- anamax 5y ago
  My question is how different covid-19 is. One of the things that has come out of Covid-19 is how little was actually known about flus, despite the fact that flus have been killing 30-70k Americans each year for decades. This ignorance is "interesting" because "we need to be ready for the next Spanish flu" has been at the core of the "give us more money for research" argument for decades. For example, it looks like we still don't understand transmission in any useful sense. There was some reasonable research in the late 40s but we've learned more in the last two years than in the intervening 80 years. Yes, some of the tools used in the last two years weren't available 20 years ago but they were available 10 years ago. That said, many of the tools have been available, albeit unused, for 80+ years.
  - avgDev 5y ago
    I think going forward we are going to learn a lot more about these long term issues. Before COVID, getting chronic fatigue from flu was mostly ignored by the medical community. Now, with popularity of covid a lot more doctors are aware of some possible neurological issues. There have been case studies, research and support groups for these things for many years. However, handful of physicians treating patients. I am now seeing more doctors seeing patients with odd symptoms at clinics all over the US, some even have ads targeting long covid. I think we are going to make some major advancements in the next 10 years, and I'm happy many suffering quietly will be heard.

throwawaycities 5y ago

There was a lot of information coming out of college athletics early on consistent with the research in this article. Young, healthy athletes that were asymptomatic showed signs of inflammation in the heart. Since then there were follow up studies which were split in their findings. The early studies used MRI testing and suggested “high-risk” of heart damage/myocarditis in the athletes. Follow up studies tended not to use MRI, opting for testing for certain proteins associated with heart inflammation and ultra sounds and those studies found heart damage to be uncommon in the athletes.

thelettere 5y ago
If there's been such heart damage to athletes that caught it, how come they all are invariably coming back to the same exact performance they had previously? Is there such a thing as damage to the heart that has no effect on performance, particularly the incredibly demanding kinds of performances that sports like professional basketball require?
- reggedtorespond 5y ago
  They haven't all. Look up Asia Durr if you want an anecdote. #2 draft pick for WBNA and hasn't played since her rookie season due to long haul covid effects. I am not aware of any study on covid in athletes in particular, though.
  - thelettere 5y ago
    Huh, you've got to reach to the WNBA to find someone. Kinda proves my point. Edit: And to all the wonderful people who no doubt checked themselves to make sure they had expertise on the subject before they downvoted my question (!), here's some food for thought: A 2021 study of 789 professional athletes found that only 5 (0.6%) had heart inflammation. https://jamanetwork.com/journals/jamacardiology/fullarticle/2777308 https://jamanetwork.com/journals/jamacardiology/fullarticle/... Another study found that COVID in athletes was rarely serious: "The severity of COVID-19 in elite athletes is predominantly mild and without complications. Athletes can return to sport after two symptom-free weeks and additional heart screening is usually not required." https://www.sciencedirect.com/science/article/pii/S1440244021001791 https://www.sciencedirect.com/science/article/pii/S144024402... 2021 review of 12 studies: "Athletes have an overall low risk of SARS-CoV-2 pericardial/myocardial involvement, arrhythmias and SCA/SCD." https://bmjopensem.bmj.com/content/7/4/e001164.abstract https://bmjopensem.bmj.com/content/7/4/e001164.abstract 2022 editorial review: "Most importantly, to date, there have been no acute adverse cardiac events reported as a direct consequence of COVID-19 infection in the athletes included in these large registries" and noted that the few smaller studies that deviated from these findings were badly designed. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8730531/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8730531/ 2022 study: "These data add to the growing body of the literature and agree with larger cohorts that the risk of cardiac involvement post-infection appears to be low among elite athletic and semi-professional athletic populations." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8791243/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8791243/ 2022 letter: "Several elite professional athletes tested positive for SARS-CoV-2. A few reports of persistent and residual symptoms of infections emerged. However, peak athletic performance in elite athletes did not seem to be affected, with some athletes recording historical performances both in the weeks following as well as several months after contracting the novel coronavirus.... These findings raise further awareness about the importance of performing regular physical activity and maintaining a favourable body composition and overall fitness, and emphasise the need for public health initiatives and actions to promote a healthy lifestyle on a population level." https://www.sciencedirect.com/science/article/abs/pii/S144024402100205X https://www.sciencedirect.com/science/article/abs/pii/S14402... The idea - however appealing to Americans and apparently hackers - that everyone is on an equal playing field of risk is absolute nonsense.

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timr 5y ago

It's worth saying that all of Al-Aly's papers so far have had the same basic structure, and the same basic problems: they take a population of older, sicker people (veteran's administration data), compare to some synthetic, non-randomized control group (this is where the "study of 15M" comes from), then extrapolate from that comparison to everyone. This is problematic for a few reasons: * the older, sicker population is simply not representative of the population at large. No amount of normalization or adjustment can truly fix this. * Moreover, the normalization process creates a "modeling problem" -- it's too easy for the researcher to find whatever outcome he's seeking by mucking with the weightings. With methods like this, you have to be very careful interpreting the results, because tiny details in the methods matter a lot. * the signals in the data often are smaller in magnitude than the covariates in the study population (e.g. finding an X% difference in thing Y, when the population is more than X% sicker, overall) * Use of ICD (medical billing) codes for a study like this is fraught. Choice of codes can create/remove a small signal in the data, and yet, it's not always clear that certain codes should be used (basic example: do you use the ICD code for a bypass graft as a "cardiac event" in a study like this? Almost certainly, a heart bypass surgery reflects a life-long problem, not an acute event due to Covid.) Again, methods matter a great deal here. * Al-Aly is...less than transparent...about the size of the observed effect and its dependence on age and health. Often these details are buried in supplemental materials, and then he goes in the news media and makes bombastic claims about something "even happening in younger populations", based on a relatively weak effect size extrapolated in younger, healthy people. * Relatively strong claims are made about small differences in outcome. For example, I just saw one last night from Al-Aly that turned a 13 per 1000 difference in outcome (1.3%), into a breathless claim of "over 40% increased risk". Mathematically true, perhaps, but utterly misleading (also, the difference was observed primarily in the oldest people, so the citing mean difference was simply wrong). I could go on. Point is, please don't take this study as definitive. This is one paper, and Al-Aly has an agenda.

SnowProblem 5y ago

We should expect some heart damage because it happens after the flu too, but this study is flawed. If you had covid but weren't tested, you were put into the control group, meaning the conclusions they draw (ie. 5% increase in heart problems after a year) are going to be higher than in reality.

fallingknife 5y ago

This chart from the actual paper contains much more useful information than the linked article. https://www.nature.com/articles/s41591-022-01689-3/figures/5 https://www.nature.com/articles/s41591-022-01689-3/figures/5 Basically, don't worry about this if you were not hospitalized with covid. Whole paper: https://www.nature.com/articles/s41591-022-01689-3 https://www.nature.com/articles/s41591-022-01689-3

zuminator 5y ago

I'd be curious to know how the numbers compare other infections generally. This page [0] leads me to conclude that all types of infections, even the common cold, often affect the heart adversely. Are Covid's effects on the heart more severe than other studied viruses, or is this really just business as usual, the main difference being the comparatively widespread nature of the Covid virus? [0] https://www.mayoclinic.org/diseases-conditions/myocarditis/symptoms-causes/syc-20352539# https://www.mayoclinic.org/diseases-conditions/myocarditis/s...

EricE 5y ago

It will be interesting to see the long term numbers for this on the vaxxed vs. unvaxxed.

wlakjlkjkerg 5y ago

Fargoan 5y ago

My friend died 2 days ago. Heart attack at 31 years old. He had some unhealthy eating habits, but nothing out of the ordinary and he was at most slightly overweight. I wouldn't be surprised if him having covid a couple months ago was a major factor in his death.

melling 5y ago
Was the person vaccinated? This was done before people were vaccinated so it’s unclear if being vaccinated helped: “THIS STUDY WAS DONE BEFORE VACCINATION WAS WIDELY AVAILABLE.”
- bsdetector 5y ago
  The study, if I found the right one, has tables where they compare myocarditis in Covid patients to non-vaccinated by excluding data after vaccination, 62% of Covid patients and 56% of non-covid group excluded, to show that Covid itself caused damage. I would hardly call half of data coming from vaccinated people "before widely available". https://www.nature.com/articles/s41591-022-01689-3 https://www.nature.com/articles/s41591-022-01689-3 Also an interesting bit, myocarditis hazard ratio for covid-infected by non-hospital / hospital / ICU vs: Contemporary: 3.47 / 12.13 / 35.57 Historical: 5.67 / 19.82 / 58.11 The other outcomes were basically identical between contemporary and historical. I wonder what caused higher levels of mycarditis in half-vaccinated, uninfected contemporary group? That is a tough one.
- Fargoan 5y ago
  He was vaccinated. Pfizer iirc. Not sure if he got a booster
stjohnswarts 5y ago
Seems unlikely. Usually something as drastic as a heart attack at a young age like that is linked to genetics.
parrellel 5y ago
Very possible, there was a teen girl who was recovering from Covid around here a month ago that just hemorrhaged to death. Cardiovascular damage continues to be no joke.

johndfsgdgdfg 5y ago

elevenoh 5y ago

temptemptemp111 5y ago

tucosan 5y ago

Has anyone found a quantification of the HR for vaccinated vs non-vaccinated patients in the study?

phendrenad2 5y ago

So basically everyone who has had COVID (presumably even the "milder" Omicron variant family, although we seem to be permanently stuck on the name Omicron, so the association with "mildness" probably won't last forever) has heart damage, that could last for a year or more? Oh boy.