Long Covid - what's the prevalence and prognosis?

Someone I know is raving about ivermectin as a treatment (and preventative) for CV and long haulers. Claims that it’s been approved by “the government” for treatment of CV, but I’ve not been able to find any verification, just a few studies with very mixed results. (This person is easily persuaded by any YouTube video. )

@needscoffee no no no

The ‘government’ has not approved of ivermectin for Covid, quite the opposite at this point (from the FDA website):

A: No. While there are approved uses for ivermectin in people and animals, it is not approved for the prevention or treatment of COVID-19. You should not take any medicine to treat or prevent COVID-19 unless it has been prescribed to you by your health care provider and acquired from a legitimate source.

A recently released research articleExternal Link Disclaimer described the effect of ivermectin on SARS-CoV-2 in a laboratory setting. These types of laboratory studies are commonly used at an early stage of drug development. Additional testing is needed to determine whether ivermectin might be appropriate to prevent or treat coronavirus or COVID-19. Read more about ivermectin.

Yes, I’ve seen these sites, having equal access to Google. And I’ve read some of the studies. The claim is that the approval just happened, which I doubt, as there’s nothing available newer than March 1 online anywhere.

I did see that South Africa has approved it for benevolent case use, but that’s a far cry from “the government”.

There are long term effects of many diseases that are similar to covid, so it’s not a new thing.

It may not be unique to Covid, but it’s still pretty prevalent if you’ve had covid.

6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records

Carrot juice and black strap molasses are also very helpful.

But what about apple cider vinegar and gin-soaked raisins? And maybe some Vick’s VapoRub?

Article today in WaPo:

Now, the National Institutes of Health might wade into the controversy. It is planning a randomized clinical trial to explore whether older, already approved drugs can be repurposed to reduce covid-19 symptoms, according to three individuals who spoke on the condition of anonymity because the plans have not been announced. Ivermectin is considered a top candidate for the trial, though the details are not final, the individuals said. Other possibilities are fluvoxamine, a decades-old antidepressant, and famotidine, the generic name for Pepcid, outside scientists said. The goal would be to get results within months.

The outpatient trial would be the latest in a series of studies, conducted with academia and industry, in NIH’s Accelerating Covid-19 Therapeutic Interventions and Vaccines program. The initiative has scrutinized monoclonal antibodies, blood thinners and other agents. Such trials, experts say, are as important in determining what doesn’t work, as what does.

FDA is going to be playing quite a game of rapidly reproducing whack-a-lotta-moles if their goal is to debunk every remedy QAnon et al can profitably popularize to their beknighted followers.

This article gives some accounts of long-covid and talks about a place helping people to cope with it. Many of the people featured were relatively young without pre-existing conditions when they got covid.

A study out of Sweden is also showing that young and formerly healthy health care workers who got mild symptoms in covid are still struggling with symptoms months later. (cross-posted in Sweden thread)

Another study showing the long term dangers of long covid. People are dying of some of the long term effects of the disease.

https://www.bloomberg.com/news/articles/2021-04-22/-long-hauler-study-shows-covid-can-kill-months-after-infection?srnd=premium

The swedish study mostly found people having trouble with smell and taste a few months out. I was surprised, given the headline.

Not sure where you’re finding this. Shortness of breath and fatigue were lumped in with lack of taste and smell. I didn’t see any numbers that show that study mostly found people with lack of taste and smell as symptoms. Did you mean those other symptoms as well?

Here’s more info.

From the article:

From the study:

Yes. I guess by the end of the study the seropositive people were 2-3 times as likely to have fatigue. But they were like 8 times as likely to have lost their senses of taste and smell. While fatigue and breathing issues were statistically significant, u thought a lot of the excess “some serious symptom” was smell or taste. Maybe i misread it.

It’s also possible that to those people who lost it, the loss of taste and smell are significant losses and dangers that may not be apparent to people who haven’t experienced it long term.

I read an article where a family almost died in a fire because they couldn’t smell it (and I guess they didn’t have a smoke detector). Luckily, one member of the family didn’t get Covid, so he warned the rest of the family.

There’s also the danger of eating food that is tainted or spoiled and getting sick or dying from it.

Here are some of the things that people with no sense of taste or smell have to live with.

I have an excellent sense of smell, and i certainly agree that losing it would be a serious problem for me. But it’s not what people usually think of when they discuss “long covid”

why i care about smell
  • I was once awakened by the smell of smoke in my house, early enough to put out the fire with minimal damage.
  • I am my household’s designated food tester, because i can smell when something is “off” before it looks funny, whereas my husband can’t smell that until long after it’s visibly spoilled. (Smelly decay isn’t generally the same as infectious-to-people decay, but the same conditions foster it, and it’s a decent bio-marker. Similarly, municipal plants test for harmless coliform bacteria because they correlate with sewage contamination.)
  • I love food. I love the taste of food. It’s one of life’s greatest pleasures.
  • I love the smell of outdoors. Ditto pleasures
  • I toss my clothes in the hamper when they smell
  • Lots of other stuff

Many chemo drugs used in cancer treatment interfere with sense of taste and smell. There are lots of problems with getting many patients on those drugs to eat enough. Food either tastes actively bad, or tastes like nothing. The one thing it doesn’t taste like is how it normally would / did.

For a couple days with a cold that’s annoying, For months or the rest of your life it’s a serious handicap with lots of bad consequences. Lots of those folks end up effectively starving themselves at a time when they need all the nutrition they can possibly get.

That may be paywalled. But some snippets and a summary:

Britain’s Office for National Statistics (ons) estimates that 14% of people who have tested positive for covid-19 have symptoms which subsequently linger for more than three months (see chart 1). In more than 90% of those cases the original symptoms were not severe enough to warrant admission to hospital.

(With a chart showing that the number is highest in the 25-69 age group, where the best estimates are over 15%, and lower for those younger and older.)

The British data also shows fatigue, cough, and headache are the most common lingering symptoms.

It goes on to say that there are, roughly, 3 types of people with lingering complaints. Some are tired and can’t tolerate even small amounts of exercise. Some have cognitive symptoms like “brain fog”, and others seem to have issues with their autonomous nervous system, and have symptoms like dizziness and digestive disorders.

They think that there may be multiple causes of the problems, and point out that long-term symptoms after an illness are not unique to covid. Chronic fatigue syndrome is often triggered by a minor illness. The “Russian flu” ~1890, which apparently is now believed to have been a coronavirus, apparently left so many people exhausted in is wake that it contributed to a famine in Tanzania because so many people were too tired to harvest the crops.

Three hypotheses for mechanisms are lingering low-grade illness, an autoimmune reaction triggered by the disease, and the result of tissue damage from the acute stage of the disease.

Another interesting piece to that article is that the relief some people found from the vaccine was temporary.

Also, they haven’t found a cure for long Covid yet, so the only solution is rehabilitation, teaching people how to deal with their symptoms. Even with rehabilitation, the rate of improvement is low. Given how many people who have gotten Covid, the long term effect of long Covid will likely affect a lot of society in some way or another.

Since the Economist article is paywalled, here is the underlying ONS research, which is not.

I’ve had great difficulty finding reliable data on the overall prevalence of long COVID, because it’s usually quite hard to understand exactly what the denominator means when frighteningly high percentages are given in headlines. When the denominator is people admitted to hospital, for example, it’s hardly surprising that there are long term effects.

This research seems to address that question, but the terminology still seems muddled. It’s odd that in a piece of technical research they persistently talk about people who “tested positive for COVID-19”. COVID-19 is a disease, defined by the presence of symptoms, you cannot “test positive” for it. We might talk that way colloquially, but the distinction is important in a technical paper.

Drilling down in the article, they are in fact talking about people with a positive PCR test for the virus, which is the denominator I was looking for. So this research is telling us that 14% of people with positive PCR test (i.e. the denominator includes infected people who are completely asymptomatic) still have some self-reported symptoms at 12 weeks.

They touched on this in the article which is not paywalled for me, at least for the 2 visits I made to it. The article considers people to have long Covid even if they have symptoms consistent with long Covid even if they don’t test positive for it or have any antibodies for it. That’s beyond the studies, I think. But they’re saying that people could have had Covid, didn’t test for it at the time, have had the antibodies leave them and still have symptoms of long Covid.