I saw a post today discussing palpitations after COVID. Folks, what I tell my patients is: if you get palpitations in the weeks to months after COVID, call your doc and get seen. Here’s why — palpitations after COVID are common, and one prevalent cause is atrial fibrillation. This is often detected by a wearable event recorder such as a Holter monitor, because a 1-time ECG (as if often done in the ER) is worthless if you aren’t in a-fib at the time. A-fib dramatically increases stroke risk.
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Common? Patients who have had COVID have only a 20% increased risk of AFib post infection. Thats hardly "common" that would make it fairly rare.
@freemo I said palpitations are common (10-20% of folks with post-COVID syndromes have them). A-fib is one of the many causes of this, and I would argue is not all that rare compared to many things we consider quite serious in Emergency Medicine, particularly since a-fib has a significant stroke risk associated with it. We can quibble over what exact cutoff makes something a concern I suppose, but to what end?
> but to what end?
Largely my concern is fear mongering (perhaps unintentional). There has been a great deal of over-hyping COVID and has caused people to be dispreportionaltly scared of the disease and its consequences. While it is of course a serious disease people have heard so much disinformation to make it sound scarier than it is that people are often irrationally afraid of it relative to the risks.
Saying its common makes people think most people who catch it will start having heart problems when in fact a very very small portion of people who catch it will. So that needs pointing out.
@freemo up to 30% of people who get COVID get some form of post-COVID syndrome. Estimates vary widely on the number who experience cardiovascular complications, but there are entire clinics dedicated the problem, so it isn’t exactly a rare presentation to healthcare. I agree that there is overhyping of some of the risk, but overall, I would argue that in fact the risks associated with infection have been downplayed quite a bit.
See this is what I'm talking about. An actual review of the literature would show the prevelance of post-covid syndroms is not yet known, the studies we do have range from <10% to 30%/35% at the absolute highest end. Yet you are 1) quoting it as if its well established, it is not 2) picking from the highest end of the spectrum (fear mongering).
Couple this with the fact that there is a great deal of fear, and an impossiblity to test for this in a double-blind fashion you get a recipe for disaster one would expect highly inflated numbers due to the placebo effect alone.
As a COVID Research scientist myself, and you as a doctor, we need to hold ourselves to higher standards when we state things as fact. You cant just cherry pick a study that gives the number you want, we have to be mindful of the consensus and the body of literature and leave our personal biases out of it.
@freemo while the prevalence is not well established, the estimates of long COVID range from 10-80%, with most studies I’ve seen landing somewhere around 30%. Arrhythmias are a commonly cited concern, and prevalence there again is variable, but 10-20% is a pretty reasonable slice of the published literature. The intro to this Nature review pretty well sums up the concerns…
Sorry but thats just not true. I will try to find it for you but the last attempt i saw at finding a mean for the prevalence among existing studies produced a value from 11% to 16%. Couple that with the fact, again we cant remove the placebo effect from the reality the actual numbers are almost certainly skewd quite a bit below this.
@freemo the CDC study I posted specifically cites a range from 10-80% for PCS, and the Nature review also shows a range up to 70% (the higher estimates are for people who were hospitalized, which is obviously not the same as ambulatory cases). Literally right there in the papers I cited, one of which is a recent and broad review in Nature…
Thats not how science is done. The existence of low-confidence studies that produce outliers is not the same as saying a literature review has consensus within that range.
No reasonable person would look at the literature on this and assert that ANY of the numbers have enough confidence to start telling the general public figures. The only responsible response is "We dont know what the figures are but the highest confidence studies are in the 15% and less range, and almost all studies show very little consensus"
I just double checked your study... its worse than I thought, you are even misrepresenting the study in what your saying here now.
You are citing upwards of an 80% figure, that is NOT what the study says. It says that in patients who were hospitalized with covid (so people who had extremely unusually bad casis) have upwards of the 80% figure. That is NOT saying 80% of all people with covid.
So turns out this was a much worse and damning misrepresentation on your part than I first thought. Given your credentials I'd go so far as to say its a lie and deceptive the way you stated it based onn the very source you used.
@mcnado That said I do think you are unintentionally sharing disinformation, which is why I am engaging you to encourage you to be a bit more conscious of it.
@freemo I think you have an opinion that COVID isn’t a big deal, when in fact, for some folks, it’s a problem. We have a poor understanding of the long term sequelae of it, but as I initially and repeatedly have noted, post COVID symptoms are not rare, and even at a conservative estimate of 10%, are a concern. Palpitations are a common ER complain, and we see folks after COVID with this not infrequently, some of whom are told not to worry, when in fact they haven’t had adequate workup.
@mcnado @freemo It did spread for a few years and took out the most susceptible.
Long term data would be nice even if it's blatantly falsified like the death data.
We can't have a control group because nearly everyone was exposed. We don't have a healthy non jabbed group because the government and the public persecuted these people.
Being in the latter group, it's difficult to show empathy as anything other than mockery. Problems quoting inaccurate data? Corruption dragged its fat sack of influence and manipulation over your profession. Medicine will have to regroup and reform to get back to some level of integrity. That's going to be a long fight.
@AmpBenzScientist @freemo in the US at least, the mortality data were not falsified despite reports to the contrary. Indeed, two papers by the same authors looking at mortality suggested a ~20-30% undercount during the early pandemic (higher early on, lower later on). This was most likely due to poor test availability, out of hospital deaths, and shoddy reporting early on.
@mcnado @freemo After reviewing the CDC reporting, the complications possibly caused by infection would result in the stated cause of death to be from COVID-19. It further points out that the long term effects resulting in death would be considered a COVID-19 death.
The situations leading to death weren't properly addressed. Regardless of proper classification, the likely damage from the virus was rightfully included. I suppose I was expecting ARS to be the cause of the deaths and, to a lesser degree, cardiovascular issues.
It seems more inclusive for contributing factors of a COVID death but not necessarily represented correctly. The car example was dismissed incorrectly. According to the guidelines, if COVID-19 contributed to the circumstances then it would indeed be reported as a COVID-19 death even if the subject could have lived if they weren't driving. It's these small things that make me question the data.
Cause, Contributing factor and the Others should be separated. It sounds like the virus directly killed so many people. It just seems misleading to call them all COVID deaths when it would be better to describe them as Covid and common complications deaths.
I agree wi5h your statements about death being accurate compared tonusual practices.
The assumption about excess death rate is a bit of a leap, we may find many other secondary effects that arent covid are at play to explain the difference.
@AmpBenzScientist @freemo perhaps, but it is in line with how we classify deaths by other causes. For instance, when I fill out paperwork for a death certificate, it includes questions about tobacco smoking history.
It should be noted as well that despite the concerns you raise here, the all-cause excess mortality data for the US has consistently been well above the COVID excess deaths, suggesting we are missing a huge number of COVID deaths in our counting (an undercount).