This is extremely interesting and more and more evidence is coming to light to support the idea that long covid is actually just a persistent covid infection. Also could explain why long covid often improves after follow up vaccinations. In my own case I found the anti-inflammatory and immune boosting affect of curcumin (at clinical dosage) also helped with my long covid symptoms. So maybe the inflammation theory has something to it.
https://newatlas.com/science/covid-autopsy-study-virus-brain-body/
I suspect part of the problem is that we need a better definition. We have the study on the four major types of long COVID now:
https://www.nature.com/articles/s41591-022-02116-3
As you pointed out we have a growing body of evidence of viral persistence. But we also have evidence of other things going on such as reactivation of other dormant viruses:
And just plain old damage and inflammation from what is a vascular disease. When you mess with the blood vessels that will affect your entire body(obviously):
https://www.nature.com/articles/s41401-022-00998-0
Personally, I had a really bad case of Mono when I was 20 that took me years to get over. Long before COVID was a thing I often looked back on that and wondered if I ever fully recovered. I'm not at all eager to risk bringing that back now that I'm much older and theoretically not able to handle it as well.
Anyway, TLDR; I'm betting years from now we'll all accept that the reason there's multiple, distinct types of long COVID is because there's multiple, distinct causes.
I sincerely hope that a "positive" to come out of all of this(if you can call it that...) would be the ME/CFS community getting some relief. Fingers crossed on that front!
@BE yeah I'm not gonna fist pump the air over it, but it would be at least something good to come out of this whole sorry mess. Tbh I think quite a few advances on different fronts are being stimulated by this. It won't be really obvious for several years yet.
I agree completely. My only fear on that front is that there was a lot of spending on research in 2020 and even 2021, but that tailed off a lot in 2022. A lot of science funding seems to be trending away, so hopefully there's still enough good science happening around it for those positives to come out.
@BE yeah I noticed that also. I have noticed at the coal face, doctors seem to be much more aware of long covid now and not treating it as imaginary. This is in Australia not sure how other parts of the world are faring. But with more doctors onside there's a better chance it will be taken more seriously by the research community, and crucially, at least in places with public healthcare, by the government who have to pay for the results of long covid.
I suspect at this point it's pretty much up to where you live. I've heard the same thing from other people that locally their doctors are listening now instead of immediately sending them for a psych evaluation. Locally here where I live I've heard it's always "That's living with COVID" when ongoing symptoms are brought up and there's nothing done beyond that.
The overall direction, though, seems to be towards the medical establishment taking it more seriously overall, though, which is definitely a good thing.
@BE one thing I'm hopeful of, this may be pseudoscience or just a total reach on my part, I'm not a scientist or even a doctor, but I did wonder if some of the similarities with long covid and me/cfs might lead to a better under standing of those diseases as well. Or even just acceptance that they are real and not imaginary.