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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.
@freemo I never (and have never) said that the 80% number is representative. What I said, and is the case, is that estimates run that high in some studies. The higher bounds tens to be in much higher risk populations, in studies from early waves, and in studies with high risk of selection bias. Similarly, low bound estimates in the single digits are likely underestimates.
And that is a lie... This is **NOT** the high end estimate.. There is **no** study that estimates 80% of people with COVID will have longCOVID symptoms, not one. You read the study you quoted wrong, or you intentionally misrepresented it. I dont know which.
The 80% number cited int eh study you linked was not the upper estimate from studies and the fact you have asserted it as such now twice is very concerning to say the least.
@mcnado @freemo
Just wanted to point out a potential skew you both might be missing here: Long COVID isn't very thuroughly defined, because it's not yet even understood as anything beyond "symptoms after infection has cleared due to damage."
This could include the type of permanently crippling nervous system damage that I have, but it could, in some studies, include ANY symptom which lingers for more than a couple weeks after infection.
Could it be possible that 80% of patients who test positive and end up in the study haven't fully recovered by a month later? Could it be that the study only includes more severe cases?
Agreed, and no i didnt miss it, that is kinda part of my point. i am arguing there is nothing remotely approaching consensus or high quality studies on this topic as of yet. As you point out it isnt even well defined in a useful way. So any assertion about long covid being real or its prevelance is negligent. The only honest answer any doctor or scientist can give right now is "we just dont know"
@Raccoon @mcnado @freemo@qoto.org It’s frankly impossible to have a narrow definition for Long Covid. Why? Because it uses ACE2 to enter cells, and almost all cells in the body express ACE2.
Hence, it can nerf nearly any system, and hence a very wide range of symptoms, and hence differntial diagnosis will not be useful except in the most common patterns.
@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.