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Long covid—mechanisms, risk factors, and management, 2021, Crook et al

Discussion in 'Long Covid research' started by Wyva, Jul 26, 2021.

  1. Wyva

    Wyva Senior Member (Voting Rights)

    Messages:
    931
    Location:
    Hungary
    Abstract

    Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives and health of people around the globe. As of 4 July 2021, more than 183 million confirmed cases of covid-19 had been recorded worldwide, and 3.97 million deaths. Recent evidence has shown that a range of persistent symptoms can remain long after the acute SARS-CoV-2 infection, and this condition is now coined long covid by recognized research institutes.

    Studies have shown that long covid can affect the whole spectrum of people with covid-19, from those with very mild acute disease to the most severe forms. Like acute covid-19, long covid can involve multiple organs and can affect many systems including, but not limited to, the respiratory, cardiovascular, neurological, gastrointestinal, and musculoskeletal systems.

    The symptoms of long covid include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of post-traumatic stress disorder, muscle pain, concentration problems, and headache.

    This review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure. Risk factors for acute covid-19 and long covid and possible therapeutic options are also discussed.

    Open access: https://www.bmj.com/content/374/bmj.n1648
     
    Michelle, Kalliope, Louie41 and 5 others like this.
  2. cassava7

    cassava7 Senior Member (Voting Rights)

    Messages:
    613
    Parts on ME/CFS below.

    It seems that the authors view ME/CFS mostly through the prism of chronic fatigue. They mention the wide array of symptoms that long Covid and ME/CFS share, but when comparing both conditions, they use the terms "long Covid fatigue" or "Post-COVID-19 fatigue" rather than directly writing "long Covid". Nevertheless, they acknowledge that research on either can help understand the other.

    Unfortunately, while post-exertional malaise, pacing, and the July 2020 NICE interim statement cautioning on GET for long Covid are mentioned, the 2007 NICE guidelines and the Cochrane review of GET for CFS are cited to support it.

    The update of the NICE guidelines is misrepresented as being the result of "backlash from the ME Association".

    The authors do not support CBT -- they explain the findings of Mark Vink's reanalysis of the Cochrane review of CBT for CFS, as well as his article on CBT being probably ineffective for long Covid, judging by the (negative) QURE study on Q-fever fatigue syndrome.

     
    Last edited: Jul 26, 2021
    Michelle, Kalliope, Hutan and 10 others like this.
  3. rvallee

    rvallee Senior Member (Voting Rights)

    Messages:
    9,334
    Location:
    Canada
    Some not quite awful bits, some other misinformed bits. Some actual disinformation relating to the NICE guidelines.

    As a State of the art 17 months into it, this is pathetic failure. One foot is barely reaching the starting line while the other is trying to escape in the wrong direction. Absolutely nothing useful has been learned, no progress has been made and the entire field of medicine is stuck in paralysis.

    There is still a common refrain of "new illness", which was false to begin with but even then by now that excuse has lost all credibility. It's true that no one has learned anything useful since, and that's complete failure, full stop. It's not an excuse or extenuating circumstances, the context makes it all so much worse.

    As usual what I don't understand is the infinite tolerance for failure. Zero urgency, zero sense of doing more. Everything's fine, no need to change anything moving forward. Almost all that has been written in this article was previously known, fragmented in related topics.

    Normally this would be the point at which people ask "have you no shame?" but we know the answer to that. Although it does place in context why it was impossible for us to make any progress. When so many obstacles and bad will are placed on the way to make sure no one moves an inch, you get full system paralysis. Hey no big deal it's just tens of millions of lives who cares right?

    To clarify, this would have been fine the first month or so, maybe by 3 months. Not 17 months in, not even 12. This is all old stuff that medicine chose to dismiss and that's a big fracking deal.
     
  4. Kalliope

    Kalliope Senior Member (Voting Rights)

    Messages:
    5,387
    Location:
    Norway
    Merged thread

    Clinical review - Long Covid - mechanisms, risk factors, and management by Harry Crook, Sanara Raza, Joseph Nowell, Megan Young and Paul Edison

    Abstract
    Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives and health of people around the globe.

    As of 4 July 2021, more than 183 million confirmed cases of covid-19 had been recorded worldwide, and 3.97 million deaths. Recent evidence has shown that a range of persistent symptoms can remain long after the acute SARS-CoV-2 infection, and this condition is now coined long covid by recognized research institutes.

    Studies have shown that long covid can affect the whole spectrum of people with covid-19, from those with very mild acute disease to the most severe forms.

    Like acute covid-19, long covid can involve multiple organs and can affect many systems including, but not limited to, the respiratory, cardiovascular, neurological, gastrointestinal, and musculoskeletal systems.

    The symptoms of long covid include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of post-traumatic stress disorder, muscle pain, concentration problems, and headache.

    This review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure.

    Risk factors for acute covid-19 and long covid and possible therapeutic options are also discussed.

     
    Last edited by a moderator: Jul 27, 2021
    Peter Trewhitt likes this.
  5. Kalliope

    Kalliope Senior Member (Voting Rights)

    Messages:
    5,387
    Location:
    Norway
    ME is mentioned a few times. Under the subtitle "Possible mechanisms:

    And here:



     
    Sean and Peter Trewhitt like this.
  6. Trish

    Trish Moderator Staff Member

    Messages:
    42,221
    Location:
    UK
    Some good stuff there, but it seems to end up as a mish mash of recommendations based on no evidence. For example goal setting is recommended with no evidence to back it, and they are contradictory on GET.
     
    Helene, Joan Crawford, Grigor and 4 others like this.
  7. Joan Crawford

    Joan Crawford Senior Member (Voting Rights)

    Messages:
    369
    Location:
    Warton, Carnforth, Lancs, UK
    Moved post
    Seen this today:

    https://www.bmj.com/content/374/bmj.n1648

    Any ideas / thoughts / feedback as to the quality of the rationales/arguments re the possible mechanisms for Long Covid suggested in the paper? https://www.s4me.info/members/jonathan-edwards.25/ @PhysiosforME

    I see they state "Negative psychological and social factors associated with the covid-19 pandemic have also been linked to chronic fatigue." without any discussion to possible mechanisms or rationale.... ! Pretty lazy.
     
    Last edited by a moderator: Jul 28, 2021
  8. Joan Crawford

    Joan Crawford Senior Member (Voting Rights)

    Messages:
    369
    Location:
    Warton, Carnforth, Lancs, UK
    It's a bit of a mish mash.... Doesn't read like there is clear thinking or a good, promising way forward - lots of bits - but no real coherent, cogent medical thinking. Just my impression. Suggests very much on the dark - as ever medically-wise.

    Any thoughts / feedback as to the quality of the rationales/arguments re the possible mechanisms for Long Covid suggested in the paper? @Jonathan Edwards @PhysiosforME

    I see they state "Negative psychological and social factors associated with the covid-19 pandemic have also been linked to chronic fatigue." Without any discussion to possible mechanisms or rationale.... ! Pretty lazy.
     
    Mithriel and Kalliope like this.
  9. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

    Messages:
    11,484
    Location:
    London, UK
    This reads like a student essay assignment. (In fact the assignment is likely to have been given to the senior author who passed it down to a fresh junior wanting publications.) It is devoid of any intelligent analysis and nobody has proof read the English properly.

    Complete drivel again I am afraid.
     
  10. Kalliope

    Kalliope Senior Member (Voting Rights)

    Messages:
    5,387
    Location:
    Norway

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