[Published in the Journal of Insurance Medicine] Long COVID is now a recognized complication of acute COVID-19 infection. As the COVID-19 pandemic moves into its third year, the prevalence of Long COVID continues to increase. Many individuals report symptoms lasting longer than a year, and a subset of this group is unable to work. This article will provide an update on Long COVID, with a particular focus on distinguishing it from other clinical entities. It will review several proposed disease mechanisms and will attempt to anticipate the impact on disability insurance. Open access, https://meridian.allenpress.com/jim/article/49/3/183/481800/Long-COVID-One-Year-On
"Are Me/cfs and Long COVID the Same? Increasingly, comparisons are being drawn between ME/CFS and Long COVID.7,8 The emergence of debilitating fatigue as a prominent symptom of Long COVID, and its persistence beyond 6 months (a defining feature of ME/CFS) has triggered this comparison. Similarly, the cognitive symptoms and post-exertional malaise described in Long COVID are shared with ME/CFS. However, other symptoms such as dys-pnea, chest pain and anosmia are common in Long COVID, but rare in ME/CFS. And multiplicity of symptoms is a striking feature of Long COVID; in contrast, those of ME/CFS are more limited. However, for a cohort of Long COVID individuals the symptom similarities are such that ME/CFS will be the correct diagnosis. This may not sit well as ME/CFS has many negative connotations. Over the past 40 years, 9 different sets of diagnostic criteria have been published, disease pathogenesis has not been finalized and most importantly, there is no effective treatment. This is not a cohort that Long COVID individuals will be anxious to join. In fact, for this cohort, Long COVID more closely resembles Postviral Fatigue Syndrome than it does ME/CFS. Long COVID is clearly precipitated by infection with SARS-CoV-2. The ICD-10 descriptors for Postviral Syndrome and ME/CFS are virtually identical; the key difference is definite evidence of a precipitating infection, which establishes the former.4,9 In contrast, evidence of previous infection in ME/CFS is not required. How Will This Sort Itself Out? In this confusing scenario, where will Long COVID land? When organ damage can be proven, when a protracted intensive care stay has occurred, or if a pre-COVID illness can be established it will be appropriate to quit using Long COVID as the diagnostic descriptor. When the symptom fit is close, it will be possible to assign other Long COVID individuals to “post viral fatigue” syndrome or to ME/CFS. The allocation of “somatic symptom disorder” will be applicable to a further subset. If one can successfully complete this exercise, one will be left with a residual cohort where the label “Long COVID” is most appropriate. It is in this group that the discovery of a unique pathogenesis would solidify Long COVID as a new diagnosis and increase the chances for an effective remedy."
Tim Meagher is Vice President and Medical Director Munich Re, Canada (Life) https://www.munichre.com/us-life/en/company/management/subject-matter-experts/Tim-Meagher-bio.html "Munich Re is a leading global provider of reinsurance, primary insurance and insurance-related risk solutions."
However, other symptoms such as dys-pnea, chest pain and anosmia are common in Long COVID, but rare in ME/CFS. And multiplicity of symptoms is a striking feature of Long COVID; in contrast, those of ME/CFS are more limited. In fact, for this cohort, Long COVID more closely resembles Postviral Fatigue Syndrome than it does ME/CFS. Not off to a good start.
In fact, for this cohort, Long COVID more closely resembles Postviral Fatigue Syndrome than it does ME/CFS. Long COVID is clearly precipitated by infection with SARS-CoV-2. The ICD-10 descriptors for Postviral Syndrome and ME/CFS are virtually identical; the key difference is definite evidence of a precipitating infection, which establishes the former. In contrast, evidence of previous infection in ME/CFS is not require. Our illnesses are in the same camp if the pathophysiology of delayed PEM are the same. It might take longer to develop delayed/PEM/ME during PVFS like it did for me. I feel that should be the main focus.
Arbitrary opinions are arbitrary. And without a biological explanation, it's all that medicine seems capable of doing. Weird and capricious. Basically looks like this, it all starts off as complete derp, then moves on to being serious. Somehow, the complete derp has to keep existing, like it's part of the process. The biopsychosocial to biomedical spectrum of knowledge:
I don't know why they have to make it so complicated. PASC is anything and everything left over from COVID infection, of which ME/CFS is one. So, they are distinguishing ME/CFS from post-viral fatigue syndrome. That is interesting. I personally welcome separation of ME/CFS from post-viral fatigue syndrome, as ME/CFS has many origins of which post-viral syndrome is one. PASC = { ME/CFS, anosmia, lung damage, ... } Post-viral syndrome = { PASC, post-mono, post-...} MECFS progenitor = { Post-viral syndrome, post-trauma syndrome, overtraining syndrome...}
lol, if only. Clearly this guy is unaware that the sheer number of symptoms in ME/CFS is what the psychs said was clear evidence that it was psychosomatic. The only difference is that perhaps in LC *some* Drs might actually listen to the long list & take them seriously, rather than glazing over & looking at their watch or getting the 'dealing with your anxiety' leaflet out, after the 3rd, as they do with CFS patients
shocking that a man paid handsomely by the insurance industry wants to include somatisation in the diagnosis .cannot fathom why . [sarcasm ]
