Long COVID has variable incidence and clinical presentations: our 6-country collaborative study, 2025, Szabo et al

[forestglip]

Long COVID has variable incidence and clinical presentations: our 6-country collaborative study

Sandor Szabo, Iryna Muzyka, Veronika Muller, Attila J. Szabo, Attila Szijártó, Klara Gyires, Tamas Doczi, Jozsef Janszky, Andreas Stengel, Siri Göpel, Antonia Trichopoulou, Rafael Diaz, Nicte Camacho, George Malatinszky, Nils Lambrecht & Oksana Zayachkivska

[Line breaks added]

Abstract
Following the acute COVID-19 disease, many countries see long-time sequences of this infectious disease, commonly known as Long COVID. This seems to be a multi-organ inflammatory chronic condition of variable intensity and incidence, partly due to the retention of the virus or viral particles in several organs.

Based on our 6-country (4 in Europe, 2 from North America) collaborative investigations, we found that the incidence of Long COVID varied from 46 (Mexico) to 17% (Ukraine), the average being 25%. In a summary evaluation of all 6 countries, we characterized as “general” the most frequent presenting signs and symptoms: fatigue (47%), hair loss (39.2%), and myalgia (35%), but no two countries demonstrated the same top 3 clinical signs/symptoms.

Hence, we promote the following 3 key points: 1. to expand international collaborations to better understand not only the prevalence and incidence of Long COVID but also to gain insights into the pathogenesis, and identify predisposing factors and diagnostic biomarkers of Long COVID; 2. find or develop new drugs for the treatments of Long COVID and identify appropriate rehabilitation, potentially organ-specific strategies; 3. most importantly, to start long-term observational studies (e.g., for 5–10–15 years) to identify potential increased cancer incidence in any organ, especially, since we know that certain viruses are carcinogens.

Link (Inflammopharmacology) [Paywall]

 

[Wyva]

Unfortunately it is paywalled. My additional info without knowing the content: Andreas Stengel is very clearly a BPS guy who publishes stuff like this and so is József Janszky, who I just call the Hungarian Michael Sharpe and who seems to love to complain about ME/CFS and long covid patients (according to him they threaten scientists and are spreading BS about the disease instead of accepting they are mental patients and spreading true science). He was the senior author of this awful review: Long COVID – neurological or somatoform disease?, 2024, Tényi, Tényi, Janszky

A few months ago I wrote an email to the journal that published it as there were a lot of problems with the review (including the fact that it promoted the Recovery Norway website). I have never got a reply.

Anyway, the last familiar name to me is Veronika Müller, a pulmonologist at Semmelweis University, who seems to be very interested in long covid but also seems to be very oblivious to ME/CFS. I believe her long covid patients are from the pulmonology clinic so they may very well have nothing to do with ME/CFS but she seems to extrapolate her experiences with those patients (successful rehabilitation) to long covid in general.

Again, I don't know the actual content.

 

[SNT Gatchaman]

It's a short communication, once over very lightly, but has extremely little BPS content. The most I really noted was

Additionally, fatigue, the most reported symptom might be treated with rehabilitation (Szarvas et al. 2023).

They pick out a few odd findings here and there.

The often-seen elevated blood levels of CRP seem to indicate a persistent inflammation in several organs, also supported by high white cell counts. This is consistent with the recently reported detection of viral fragments in many cells and organs of Long COVID patients (Peiris et al. 2021) that seem to maintain a persistent immune/inflammatory response. The heightened D-dimer levels indicate coagulation and vascular abnormalities that we implicated early in the development of acute COVID-19 infections (Szabo et al. 2023; Libby and Luscher 2020; Davis et al. 2023).

As a recent, major review article on Long COVID points out, “no biomarker currently available demonstrates conclusively the presence of long COVID” (Wesley et al. 2024), and thus, one of the goals of our international collaborative study is to develop such a biomarker. Furthermore, based on these clinical needs and results, also encouraged by the recently reported high abnormal autoantibody levels (Editorial 2024).

Thus, we promote the following three key points:

To expand international collaborations to better understand not only the prevalence and incidence of Long COVID but also to gain insights into the pathogenesis and identify predisposing factors and diagnostic biomarkers of Long COVID.

Develop new therapeutics or test existing drugs for the treatment of Long COVID. […]

Most importantly: start long-term observational studies (e.g., for 5–10-15 years) to identify potential increased cancer incidence in any organ, especially, since we know that certain viruses are carcinogens (e.g., Hep B, Hep C, HIV, papillomaviruses, Epstein–Barr virus).

 

[Utsikt]

3. most importantly, to start long-term observational studies (e.g., for 5–10–15 years) to identify potential increased cancer incidence in any organ, especially, since we know that certain viruses are carcinogens.

I don’t mind cancer funding, but this came a bit out of nowhere. Did they find increased cancer rates in their data?

 

[rvallee]

I don’t mind cancer funding, but this came a bit out of nowhere. Did they find increased cancer rates in their data?

Maybe just a hook to get funding? Given the near total indifference to LC, it probably helps to add some "we're also checking for this other thing that is taken seriously". But if it comes from psychosomatic ideologues, I assume shady intent. Something like making sure they grab the concept, to make sure nothing comes out of it that doesn't conform to standard psychobehavioral pseudoscience.

 

[Jonathan Edwards]

full text

 

[Utsikt]

full text

No mention of cancer, just that some viruses can be carcinogenic. Just a hook then..

 

[Peter T]

No mention of cancer, just that some viruses can be carcinogenic. Just a hook then..

There has been work on cancers linked to EBV. So it might make sense for there to be similar links to Covid.

 

[Utsikt]

There has been work on cancers linked to EBV. So it might make sense for there to be similar links to Covid.

Yes, but this reference was seemingly without any other contex. They just name-dropped cancer for no apparent reason.

I would not be surprised if Covid increases the long term risk for many illnesses, including cancer, Alzheimers and Parkinson. Time will tell, I guess.

 

[NelliePledge]

full text

@Wyva in case you didn’t see this post

 

[Wyva]

Thanks @NelliePledge

It indeed doesn't seem to be particularly problematic. Something I'd like to share though: Janszky always seems to make a big deal out of the inconsistencies in the prevalence of LC. This is how he started his presentation at the LC symposium of the Hungarian Academy of Sciences and this is how they also started their review (mentioned above) that tried very hard to psychologize LC.

I believe he is using this inconsistency to cast doubt on the existence (or biomedical nature) of LC. He never seems to explain that this may be due to the loose and different definitions of LC the different studies use, etc. In the review they also said that when there was a control group, then LC symptoms were only about 3% more common after covid than for the general population (if my memory serves me right). This was data taken out of context and actually was only one piece of datum out of several others. It was super cherry picked and if you read the original source, it was clear that it didn't even prove his point as the source had (even acknowledged) metholodogical issues. (I went into detail about this in my takedown of their review.)

The point is that Janszky et al don't shy away from using the inconsistent prevalence to cast doubt on the credibility of LC or even play around with cherry picking and misrepresenting such data. I understand that here, in the study in this thread, the authors provide some explanations for why there may be such inconsistency. But I also don't trust Janszky that next time there won't be another study where he quotes the above variations in different countries to cast doubt on the credibility of the disease itself.