Review Long COVID science, research and policy, 2024, Al-Aly, Davis, McCorkell, Iwasaki, Topol+

Discussion in 'Long Covid research' started by SNT Gatchaman, Aug 9, 2024.

  1. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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    Long COVID science, research and policy
    Al-Aly, Ziyad; Davis, Hannah; McCorkell, Lisa; Soares, Letícia; Wulf-Hanson, Sarah; Iwasaki, Akiko; Topol, Eric J.

    Long COVID represents the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection; it is a complex, multisystem disorder that can affect nearly every organ system and can be severely disabling. The cumulative global incidence of long COVID is around 400 million individuals, which is estimated to have an annual economic impact of approximately $1 trillion—equivalent to about 1% of the global economy. Several mechanistic pathways are implicated in long COVID, including viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, endothelial inflammation and microbiome dysbiosis.

    Long COVID can have devastating impacts on individual lives and, due to its complexity and prevalence, it also has major ramifications for health systems and economies, even threatening progress toward achieving the Sustainable Development Goals. Addressing the challenge of long COVID requires an ambitious and coordinated but so far absent—global research and policy response strategy.

    In this interdisciplinary review, we provide a synthesis of the state of scientific evidence on long COVID, assess the impacts of long COVID on human health, health systems, the economy and global health metrics, and provide a forward-looking research and policy roadmap.

    Link | PDF (Nature Medicine) [Open Access]
     
    Last edited: Aug 10, 2024
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  2. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights)

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  3. Jaybee00

    Jaybee00 Senior Member (Voting Rights)

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    Really happy that Ziyad’s citation count will increase with this paper—is there any other point to this paper? 30 self-citations here—great job Ziyad!

    400 million people with “Long Covid”. At least they didn’t claim that 400 billion people had Long Covid, because that would be a lot!
     
    Last edited: Aug 10, 2024
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  4. Andy

    Andy Committee Member

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    ME/CFS is mentioned a grand total of twice in the whole review.

    "Due to near-total absence of evidence from randomized clinical trials to guide treatment decisions, approaches for the assessment and treatment of respiratory sequelae106, cardiovascular complications107, fatigue108, cognitive symptoms109, autonomic dysfunction (including POTS)110,111,112,113,114 and neuropsychiatric impairment115,116 in adults and children117 are based on evidence of treating similar symptomatology from other conditions—including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Gulf War illness"

    and

    "Quantitative estimates of the total economic impact of long COVID remain preliminary. A study in 2022 estimated the economic cost of three key parameters in the United States, including lost quality of life ($2,195 billion), cost of lost earning ($997 billion) and spending on healthcare ($528 billion), for up to a total cost of $3.7 trillion154,155—this amounts to $11,000 per capita or 17% of the 2019 gross domestic product (GDP). These economic losses are on par with the global 2008 Great Recession. Assumptions included in these estimates are that burden of disability from long COVID is on par with that of ME/CFS and that long COVID lasts on average for 5 years"
     
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  5. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    The more a scientist co-authors hot air papers with other hot air merchants the more they prove themselves to be a hot air merchant.

    Who cares if illness threatens 'economies'? In fact it will boost economies no end by creating healthcare and science jobs - which is what this puff piece is all about. If anyone had actually cared the pandemic would have been curtailed the way the Chinese and New Zealanders did.

    Hot air mixed with crocodile tears.
     
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  6. NelliePledge

    NelliePledge Moderator Staff Member

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    Assumption that Long Covid lasts on average 5 years based on what?? It’s only been around 5 years. Has anyone actually done any work in illness duration in ME/CFS??
     
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  7. Andy

    Andy Committee Member

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  8. NelliePledge

    NelliePledge Moderator Staff Member

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    Thanks Andy I forgot we now have some proper data
     
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  9. Yann04

    Yann04 Senior Member (Voting Rights)

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    It seems the way things are going, long COVID is going to also count people with the sniffles for a couple weeks post infection. Hence the high prevalence data.

    Anyways, nice to have a review published in nature that takes a biomedical and non-minimising stance even if the numbers feel weird.
     
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  10. rvallee

    rvallee Senior Member (Voting Rights)

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    According to comments from the authors, the near absence of ME/CFS was due to editorial demands.

    I don't know what it says about medical journals that they so commonly engage in cover-ups of basic information relevant to the paper they want to publish, but my surprise level is exactly 0. The academic model as it is right now is unfit for too many purposes.
     
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  11. rvallee

    rvallee Senior Member (Voting Rights)

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    Not sure why you're saying that. Economics is the only consideration in most matters of health care and public health. It's everything. Moral issues, doing the right thing, "helping people" is the bunch of hot air. Economics isn't just dollars and financial markets. It's resources. People are resources. Working age people are resources. Resources that contribute to everything we do as a civilization.

    The only thing that matters here is the cost. The number of lives destroyed is completely irrelevant, and is their suffering. Almost no one cares about that. Even most physicians, the technology allowing them to care doesn't exist yet. What matters is: how much does this cost, and how much return on investments can we get if investments are made.

    We are basically Ferengi. Let's be honest about who humans are.
     
  12. Jaybee00

    Jaybee00 Senior Member (Voting Rights)

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    Link for this please—thanks.
     
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  13. Yann04

    Yann04 Senior Member (Voting Rights)

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  14. Jaybee00

    Jaybee00 Senior Member (Voting Rights)

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    https://twitter.com/user/status/1822407919486349475


    Wow. If 400 million people have Long Covid then 50%, or 200 million people, have ME. This is up from the 24 million pwME pre-pandemic. If people with ME had not been neglected & dismissed for decades, hundreds of millions would have effective treatments or not gotten it at all.
     
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  15. rvallee

    rvallee Senior Member (Voting Rights)

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    Maybe I got it wrong but I think this is misinterpreted, that it's 400M who had, at some point, Long Covid, most of which have and/or will recover, not 400M right now.

    The important takeaway is that infections are bad for health. Even mild ones. They all carry some risk. But the fashionable standard right now is to maximize all the infections.

    Of course the fact that many such infections also cause chronic health problems has been misinterpreted as "COVID is no worse than other infections", which is true, but incorrect in that it's far, far more common, and that it's on top of maximizing all the other infections, because it's "good" for the "immune muscles".

    Humans seem to learn only by the process of making all the mistakes, then making them some more, then doubling down and making entirely new creative versions of the same mistake, then maybe learn some small part of it, then someone figures out the root cause with a workable solution and finally people accept it. And we haven't made that mistake yet. So... fun times ahead.
     
  16. DMissa

    DMissa Senior Member (Voting Rights)

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    And this is why it is important that it gets very clearly stated in publication. When applying for govt grants that are administered with a business RoI mentality, having a big figure with a citation next to it is essential.
     

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