Looking for Long Covid: A Clash of Definition and Study Design

Influential studies from the VA St. Louis take a broad view of long Covid. Not every expert agrees with the approach.


https://undark.org/2024/07/25/long-covid-clash-of-definition-study-design/

 

This is a deeply reported article. One criticism is that the author didn’t do enough to equate the “core” LC symptoms to MECFS. Hardly mentioned at all until
the very end. I agree that Al Aly’s definition of LC is far too broad.

 

Long thread from Zeynep

https://twitter.com/user/status/1816488858282049800

 

I see the Wyller/Selvakumar study is referred to in the article. The study was on prevalence of LC in adolescents. Using WHO criteria for LC, they found that adolescents could have some of the symptoms of LC, without having been infected with Covid-19. The message in media was that whatever LC is, it has nothing to do with Covid.

thread on study:
https://www.s4me.info/threads/jama-...lvakumar-wyller-et-al-2023.32677/#post-468290

Edited for clarity

 

Undark has a summary of the article on Twitter:

1/ Our latest feature from @Sara_Talpos explores the heated debate around long Covid research, focusing on influential studies by Dr.
@zalaly and the VA St. Louis team.

2/ Al-Aly's work suggests long Covid is widespread and poses significant health risks. His studies have shaped public health policy and garnered media attention.

3/ However, critics argue that Al-Aly's methods may overestimate long Covid's prevalence and severity. They question the broad definition used and the applicability of VA patient data to the general population.

4/ Contrasting research, like studies from Denmark, found lower rates of long-term symptoms in non-hospitalized Covid patients. Some suggest most people recover within a year.

5/ These conflicting results highlight the challenges in studying long Covid. With no clear biomarker, researchers struggle to reach consensus on its true impact.

6/ Recent U.S. government reports have adopted broad definitions of long Covid, similar to Al-Aly's approach. Some experts worry this could complicate research and treatment efforts.

7/ The debate reveals how scientific disagreements have unfolded amid real patient suffering and polarized public discourse about Covid-19.

8/ As research continues, experts agree on the need for more precise studies to understand long Covid's prevalence, risk factors, and potential treatments.

 

More from Twitter (Professor Hviid is an epidemiologist from the Danish public institute SSI who "prevents and controls infectious diseases, biological threats and congenital disorders". He is one of those ciritising Al-Aly's research in the Undark article):

@inkblue01:
A new hit piece is out targeting Ziyad Al-Aly. Don't believe any of it, the guy is on the cover of Time Health 100 for a reason. Cry harder minimizers. 1/2

@NielsANielsen as reply:
Yes, the article reads like a hit piece on Al-Aly and LC more than anything else: "Hviid and his colleagues aren’t the only researchers to find that long-lasting Covid-19 symptoms are rare for people with mild illness" Hviid et al: 17% of infected gets LC https://politiken.dk/danmark/sundhed/art9256963/17-ud-af-100-tidligt-coronasmittede-oplever-senf%C3%B8lger

...

The scientific paper from Anders Hviid's group behind the reporting in Politiken:

...

So no, Anders Hviid has not found that "long-lasting Covid-19 symptoms are rare for people with mild illness" as the article claims. Quite the opposite is true. They have found that long lasting symptoms are very common. As in 17% of the people infected early in the pandemic.

 

I didn’t see this as a hit piece..I thought it was pretty balanced.

 

I couldn't see where they mentioned ME but in general having overly broad criteria is bad for research and bad for the reputation of the illnesses you're researching. Think of the Oxford criteria and 2007 NICE criteria for ME.

 

I tend to agree with some of the criticism. Overstating the prevalence of Long Covid is not useful for research or patients IMHO.