Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection July 2020 Townsend et al

The full paper has now been published via @rvallee
https://twitter.com/user/status/1326924789676724224

 

They use the Chalder Fatigue "Score"!
Now to read on...

 

"The lack of distinct immune signature, coupled with the association with depression, lends credence to the multifactorial aetiology of CFS [59]. It also supports the use of non-pharmacological interventions for fatigue management and provides no basis for the use of immunomodulation in treating post-COVID fatigue."

Above is from the discussion.

 

These authors have about as much insight as a brick wall. Did it not occur to them that perhaps the pathology is not in the small number of places where people keep looking?

It's like losing your keys, you look on the table and the couch and then assume they're lost forever, when really you just haven't looked in many places.

Here is the paper they reference with regards to illness-without-demonstrable-disease. It is bad, very bad: potential readers, you have been warned.
https://sci-hub.st/10.1093/clinids/13.Supplement_1.S138

 

This is a thing of beauty (unfortunately not rare beauty):
"Despite a lack of distinct immunological findings, it is accepted that CFS can occur in the absence of demonstrable disease [57, 58]."

Possibly re-phrase as:
Despite a lack of distinct immunological findings [replace "distinct immunological findings" with "any credible evidence"], it is accepted [replace
"it is accepted" with "we accept"] that CFS can occur in the absence of demonstrable disease [57, 58]. "

 

Not the Leighton Cluff who started out with a cohort of 540 men and 60 women from Fort Detrick, whittled them down to 480 men, but produced the same number of positive results, notwithstanding that one of them was originally said to be female.

 

Lest any body take that paper by Cluff too seriously I would just point out one further issue. He says

It was striking that virtually all of those individuals who had CFS following acute influenza had appeared in the clinic complaining of being sick, but fewer than 4 % of those who did not have delayed convalescence came in complaining of being sick.

Despite having the facilities and resources of the biowarfare staff medical provision, and funding from the Chemical Corps, the follow up period for patients was between three and six weeks. There is no indication that any later data were collected. It is therefore not clear upon what basis he was able to make any comments about CFS, or to generalise his findings. It seems a strange omission. It should not have been difficult to arrange to see them again at, say, six months.

 

When the authors uploaded their pre-print to medRxiv on July 30th, I sent the following mail to Dr Townsend:

I received a reply within the next hour, in which Dr Townsend said he would "ensure that [the non-necessary inclusion of graded exercise] is clarified following peer review and prior to formal publication":

The authors left the text as it was in the pre-print, and it now appears unchanged in the published version of the article. Peer review history on PLoS ONE indicates they did not propose changes during the process.

 

Sigh. Not the first time genuine concerns from patients goes completely ignored by researchers...

Given the citation of the aforementioned Leighton Cluff paper which shows clear contempt for patients (not to mention ableist and racist), I'm not overly surprised.