Symptom profiles and their risk factors in patients with post-COVID-19 condition: a Dutch longitudinal cohort study.

Sander K R van Zon, Aranka V Ballering, Sandra Brouwer, Judith G M Rosmalen, Lifelines Corona Research Initiative.

Abstract

Background

To improve research and care for patients with post-COVID-19 condition more insight into different subtypes of post-COVID-19 condition and their risk factors is urgently needed. We aimed to identify risk factors of post-COVID-19 condition in general and for specific symptom profiles.

Methods

This study is based on data collected within the Lifelines Coronavirus disease 2019 (COVID-19) cohort (N = 76 503). Mean pre- and post-SARS-CoV-2 infection symptom scores were compared to classify post-COVID-19 condition. Latent Profile Analysis was used to identify symptom profiles. Logistic and multinomial regression analyses were used to examine the association between demographic, lifestyle and health-related risk factors and post-COVID-19 condition, and symptom profiles, respectively.

Results

Of the 3465 participants having had COVID-19, 18.5% (n = 642) classified for post-COVID-19 condition. Four symptom profiles were identified: muscle pain, fatigue, cardiorespiratory and ageusia/anosmia. Female sex was a risk factor for the muscle pain and fatigue profiles. Being overweight or obese increased risk for all profiles, except the fatigue profile. Having a chronic disease increased the risk for all profiles except the ageusia/anosmia profile, with the cardiorespiratory profile being only significant in case of multimorbidity. Being unvaccinated increased risk of the ageusia/anosmia profile.

Conclusions

Findings from this study suggest that Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger different pathophysiological mechanisms that may result in different subtypes of post-COVID-19 condition. These subtypes have shared and unique risk factors. Further characterization of symptom profiles and quantification of the individual and societal impact of specific symptom profiles are pressing challenges for future research.

https://academic.oup.com/eurpub/advance-article/doi/10.1093/eurpub/ckad152/7248369?login=false

 

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The sub-types are not cleanly separated, though. So they are more like sets of possible outcomes that aren't mutually exclusive. Like how car injuries don't have types of injuries that are mutually exclusive with falling from on high, or sports injuries.

The obsession with cleanly separating based on the standard practice of differential diagnosis is seriously hindering progress here. They are rejecting pieces of the puzzle simply because they don't have boxes that accept those precise shapes. And they still don't have boxes for those shapes because of decades of blatant refusal to do so, the very same failure in an infinite loop. Same with the refusal to follow the evidence, in ignoring PEM and cognitive dysfunction

This is simply unacceptable and makes it really close to an invalid study. Too many assumptions and judgmental decisions still. It's been 3.5 years and it's not even improving. It's almost like there's something to this old "germ theory of disease" and that it's obviously not a simple "get pathogen X, get disease Y-caused-by-X", which seems to be an obsessive need. In some cases it works. In most it clearly doesn't.

And still the obsession with demographic and lifestyle risk factors, even though a huge number of long haulers were in that exact range of criteria that would qualify as "so healthy they literally could not possibly get sick" in the minds of way too many MDs.

It wouldn't be so bad if those errors of judgment were common, but they are literally routine, even used as a weapon. How many times have we seen logical fallacies like "you're too young to be ill"? Or the weird inability to understand that one disease may be rare, but with thousands of rare diseases it's still not nearly rare enough to dismiss as a possibility?

At least half of the research so far has had an explicit and blatant minimizing intent, refusing to follow the evidence for arbitrary reasons. Medicine is seriously crapping the bed and showing itself to be very underwhelming. Exactly how much more are they oblivious to if they can miss something so big happening right in their faces?