Good news about a bad thing: Two big studies just appeared in Nature and JAMA suggesting that in most cases the risks from even serious Long COVID fades after 1.5-2 yrs. Until this, there'd been a lot of (understandable!) fears that it could last for a lifetime. But for most people, it seems not. - ThreadSky

charlescmann.bsky.social • 551 days ago

Good news about a bad thing: Two big studies just appeared in Nature and JAMA suggesting that in most cases the risks from even serious Long COVID fades after 1.5-2 yrs. Until this, there'd been a lot of (understandable!) fears that it could last for a lifetime. But for most people, it seems not.

Comments

jlgittinger.bsky.social•551 days ago

Depends if your "long haul" issue is no sense of taste, or heart/organ damage. I think there are too many deadly serious long haul effects to make a blanket statement that long haulers will be fine in 2 yrs.

megclems.bsky.social•551 days ago

No kidding… especially considering how many of us are >3 years and either plateauing or getting worse 🥴 too many of these studies are lagging behind reality and giving people false hope. Yes there are people who recover after 1-2 years, but that’s not a gamble we should encourage people to take

charlescmann.bsky.social•551 days ago

Happily, neither I nor anybody else is saying that. The results in Nature are ~70% of the 80 sequelae "became not significant" (including cardio and mental health) in the nonhospitalized Long COVID ppl and even ~35% of the hospitalized. The big strikeout seems to be fatigue.

endofmind.bsky.social•551 days ago

Of the DIAGNOSED sequelae, in areas without universal healthcare, in a VERY short time interval.

Some people learned from HIV and some didn’t. Some have agendas and some just want grant money.

Good luck with this nonsense.

mag29.bsky.social•551 days ago

I guess the trick is not to get reinfected and compound the issues 😮‍💨

auntieoddfur.bsky.social•551 days ago

I got long haul symptoms the 1st time, started slowly recovering after a year, then got it again - but other than the ~2 week acute phase, it didn’t affect my recovery trajectory at all. Obviously MUCH better to avoid it, but my body reacted totally differently (and much better) to the 2nd round.

mag29.bsky.social•551 days ago

I’m glad to hear it! I had coco infection June last year, and other than slow recovery from one of the worst sick experiences I’ve had, I lucked out. Managed to keep my fam negative too. But I am scared of getting sick again. And really don’t want my fam in the long covid lottery :/

auntieoddfur.bsky.social•551 days ago

Yes, do not recommend. I got it from my best friend and quarantined within hours of her testing positive, so fortunately didn’t give it to any family members. I worry a lot about my elderly parents.

auntiesis.bsky.social•551 days ago

In that study, in predominantly older males… I’ve had post viral squelae for 30 years. The worst/acute phase improved at 6 mos. The neurological diagnosis came in year 26. Good luck.

euqinimodart.bsky.social•551 days ago

OH MY GOD YAY, i’m hoping that this is true. I don’t wish for anyone to have long covid for the rest of their life

stephenjudkins.bsky.social•551 days ago

Curious: who are the non-infected cohort here? I thought pretty much everyone has gotten it

markelindsay.bsky.social•551 days ago

There isn’t a noninfected cohort, it’s 🪄

arkenor.bsky.social•551 days ago

I haven't had Covid. I have achieved this via the genius plan of only leaving the house for medical appointments, and wearing a mask when I do.

stephenjudkins.bsky.social•551 days ago

yes, which also implies that there are an extraordinary amount of confounding factors in studies like this

mainejane.bsky.social•551 days ago

Neither of my parents has had it.

hekaton.bsky.social•551 days ago

yeah its got 6 million uninfected veterans out of about 18 million veterans in the US, i think more than 2/3 of people have been infected at this point. most people i know (not me tho) have been infected multiple times.

stephenjudkins.bsky.social•551 days ago

My understanding is that plenty of people have been infected more times than they know, it's just that they've had asymptomatic infections they haven't noticed

executiveotaku.bsky.social•551 days ago

There are dozens of us, dozens!

OK, probably more than that.

yoderofkansas.bsky.social•551 days ago

Still haven't gotten it myself, but I was never one to really go out much anyway.

omegamom.bsky.social•551 days ago

I will also mention that there are studies of SARS1 patients that show for some people “Long SARS” has lasted 18 years.

omegamom.bsky.social•551 days ago

These were based on medical care records, right?

I pretty much have just stopped going to the doctor except for acute things at this point. My last doctor’s visit, she shrugged and said, “There’s not much I can do. Have you tried supplements? They might help.” 1/

omegamom.bsky.social•551 days ago

Still have the fatigue, the PEM, the muscle weakness, the brain fog (executive function in particular, which seems to be getting worse). No answers, so why bother going to the doc, y’know? It just leaves me drained for two days for…nothing.

mattjrosenberg.com•551 days ago

Is this saying that symptoms of long Covid fade over two years? Or that long Covid symptoms are unlikely to arrive after 2 years of an infection?

claiborne.bsky.social•551 days ago

Judging from the text that was posted, it looks like this only considers the chance of death, not specific symptoms.

charlescmann.bsky.social•551 days ago

The Nature article considers 80 other symptoms; the JAMA article is only mortality. The good news from the JAMA article is that the extra risk of death from Long COVID seems to drop even faster than the risk of less serious effects. (Again, this is for most people, not all.)

mattjrosenberg.com•551 days ago

Got it. Thank you

This WaPo write up seems a good recap though the news doesn’t seem good -

https://www.washingtonpost.com/health/2023/08/21/long-covid-lingering-effects-two-years-later/

charlescmann.bsky.social•551 days ago

I guess it depends on where you're standing. A number of people I know have Long COVID. They feared--as did their doctors--that they were looking at a life sentence, or at least decades of suffering, like the folks who have chronic fatigue. These results say, probably not (on average).

mattjrosenberg.com•551 days ago

Yeah, I’m think specifically of a friend who has the fatigue issue really bad. Hopefully it is true that it fades

meredithw.bsky.social•551 days ago

I don't consider 1.5-2 years good news. IMO, it's just "less bad than feared" news. Two years is a long life disruption, not to mention that for many it lasts longer than that.

romatowski.bsky.social•551 days ago

That does not seem to be the Nature corresponding author’s takeaway:

“Risks remained elevated for many Long Covid conditions even 2 years infection” https://twitter.com/zalaly/status/1693640539537555921?s=20

charlescmann.bsky.social•551 days ago

Yeah, it's weird. His own paper says ~70% of the 80 "sequelae" "became not significant" w/i 2 yrs for the unhospitalized patients (5/6 of the total) and even among the hospitalized patients "35% of them became not significant." I.e., the big majority of Long COVID in their sample got better.

levin.bsky.social•550 days ago

Many people with long covid give up on trying to get care. Especially since medical environments stopped masking its dangerous. These studies don’t account for people who give up on the studies or stop going to their doctors because they have lost hope and don’t have the energy.

charlescmann.bsky.social•550 days ago

I think this is incorrect. They're reporting on patients for whom they have data at 2 years. That wouldn't include people who stopped coming to see their doctors, because they wouldn't have data on them.

romatowski.bsky.social•549 days ago

No, EHR studies like this one look at risk of a given outcome (a diagnosis, hospitalization, death) in the entire patient pool, not just among the subset who sought out health care. (Doing the latter would always only tell you people who go to the doctor tend to be sick.)

charlescmann.bsky.social•549 days ago

But "diagnosis, hospitalization, [ID of] death" occur only through interaction w/ the health-care system. You can't be diagnosed if you don't go to a doctor. The researchers followed 160K VA patients for whom the VA system had 2 yrs data from diagnosis. People who dropped out wouldn't be included.

charlescmann.bsky.social•550 days ago

To affect the results, you'd have to show that more people stopped seeing their doctors because they gave up than because they felt better. FWIW, my doctor friends say they don't think that's the case--they see their patients as determined to get well, and devote considerable time to their care.

levin.bsky.social•550 days ago

I am literally in groups for getting care where people say they have run out of specialists to see. But beyond that, your doctors don’t know who is dropping out and why because they don’t talk to who they didn’t talk to, who’s insurance has denied etc. The other studies haven’t accounted for

charlescmann.bsky.social•551 days ago

Considering that the big question currently facing Long COVID sufferers is whether this is going to continue forever, like Epstein-Barr or CFS, this is obviously good news.

romatowski.bsky.social•551 days ago

Like Dr. Al-Aly, it’s not obvious to me that 24 of 77 sequelae persisting 2 years after a mild infection is good news. I notice also the highlighting you posted is from Eric Topol’s writeup, who summarized: “Unfortunately, what was seen at 6 months largely continues out to 2 years.”

charlescmann.bsky.social•551 days ago

Like I said to someone else, it depends on where you're standing. My pal L-- has had severe neurological Long COVID symptoms for months after a mild infection. Her drs have no idea whether they ever can or will stop. Now they can say that evidence shows for most ppl they do stop. That's good news.

romatowski.bsky.social•551 days ago

Unfortunately risk for 9 of 20 neuro sequelae remained elevated 2 years after mild infection and neuro LC often involves more than one of these, but, as Dr. Topol said, “Some people, albeit a small proportion, completely recover over time.” Crossing fingers your friend will be one of the lucky ones!

lifelivedwildly.bsky.social•551 days ago

So as long as everyone has two years worth of savings to stay housed and fed it'll be fine! *cries in millennial and gen z*

charlescmann.bsky.social•551 days ago

I know. This is only good news in the context of "we had thought that Long COVID was a life sentence." That doesn't mean it's easy for sufferers, or not a heartbreaker for their families and friends, or in any way actually good.

afthescientist.bsky.social•551 days ago

Do they discuss how many times individuals are infected? Is that considered? Is there any breakdown of high risk vs not high risk individuals?

charlescmann.bsky.social•551 days ago

No. They did the simplest trial possible, hoping to produce more reliable results. They compared "people we know had COVID" vs "people who show no signs of COVID". Here's the paper: https://www.nature.com/articles/s41591-023-02521-2

afthescientist.bsky.social•551 days ago

Thanks! I will read it later.

I would like to see those breakdowns too since we know multiple covid infections increases risk over time. I hope that’s the next direction they go in the future. I am also concerned about this conclusion not knowing how future variants will affect individuals.

charlescmann.bsky.social•551 days ago

All good questions! But finding the answers will take time. For now, this seems like an important first step.

jostewart.bsky.social•551 days ago

From a pure data perspective, this is excellent news, but I'm also very wary of stating total length of disease course 1) so early in study of the disease, 2) without full understanding of (probably multiple) etiologies, and 3) while I—just me personally—know 3 people with severe disability >2yrs.

jostewart.bsky.social•551 days ago

It's still good news, but this version of most is far from all, and considering how many people are suffering from long COVID, and how they continue to be dismissed, undertreated, and mistreated, I look askance at anything that can be twisted toward *more* dismissal and less study.

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