It most likely isn't actually rising. First, they referred to estimates adjusted to a pre-pandemic baseline of long-COVID-like symptoms as a lower-bound estimate mostly based on speculations. It should be their primary estimate. It doesn't make sense to have >0 long-covid before the pandemic. 1/4
It also explains the discrepancy between the two adult cohorts. The difference between 10% and 25% is huge; the authors attributed it to a more or less restrictive definition. However, the difference between adjusted values is only 5% vs 6%, which makes much more sense. 2/4
Second, they wrote that cases are undercounted at the beginning, but not about missed cases during the omicron era. The graph of case count looks like official underreported cases. They missed at-home rapid test results during the Omicron era, mostly mild cases with fewer long COVID. 3/5
Acute COVID-19 illness severity was the strongest predictor of long-COVID risk in this study. The inclusion of rapid tests also tracks well with wastewater data. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824211 That alone most likely explains the apparent long-covid rise for the latter omicron variants. 4/5
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