Is long covid just a “joke”?

Published: September 25, 2020
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Many lockdown skeptics assume that post-acute “long covid” in young and healthy people doesn’t really exist or is insignificant; they assume it must be another media scare tactic to justify lockdowns. But they are wrong: long covid is real, significant, and entirely expected.

In the UK alone, about 600,000 people report post-acute covid symptoms for more than one month (12% of symptomatic covid patients), and about 60,000 people report symptoms for more than three months. These symptoms can range from rather mild to crippling severe.

Nevertheless, some vocal non-medical skeptics continue to claim that long covid is just a “joke” pushed by “self-proclaimed victims” who want to be “part of the illness of the moment”. But as a quick review shows, the claims of these highly motivated skeptics are misguided:

  1. Covid is of course much less deadly than SARS, but it affects many, many more people; this is why post-acute covid is affecting many more people than post-acute SARS did;
  2. Hospitalized and non-hospitalized covid patients do not get “mixed up”, they add up: post-acute covid occurs even in mild to moderate, non-hospitalized cases;
  3. The German heart study (showing myocarditis in non-hospitalized covid patients) has not been “debunked” at all, as its results remain unchanged: 60% showed myocardial inflammation and 36% reported persistent shortness of breath and/or chest pain after 2 to 3 months.
  4. The fact that long covid affects younger rather than older patients and more women than men is not “unexplained” or “suspect” at all; rather, it is a direct result of immunological properties.

Post-acute covid is likely a combination of immune-mediated pulmonary (lung), cardiac (heart), cardiovascular, neurological and possibly renal (kidney) effects. It is more common in young and healthy people (and in women) precisely because their immune response is stronger.

Indeed, the triggering of an immune overreaction is how earlier flu pandemics could kill so many young people, with 30% to 50% of deaths showing acute myocarditis (inflammtion of the heart muscle). In comparison, covid-19 certainly seems to be much less severe in young people.

Nevertheless, one to two months after coronavirus infection, symptomatic Swiss army recruits (median age 21 years) still showed a reduction of up to 20% in their maximum lung performance, most likely due to interstitial pneumonia (even if they experienced only mild acute symptoms).

In Sweden, a survey estimates that 100,000 to 150,000 people currently experience post-acute covid for more than 10 weeks (showing post-viral fatigue, chest pain or other symptoms).

On the positive side, most studies so far have shown a substantial improvement and regeneration within three to six months even in previously hospitalized patients. As noted before, one strategy to possibly reduce or avoid long covid is early treatment to prevent disease progression.

In conclusion, post-acute “long covid” is a real and significant issue that was to be expected from a medical-historical perspective; downplaying or exaggerating it is unprofessional and inappropriate. It must be taken into account in order to design a comprehensive public health policy.

More: On post-acute or long covid (updated)

A video from people affected by long covid

Not a joke, not a “hoax”, not a “professional PR campaign”.

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