> we saw that the mitochondria of the muscle, also known as the energy factories of the cell
*Ahem*, powerhouse of the cell
Jokes aside, this is a terrifying stat:
"Although the majority of people infected with the SARS-CoV-2 virus recover within weeks...around one in eight will get long-COVID. Symptoms in patients with long-COVID...include severe cognitive problems (brain fog), fatigue, exercise intolerance, autonomic dysregulation..."
There is nothing to be “terrified” about. You are conflating different types of “long covid”.
Some covid infections, just like the cold or the flu, cause symptoms longer than the 5-7 days, maybe for 2-3 weeks. That’s long covid. Also remember that long covid symptoms include symptoms like depression and it ends up not being very rigorously defined.
Then there is the version that creates long term chronic fatigue symptoms. That is a much smaller percentage of the population, more like 1% or less. The chances of getting that are extremely small and there’s nothing to be terrified about. You can also get CFS from the flu, and other benign diseases.
Just from looking at the general population it’s easy to see that 1/8 people are not suffering from long covid. Just like how I know someone who got the vaccine and she ended up being crippled by arthritis from the vaccine, but that is not a common side effect at all otherwise we would have seen that more often in the people around us.
You're right, and I wish we had terms to differentiate them. It's ridiculous that "chronic fatigue and brain fog for the rest of your life" and "flu-like symptoms for 3 weeks and then back to normal" are both discussed under the term "long covid".
I wouldn’t characterise 1% as an “extremely small chance”, especially considering the prevalence of the disease, especially if it’s possible to develop it on your second or 3rd infection. Would you play Russian roulette with a gun with 100 chambers?
Compared to new-onset arthritis from the vaccine - the biggest lit review I can find found 45 confirmed cases across 31 studies. [1] For comparison there are over 730,000 (self reported, admittedly) cases of long covid lasting more than 104 weeks in the UK alone. [2]
As someone without long COVID (or Covid ever). Your description of long COVID o only a little bit worse than a decent day for me. (Multiple chronic conditions, including multiple respitory). If I had chronic fatigue on top of what I already have, I’d be hardly capable of getting out of bed to go the bathroom. Working would be absolutely out of the question.
I think that for people without enough paid sick leave (maybe especially in the US), being knocked out for 2-3 weeks with a virus that is more infectious than flu is an event causing long term damage to their life. Especially with the repeal of many COVID-safety protocols at companies because of social pressure.
> Some covid infections, just like the cold or the flu, cause symptoms longer than the 5-7 days
That's arguably also terrifying if even common viruses are known to cause long term conditions. Also consider the evidence pointing to a link between viral infection and dementia:
When the symptoms are "a lingering cough" (which is what we're talking about most of the time), it's not terrifying. It's just something you ignored before and are not ignoring now.
As OP notes, there are certainly some small fraction people with worse outcomes. But the generic "long covid" term has mixed up all sorts of things -- from hospital syndrome (absolutely real! but very rare!) to symptoms that anyone would completely disregard prior to 2020 as "a head cold" (very common!)
Also, of course, there's a ton of motivated reasoning surrounding this topic where people are in forums and comment threads attributing every symptom under the sun to Covid, and dredging up bad observational studies to support their claims. The link to dementia likely falls in this bucket. It's not coincidental that most of the people to get seriously ill with Covid were/are old, and that most of the people who get dementia are...old.
The argument wasn't specific to Covid. The people who get "severe viral infections" tend to be people who are old and unhealthy to begin with. When you start with a population of medical records (as this study did) you unavoidably bias your sample toward sicker people.
Observational studies don't/can't perfectly correct for this residual confounding. This exact error has been repeatedly made by "long Covid" research as well (most notably by Ziyad Al-Aly, who has published a half dozen different articles on Long Covid using the same confounded, observational VA medical record dataset, and claimed associations with a huge number of different illnesses. This research is garbage, but it has scared people out of their wits.)
You literally have that same symptom with the flu.. or a cold.
ME / CFS is a horrible disease. My younger brother was out with it for a year but I know several women for whom it has effectively been a life changing condition.
What is the fitness level of people suffering from the more extreme cases of "long covid"? As in, are they overweight and unhealthy in other ways? Because if that is the case the issue isn't the virus, it's the general health of that population in the first place. That's my gripe about this discussion, because I can never tell, since all I get is anecdotes, if this is a result that's agnostic to body type/fitness. Does any research control for this?
Just anecdotal, but there are many fit, marathon runners that have suffered from this, myself included. I had LC for five agonizing months. I think it was because I tried running through some of the mild symptoms that caused me to get this. I don't think I lost my overall fitness, but rather my muscles/cells, etc. lost its ability process oxygen properly. Once I got "better", my ability to run fast returned quickly, like within one or two months.
Again, anecdotal, but your story checks out in that fit people who have described LC symptoms are almost always distance runners or very overweight. I'm really curious if there's something there and if the correlation to body-type exists at the tails for some reason.
I had chiseled abs. Trained Jiu-Jitsu 2 times per day 5 days per week as well as lifted weights, etc. My diet consisted heavily of fruits, veggies and lean meats. Nothing artificial. Only water, coffee, and an occasional pre-workout.
I lost my sense of smell and taste for ~6 months. Was in bed for 1 week, sleeping like 18 hours per day. Some foods still don't taste the same (mostly eggs and chicken).
This was about 2 days after I got the second dose of Moderna's vaccine.
Thanks, but this doesn't really address my question. It looks like they took 25 people, and measured some variables before and after exercise post recovery (why such a small sample size? looks like a really easy test to run). I'm not really talking about how covid affects ones ability to exercise. I'm talking about the likelihood of "long covid" appearing in people who are fit and healthy vs not.
1.2% of the French population has long COVID with large/very large impact on daily activities. 4% has long COVID more generally. So I expect more than 1% of chances of getting debilitating symptoms.
Though it could be that people with "light" long COVID recover while people with debilitating long COVID don't and make for an unexpectedly high share of the population as they accumulate. (not saying I think that this is the case, just saying this is a possible alternative explanation to "chances of debilitating long COVID are chances of long COVID / 4")
Under some developing models by long covid researchers, they believe that with enough of a "viral load" of persistence in your body(or different areas of your body), it can be the difference of being asymptomatic and symptomatic.
hmm
friends of mine who got infected in early 2020 are still feeling quite unwell
also recent studies have shown the body never totally clears the virus.
Yes, but isn't it more like if there is perhaps a factor X you don't belong to the 1/8 risk group that the chances that with subsequent infections you get long covid-19 is smaller (or near zero)?
It's likely that this factor exists as lots of people got infected multiple times and not everybody has long covid-19.
Is it a matter of rolling those odds every time for everyone or is that only for 1 in 8 people or would they get long covid-19 100% after each infection. Would mRNA vaccines adequately protect this group from long COVID-19?
Could it be a side effect of some treatment, similar to contagan? You take something to reduce side-effects, covi let's it into cells where it poisons the mitochondria?
> People that had their first infection early in the pandemic, though, were also more likely to report multiple COVID-19 infections. For example, in this study the average date of first infection for those with three or more infections was May 2021, compared to September 2021 for those with two infections, and May 2022 for those with one infection. Those infected earlier in the pandemic, before vaccination and the emergence of the Omicron variant were more likely to develop long-term symptoms, but also had more time since their first infection to become infected with COVID-19 again.
This is also all self-reported surveys. That means that they're selecting for people who will self-report questionnaires, which is incredibly highly biased.
Immunologically it doesn't make a lot of sense to me and there's no theoretical foundations for how this could be happening. If its linked to people with susceptible genetics/biology (something like MHC subtype) then long COVID should stabilize affecting only that population. If it is due to autoimmunity then people who have formed healthy immune responses to COVID shouldn't increasingly be susceptible after the initial immune response is formed. Give it a few more years, and I strongly suspect that better studies come out finding that long COVID risks decrease over time (although they probably never go to zero, but it starts to look more like flu/cold risk of ME/CFS and that antibodies to vaccination/prior infection are actually protective, like one would logically expect).
I think we need more, better, and longer-term studies before we can adequately conclude that reinfections lead to more long covid. And I think the answer to that question, if it comes with enough accuracy, could influence long-term decisions about how we respond to COVID.
Already the progressive subset of my social media is mostly working on the assumption we are seeing a "rapidly rising, ever-worsening reinfections leading to continuously increasing amount of long covid", but that's not what I'm hearing from the medical subset (in person, off the record, not on social media, because they're tired of the whole social media garbage cycle).
I mean from the start of the pandemic most virologists were leaning towards COVID becoming another seasonal human coronavirus. Fauci initially was prepping us for the vaccines only being 50% effective against infection (which is probably around about where they actually wound up).
There's this Mandela effect in left-leaning circles which thinks that the messaging started with the early 3-month >90% efficacy-against-infection results from Dec 2020, and they're getting fairly hysterical that we abandoned zero covid, when that actually was never the policy. We just collectively all leaped to that hope with the first round of vaccine results because we wanted the pandemic to just have a simple off switch.
And now that's been twisted up into weird us-vs-them political pathologies where the nominally right-wing antivaxxers are shouting about how the vaccines don't work because they weren't what was "promised" while the left-wing is getting hysterical about giving up on covid eradication.
Most virologists/immunologists/microbiologists are happy that we have vaccines that are 95% efficacious against severe disease/death and that the pandemic is either over or winding down (based on entirely debatable definitions), but this pisses off both different political tribes in different ways.
Also if there's a study on how the symptoms change with reinfection that'd be great too.
EDIT: I just realised that some people may interpet the comment as saying that long-covid's symptoms are a great thing or something along those lines. I just meant that it would be nice to find such a study. Sorry.
A news thing I read today said the trend was opposite. Norwegian article and no reference to whatever publication they based that claim on, but serious newspaper at least.
It's less terrifying when you make the proper comparison. What proportion of people would self-report brain fog, fatigue, etc, on any given day with nothing to do with Covid? Probably close to one in eight.
Got exposed to a lot of chemical gas in a home that had a gas leak. Developed all the above symptoms and more.
Later diagnosed with an autoimmune disorder. Sjogrens.
Best I can figure, I had Sjogrens before, but it was so mild. I didn’t really notice or care. After the exposure, all the symptoms were amped up 50 fold. Also had Factor V Leiden. Which went from not an issue to multiple clots every single week.
After about four years, the symptoms dad calmed down to certain degree. Getting Covid was a full relapse for about six months.
Of course my wife got the vaccine and her arm swelled up and years later still hasn’t gone back down.
The title is a lot more exciting than what is actually being claimed. They say that malfunctioning mitochondria are to blame ... but there is no insight into why the mitochondria are malfunctioning.
My wife, a formerly energetic, outgoing, type A person, has been suffering from ME/CFS for 20 years. Long COVID symptoms are highly similar to ME/CFS problems, and the hope has been that the long-underfunded ME/CFS research would benefit from the research money that has come with COVID. Thus, I felt let down when I read the linked blurb.
It is exciting. Before this, we could only posit wild guesses as to the physical mechanism behind long COVID (if there was one at all). In the first year or two, scientists even doubted whether it was real at all. When you know the physical mechanism, it allows you to figure out a way to treat it.
Right, the mitochondrial dysfunction has known for a while. But is not not the cause, it is the symptom. Many argue the cause is viral persistence, causing a continual immune response causing the body to be dysregulated and mitochondrial dysfunction. Another idea is endothelial damage that simply takes time to be repaired and that sometimes can be made worse by over taxing your body.
An interesting fact: this research was paid for by crowd funding because the Ministry of Health refused to fund it. The Netherlands is also unique in Europe as the only country which does not even try to treat this condition.
If you get ME/CFS you are, quite literally, left to die here. Unless someone in your network looks after you.
A friend is going through the ME/CFS "journey" in Canada right now. Apparently, to get disability for CFS, one needs to first apply for disability, which will be rejected. Then, one needs to be able to afford a lawyer to sue the government, which ultimately gets CFS recognized on a case-by-case basis to be debilitating. There are apparently a couple of clinics who specialize in CFS, but they're nearly impossible to access.
Cool. I wonder if they’ll ever discover the reason behind the loss of smell. I lost mine completely for about a year, and I still can’t smell most things. Luckily one of the smells I got back was shit, I say lucky because it’s handy when you have diaper wearing children. In general what I’ve gotten back has been “nasty” smells, I can also smell things like vomit or rotten food. But “good” smells are still completely gone. I can’t smell flowers, I can’t smell candy and so on.
It never really affected me, as I apparently cared a lot less about smells than many other people, but it is a little frightening to lose something because of a disease. I’m happy it was the only side effect I got, I’d obviously rather have had none, but I’d frankly be comforted by scientists knowing more about it.
Have you tried smell training (basically you sniff 3-4 different types of essential oils daily). My girlfriend lost her smell due to covid for a year or so, and got it back about a month after starting smell training
One hypothesis is that long covid is caused by reactivated Epstein Barr virus or other herpes family virus.
It hasn’t been confirmed but it seems clear that the initial Covid infection has great impact to the immune system and triggers all sort of collateral effects.
Somehow I think of epigenetic processes. That COVID had an interaction with the way genes for mitochondria are transcribed. I also heard somewhere that mitochondrial dysfunction is related to psychiatric diseases, IIRC bipolar disorder or depression. Although that mechanism seems different as antidepressants and mood stabilizers don't make a dent long COVID.
It isn't these researchers job to distinguish every phenotype of long covid as there are other groups trying to figure that out. When those definitions are clearer, I'm sure more upcoming literature will distinguish that. But for now, the current definition are symptom/observational based as we have no biomarker or means to distinguish post-vaccination / infection based long covid yet.
I don't think "tiredness" is a good word for the title. The type of symptoms experienced as post-exertional malaise is not really the same being sleepy.
When I had an ulcer and was losing blood and therefore iron, I described it to my doctor as not being tired but weak and lacking stamina. Would those be better descriptions?
Researchers from Amsterdam UMC and Vrije Universiteit Amsterdam (VU) have discovered that the persistent fatigue in patients with long-COVID has a biological cause, namely mitochondria in muscle cells that produce less energy than in healthy patients. The results of the study were published today in Nature Communications.
I'm sorry HN, but you continue to downplay long covid when there is evidence like this for a biological pathology right in front of you.
Please stop saying it is psychosomatic. Please stop saying only unfit people get it. People stop saying it is caused only by the vaccine.
All of these things do nothing helpful. The science will continue to push through these opinions regardless.
Why can't the discussion be focused on the actual finding here which is that we have a much clearer model of what is causing PEM / exercise intolerance in symptomatic long covid patients versus asymptomatic controls via amyloid deposits, mitochondria dysfunction, and muscle structure changes.
You realize that there was no vaccine for about a year, during which millions of people were infected, many dying and many more left with long COVID symptoms. There is no need to scapegoat vaccines for causing these problems.
You keep bringing that up, but Long Covid is exceptionally well documented at this point. We can't pretend it's entirely in peoples heads like you seem to be doing.
People have staked their whole identity on the whole thing being a hoax. I have a (ex) friend convinced that billions of people died of heart failure specifically due to the vaccine and the whole thing was covered up, and his evidence is basically that he believes the virus wasn’t real and the vaccine was some kind of government plan to murder everyone. What can you say to that? He will just keep doubling down forever at this point.
I generally don't like to pretend I can read minds, but it seems unlikely you needed my comment to know there are unvaccinated people. The comment I'm replying to know seems pretty coy, a "just asking questions" defense.
Are we still trying to find some direct physical correlation betwee the symptoms of "long covid" and the virus infection itself?
Such symptoms occuring are unsurprising given the psychological effect of the pandemic at its height, its societal and economical effects.
Adding to this getting infected and all the fanfare, along with fear mongering we've been subject to via the media and mandates, long covid could alone so easily be caused by the side effects on mental health.
I won't dare claiming most disease have psychological root causes, not a medical professional.
Yes it is my reaction off the post.
I challenge it and posted a couple of cousin comments to argumen. What more can I say, happy to be proven wrong, until then
> Palmer also sheds light on the new treatment pathways this theory opens up--which apply to all mental disorders, including anxiety, depression, ADHD, alcoholism, eating disorders, bipolar disorder, autism, and even schizophrenia.
Because he's an obvious hack who's completely full of shit? I always wondered what kind of person would ever have bought those early 1900s "Dr. Amazing's Medicinal Tonic" claims about curing syphillis, headaches, snake bites, cancer, broken bones, and bad breath. I guess I found one?
Sure can, right after you give me concrete evidential examples that refute the Time Cube guy. The reason people don't bother to refute bullshit-on-their-face claims is because it takes 20x more effort to refute a bullshit claim than to make one in the first place, and it's absolutely pointless to argue with a hack who never intended to base his argument on evidence anyway. The best thing to do with these guys is completely ignore them, the same way they ignored the vast body of human knowledge and understanding in the first place.
I'm not saying you're wrong in your view of Dr. Palmer. I can see this is a subject that you have strong feelings about but, unfortunately, you've given me nothing to work with. I'm earnestly trying to understand another side of his claims, which is why I asked for more concrete evidence.
I had not heard of "the Time Cube guy" before but a quick search brings up a lot of conspiracy theories. However, I don't see what that has to do with Dr. Palmer's Brain Energy theory.
For what it's worth, I hate conspiracy theories. It's intellectual laziness. So, when you said Dr. Palmer's Brain Energy theory is pseudoscience I immediately wanted to know more because I want to be able to disregard it if the facts warrant that.
I think my quoted passage says everything it needs to say (emphasis mine):
> which apply to all mental disorders, including anxiety, depression, ADHD, alcoholism, eating disorders, bipolar disorder, autism, and even schizophrenia
All mental disorders!? That is not the kind of claim anyone with a real discovery has ever made. Everyone who claims that their discovery could cure everything in that list is a huckster. He's claiming that mitochondrial issues cause everything that can ever go wrong with the brain! He's simply casting aside the possibility that any of these conditions could be caused by any of the dozens of causes that we know are associated with various cognitive decline (even if there isn't a simple causal link to any specific mental disorder):
* Lead, mercury, or other heavy meatal poisoning
* Neurotransmitter deficiencies or reuptake problems
* Infection and auto-immune issues
* Blood flow issues
* Prions
* Cell death from toxic substances (e.g. huffing paint)
* Problems with myelin sheathing
* Problems cleaning junk out of CSF
The list goes on and on. No, screw all that, every other scientist on the planet is wrong: it's just this guy's one thing that he found that causes all mental disorders. Maybe he'd say "ok but lead poisoning is actually damaging the mitochondria, so I'm still right!" but that's at best moving the goal posts, and at worst obviously wrong: toxic metals damage everything. Other scientists have studied lead poisoning, and the main problem seems to be its action on myelin sheathing, not on mitochondria. Most of this stuff has no causal relationship with mitochondrial damage at all. You have to completely disregard almost the entire body of neuroscience to make the claims he's making.
The list of "all mental disorders" is so vast, so complicated, so nuanced, that we can't even agree on what something like schizophrenia even is. We're talking about the brain: the most complicated system in the known universe. It's not all caused by this one guy's pet theory.
Anyone who comes out of the gate with "Einstein was wrong! Perpetual motion machines! The rest of the world is lying!" can be completely ignored. This guy may not be explicitly claiming that every other scientist who studies the brain is wrong, but they are implicitly claiming that.
Maybe because covid 19 has been accompanied with an avalanche of commenting along with draconian measures that we haven't seen for at least an entire generation.
Other illnesses still existed during the lockdowns and various other health conditions have forced people to be as isolated for years in the past. Many people got mental problems like depression but no long covid during the pandemic.
I'm not sure why it is so difficult to see the point in my comment.
My argument is that the level of fear inducing information surrounding most people on the planet, associated with covid, was nowhere comparable to fear inducing info associated with any disease and their potentially correlated (or not correlated) potential psychological side effects.
By saying this I'm not claiming that long covid is caused by a psychological side effect of a/ having been infected and b/ the information and fear induced state most people fell into and/or c/ other complex compounded side affects of the measures put in place to fight the pandemic: loss of income, job, sense of safety, isolation and containment driving our minds pretty sick
I'm saying it could be hence finding correlation between covid infection and longer than short term symptoms described in many independent observation MAY be a red herring
Last, an over simplified illustration:
- put, furtively some toxine in food and 1000 consume it.
- 800, let's say. get sick then recover entirely in the short term.
- put, some toxin in food, followed by massive information campaigns, hammering everyone day in and out of the presence of a toxin in food, then lock everyone up, have 200 lose their job, lose contact with their closed ones, etc etc
- 200, let's say, global knowledge some food was contaminated didn't help an ounce to reduce their consumption, get sick.
- 20, let's say, don't fully recover short term and are left with what we would call "long toxin consumption syndrome", suffering various side effects.
And we have research insisting they are seeing correlation between a toxin and long term side effects. Ignoring the social, economical and psychological very potential effect/contribution to these longer term symptoms, I find flagrant lack of hollistic view to phenomenon often lacking scientific researchers.
It’s not psychosomatic, but there usually are multiple contributing factors to serious respiratory disease, and I think it’s OK to consider it as a relevant one of them in many cases.
I was expecting the linked study to support your hypothesis that fear of covid-19 causes long-covid, but unfortunately it was just a writeup of 1 person's opinion of something that might have happened nearly a century ago, with literally 0 experimental methodology (because it appears to be an op-ed rather than an experiment?)
Your hypothesis doesn't seem super likely, though I'd entertain the theory if there were a study showing a linkage here. But as for your literal question, I don't think anyone supposes you specifically must do anything. After all, what's 1 person out of billions?
*Ahem*, powerhouse of the cell
Jokes aside, this is a terrifying stat: "Although the majority of people infected with the SARS-CoV-2 virus recover within weeks...around one in eight will get long-COVID. Symptoms in patients with long-COVID...include severe cognitive problems (brain fog), fatigue, exercise intolerance, autonomic dysregulation..."