Talk:Long COVID

Epidemiology edit

Some reports of long term illness after infection appeared early in the COVID-19 pandemic and can be thought of as the time difference between microbiological recovery from COVID-19 and clinical recovery as patients with Long COVID are generally PCR negative. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056514/. The reports included people who had a mild (not requiring hospitalization) or "moderate" (requiring oxygen supplementation) initial infection as well as those with more severe infection with about 40% of patients who reported Long COVID symptoms 3-6 months after infection not reporting them in the first 3 months emphasizing the remittent and not necessarily continuous nature of the diagnosis. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003773#pmed-1003773-g005. — Preceding unsigned comment added by ‎Gracesweeney (talk • contribs)

Bringing this to GA

Over the next 6 months or so, I'd like to bring this article to GA. Never written any medical articles, so if there are people willing to help, that would be much appreciated. Femke (talk) 09:44, 2 October 2022 (UTC)

Hi Femke, glad to hear it. I'm happy to help with whatever you need. I probably won't have huge chunks of time to dive into the topic, but if you point me to sections, sources, et al. you'd like a hand with, I'll do my best. Cheers! Ajpolino (talk) 15:37, 8 October 2022 (UTC)

That's very much appreciated. I'm first trying to get a good structure in the article. First question

• I see some disease GAs have a separate section about causes and pathophysiology. What's the difference? And is there a simpler term for pathophysiology?

Femke (talk) 12:26, 9 October 2022 (UTC)

Think Causes and Mechanism as the distinction ... have a look at Tourette syndrome for an example of what goes in each (or dementia with Lewy bodies, but I think the distinction more clear at TS). You've probably seen Wikipedia:Manual of Style/Medicine-related articles#Diseases or disorders or syndromes? SandyGeorgia (Talk) 14:37, 9 October 2022 (UTC)

It's amazing to have a preset structure!

I'm wondering how to organise the 'Health system responses'. At the moment it's a bunch on news about a small set of countries. I don't think it has a place in this article, but we could dedicate a single paragraph in the management section to the existence of long COVID clinics. There is some information about research, but that's too outdated/vague to save. A timeline of events is not really suited to a history section, right?

As an alternative, the section could be split into a new article Health system responses to long COVID. —Femke 🐦 (talk) 17:31, 25 October 2022 (UTC)

Grouping the non-scientific further reading?

It seems the Guardian now has a general link of https://www.theguardian.com/society/long-covid and BBC has https://www.bbc.com/news/topics/c6v43w0z9gdt So should individual items be removed in favor of such links? Chidgk1 (talk) 12:36, 18 October 2022 (UTC)

The further reading should certainly be trimmed. However, per WP:further reading, further reading elements should be reliable and balanced. If we link to a repository of lay articles, we cannot guarantee that's the case. Femke (talk) 16:22, 18 October 2022 (UTC)

True but BBC have been trying for 100 years now so I just added them for news for now and deleted the 2020/21 news Chidgk1 (talk) 17:56, 20 October 2022 (UTC)

Hmm.. I think it's a bad idea to remove all patient stories. Even though the BBC's reputation is good, they're not scientists, and their history of featuring climate misinformation does not give me confidence that a random sample of their articles around long COVID are of high quality. Femke (talk) 18:53, 21 October 2022 (UTC)

Further reading isn't quite the same as external links, but WP:ELNOT#9 mentions we shouldn't list search results, and this comes quite close to search results from the BBC website. Femke (talk) 18:55, 21 October 2022 (UTC)

I was probably rushing a bit - I won’t be peeved if you or anyone else reverts any of my changes to this article Chidgk1 (talk) 15:12, 28 October 2022 (UTC)

Treatment Experiments

https://www.reuters.com/business/healthcare-pharmaceuticals/addiction-drug-shows-promise-lifting-long-covid-brain-fog-fatigue-2022-10-18/ 2600:8804:6600:45:D4B9:3263:D519:E912 (talk) 17:20, 19 October 2022 (UTC)

Good news that there will be multiple studies on this drug, even if they seem a bit small. We cannot add anything to Wikipedia before the outcome of large-scale trials are published, and preferably described in review papers, per WP:MEDRS. Femke (talk) 17:24, 19 October 2022 (UTC)

Appropriate for U.S. response section?

National Research Action Plan on Long COVID and Services and Supports for Longer-Term Impacts of COVID-19, both US HHS August 2022 Mapsax (talk) 22:13, 21 October 2022 (UTC)

Semi-protected edit request on 26 October 2022

Causes: Mitochondria dysfunction and fatty acid metabolism changes IrinaPetracheMD (talk) 12:42, 26 October 2022 (UTC)

@Irina: Thank you for that suggestion. I have posted a mention of this to the article, which I hope you will find acceptable. Let me know if not. JBW (talk) 13:31, 26 October 2022 (UTC)

not sure if the study on Inflammation and dysfunction of the lining of blood vessels that relates to post-covid can be included

Recently, I came across Eric Topol tweet on Inflammation and dysfunction of the lining of blood vessels linking to the nature's article, here's the tweet with the article, do deliberate on including this study if it's reliable "Inflammation and dysfunction of the lining of blood vessels—the endothelium—is the basis for many of the cardiovascular complications of Covid. A new, solid review here https://www.nature.com/articles/s41401-022-00998-0#citeas Kaveinthran (talk) 17:02, 28 October 2022 (UTC)

Post-COVID brain changes seen in MRI scans - Nature

"SARS-CoV-2 is associated with changes in brain structure in UK Biobank" [1] "Here we investigated brain changes in 785 participants of UK Biobank (aged 51–81 years) who were imaged twice using magnetic resonance imaging, including 401 cases who tested positive for infection with SARS-CoV-2 between their two scans—with 141 days on average separating their diagnosis and the second scan—as well as 384 controls. The availability of pre-infection imaging data reduces the likelihood of pre-existing risk factors being misinterpreted as disease effects. We identified significant longitudinal effects when comparing the two groups"

May be too theoretical for Wikipedia. John Nagle (talk) 08:00, 30 October 2022 (UTC)

@Nagle Without data showing how many of the patients are self reporting "long COVID" symptoms, I'm not sure these results apply here. Many post COVID biomarkers are present in those not identifying with long covid as much as they are present in those who do report long covid. Mameyn (talk) 06:26, 26 December 2022 (UTC)

Discussion of psychological distress associated with PASC

Wang et al. shows a 1.3-1.5 times higher risk of self reported PASC in patients who had depression, anxiety or other forms of psychological distress and I'm wondering if this has a place in the article, considering it is one of the few things besides having COVID that we can tie to PASC.

I'm cautious to even bring this up, but these reports have led to discussion that PASC may be in part psychosomatic (Derek Lowe in an infamous editorial for Science Magazine interprets similar results, albeit from a different and somewhat questionable study, as contributing evidence that PASC is a psychosomatic condition) however the prevailing wisdom is that PASC has at least some sort of non-neurological basis, and a UMN article, through not an academic one, cautions against interpreting these results as evidence of PASC being psychosomatic.

Still, the results are interesting, and this is a hint as to what may be behind PASC when we have little other complete data. I want to ask if these results deserve a place in this article, and how they should be presented. I have no experience writing for medical articles, nor have I been to medical school, so any feedback is welcome. Thank you in advance. Mameyn (talk) 06:47, 26 December 2022 (UTC)

Hello @Mameyn. The article already has depression and anxiety as a risk factor from a high-quality source, and post-traumatic stress from a source that does not seem to meet the minimum requirements for medical sourcing on Wikipedia. Unless we have a good review article describing the link, I think that is sufficient.

In general, a medical source needs to be a review article (or academic book/official guideline). As long COVID research is developing fast, we can also use the results of massive studies while we're waiting for review articles to assess them in context. Feel free to propose something here (or WP:BEBOLD and add something to the article with a WP:MEDRS source!).

Given the sensitivity of this issue, we should strive to use the best sources out there. —Femke 🐦 (talk) 18:56, 27 December 2022 (UTC)

Distinct etiologies of PACS symptom clusters

A recently published study in the journal Nature identified at least two distinct etiologies of PACS symptom clusters (pulmonary and "miscellaneous"). Differences in gene expression, as evidenced by cell type specific RNA sequencing, correlated with the subsequent development of post-infection symptoms were apparent at the time of infection. The miscellaneous symptom cluster was comprised of skin rash, smell/taste problems and sleep problems. Pulmonary symptoms were found to be independent of anti-SARS-CoV-2 Spike protein antibody titers while the evolution of the miscellaneous symptom cluster was dependent on antibody titers. This suggests that the emergence of some PACS sub-phenotypes are contingent on separate pathological mechanisms which are observable at the molecular level.

https://doi.org/10.1038/s41591-022-02107-4 MagicTheater (talk) 15:20, 9 January 2023 (UTC)

Davis et al (2023) article on Nature

According to the new paper by Davis and coauthors, long covid symptoms are often severe. Should we include this fact in the lead? Forich (talk) 22:31, 13 January 2023 (UTC)

Semi-protected edit request on 14 January 2023

Addition to top of article: A comprehensive review article published 1/13/23 at https://doi.org/10.1038/s41579-022-00846-2 concluded: "Long COVID is a multisystemic illness encompassing ME/CFS, dysautonomia, impacts on multiple organ systems, and vascular and clotting abnormalities. It has already debilitated millions of individuals worldwide, and that number is continuing to grow. On the basis of more than two years of research on long COVID and decades of research on conditions such as ME/CFS, a significant proportion of individuals with long COVID may have lifelong disabilities if no action is taken. Diagnostic and treatment options are currently insufficient, and many clinical trials are urgently needed to rigorously test treatments that address hypothesized underlying biological mechanisms, including viral persistence, neuroinflammation, excessive blood clotting and autoimmunity." Anan Isapta (talk) 02:45, 14 January 2023 (UTC)