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While this topic is very much a 'work in progress' - as the science and medicine is moving at such speed and there are so many blanks to be filled in about the long-term consequences of COVID-19, I thought there was probably enough to start having a specific page on the topic, given the publishing of a rapid review by the National Institute of Health Research and the subsequent media coverage. It finally feels that there are enough reasonably sources to start a Wikipedia article - particularly as there's a lot of public interest and discussion on this topic.
I'm UK-based, so I have very much that view of the world, so contributions from elsewhere around the globe would be much appreciated.
Jpmaytum ( talk) 15:15, 15 October 2020 (UTC)
And thanks for your work Laterthanyouthink. I've tweaked the intro to get straight to the scale of the issue (we can leave the general articles to say that that COVID-19 is caused by the virus, and there's a pandemic) and to push the academic references up. I've also added references further down. Little by little we get there!
Jpmaytum ( talk) 10:09, 19 October 2020 (UTC)
Should we say who Elisa Perego is? We could say "of the UCL Institute of Archaeology"? Should we also move it further down? GPinkerton ( talk) 18:12, 20 October 2020 (UTC)
"Long Covid" is a patient-made term which was first used in May 2020, during the COVID-19 pandemic, as a hashtag on Twitter by Elisa Perego.
Perego is the author of the source, but it never says that she made the hashtag for it. — Tenryuu 🐲 ( 💬 • 📝 ) 19:11, 20 October 2020 (UTC)On 7 July, a BBC interviewer asked Suett about ‘this Long Covid, as they call it’ (BBC News 24, 2020a), and the Royal College of General Practitioners noted general practice was ‘preparing for an “influx” of patients with ‘long Covid’ (Royal College of General Practitioners, 2020). 8 July, New Statesman published a piece by a doctor with ‘#LongCovid’ in the standfirst: the hashtag indicated the term’s emergence through social media (Whitaker, 2020).
GPinkerton ( talk) 04:15, 21 October 2020 (UTC)Long Covid as a term gained consistency in just a few weeks. #LongCovid was first used by Elisa Perego, from Lombardy (a very hard-hit, early hotspot) on 20 May (Perego, 2020), to summarize her experience of disease as cyclical, progressive, and multiphasic. She used #LongCovid to intervene ontologically in formulations of COVID-19 in peer-reviewed papers – by integrating the ‘biphasic’ disease pathway from (Lescure et al., 2020), and pointing to multiple sequelae. In June, #LongCovid became increasingly prominent – complementing other hashtags used by emergent patient collectivities (e.g. #apresJ20 in French, #covidpersistente in Spanish; #MitCoronaLeben in German; #koronaoire in Finnish; #長期微熱組 in Korean; see also patient websites https://www.apresj20.fr and https://apuakoronaan.fi). ‘Long Covid’ moved from social to print media in late June when a newspaper described how doctor Jake Suett had joined a ‘Long Covid’ support group (Keay, 2020). This group ( https://www.longcovid.org) changed its name to ‘Long Covid Support Group’ in response to growing use of #LongCovid – having previously added #Covid1in20 to its name on 23 May in response to the COVID-19 Symptom Study prevalence data (personal communication, Claire Hastie, 19 August 2020).
I think the real challenge for this article will be to keep it simple for the casual reader - particuarly given the level of research interest in this area. I've tried to do this by simplifying the initial sections (and there was a great table in the appendix to the Yellin paper which was really helpful) - we can save the more analytical stuff about the research studies (and things like where the name Long Covid came from) for later in the article.
I hope this makes sense - I'm sure there's plenty more to come
Jpmaytum ( talk) 11:27, 21 October 2020 (UTC)
The lead will need more work, as per WP:LEADFOLLOWSBODY, after the article has more content added and undergone more copyediting to smooth the flow and reduce repetition. Boghog, many articles that I have edited have a Background section, and I added it here as a building block in a very young article. The lead as it stands is not a summary of the article, but will get there with more work. IMO opinion it's more useful to keep that "background" info in the body until such time as the article has taken shape - section headings can always be changed to something more appropriate, but the lead should cover just the most important points in a more general way, until the content has been built further. Laterthanyouthink ( talk) 13:08, 19 October 2020 (UTC)
Hopefully I've picked up some of this in my most recent edits - see the Keeping it Simple section below. Hope this fits in with your thinking.
Jpmaytum ( talk) 11:30, 21 October 2020 (UTC)
I want to add links to this article from some of the main Covid pages, the Covid-19 templates (under health issues?), maybe complications(?) in the Covid-19 infobox, but I am holding off because I'm not a medical expert and don't know to what extent this article is current suitable for wider entry points/under what sections it would belong. Could anyone here with more experience on how to properly integrate this topic maybe add in links in the appropriate templates? BlackholeWA ( talk) 15:08, 27 October 2020 (UTC)
from the given link
A report in The New York Times details anecdotal evidence that the coronavirus can cause unexpected dental problems. People have even had their teeth falling out without experiencing any kind of pain or bleeding.
A 43-year-old woman from New York lost a tooth after sensing it was loose. The tooth just flew out of her mouth one day without warning. There was no pain or blood. The woman had been experiencing Long COVID after surviving an infection in the spring. Her other symptoms included brain fog, muscle ache, and nerve pain.
The report also details the case of a 12-year-old boy who lost one of his adult teeth months after he had a mild case of COVID-19. Unlike the woman, who had a history of dental issues, the child had normal, healthy teeth. Others lost teeth similarly after being infected, describing their experiences in support groups.
That's not enough IMO. Remove it? — Preceding unsigned comment added by 79.76.143.248 ( talk) 17:26, 21 December 2020 (UTC)
Some people have changed the spelling of COVID to Covid - in line with style guides used by some press agencies.
Please ensure the capitalized spelling is used, in line with the World Health Organization spelling. — Preceding unsigned comment added by EpicChefUK ( talk • contribs) 20:14, 15 December 2020 (UTC)
As written, this would only be applicable to any mention of COVID-19. "Long Covid" could be considered to be a separate term that describes longstanding symptoms of COVID-19, and can be argued to not fall under item 1. — Tenryuu 🐲 ( 💬 • 📝 ) ( 🎁 Wishlist! 🎁) 01:50, 17 December 2020 (UTC)Coronavirus disease 2019 is the full name of the disease and should be used for the main article. COVID-19 (full caps) is preferable in the body of all articles, and in the title of all other articles/category pages/etc.
This article remains full of weak sourcing. It has improved some since its initial creation, but it still has many primary sources and poor assertions. I would make edits but I'd chop out half the article and imagine I'd risk an edit war. Can you guys review WP:MEDRS and make edits to your sections of interest? MartinezMD ( talk) 21:25, 22 December 2020 (UTC)
History sections often cite older work.which I guess in this very new instance means that a History section here would be mentioning (if not citing) reports and studies that are newer than would usually appear in older diseases' articles. GPinkerton ( talk) 23:21, 27 December 2020 (UTC)
References
talk-reflist template added by boud Boud ( talk) 20:32, 27 December 2020 (UTC)
There have been a few recent study that Long Covid is may have been cause by Autoantibodies as immune goes overdrive after getting Coronavirus, but it is unclear if cause by virus itself. But Long Covid could be a separate diseases as it could be an Autoimmune disease, while Covid 19 is mainly a respiratory disease. It is probably a secondary diseases which usually happened around few week after getting Coronavirus. Autoimmune disease is a condition in which your immune system mistakenly attacks your body. I think Long COVID could be an autoimmune disease due to Immune goes overdrive and it affect other part of body. I left the sources below to help to explain more details about it from www.theguardian.com/science below:
[1] 80.233.63.170 ( talk) 09:33, 30 December 2020 (UTC)
References
If you follow the link from the BMJ source you'll find that that 10% figure comes from a website (not a paper), and that the website is KCL data which is the basis of the subsequent - unreliable source for the 2% figure. I don't see how one can argue that the 10% figure is reliable and the 2% figure is not given that they likely come from the same dataset (and the 10% figure does not even come from a paper). I'm open to arguments though ... Talpedia ( talk) 23:12, 30 December 2020 (UTC)
;-)
WhatamIdoing (
talk)
04:03, 24 January 2021 (UTC)Long Covid | |
---|---|
Other names |
|
Specialty | Sequelae * immunology |
Symptoms | Fatigue, chronic cough, brain fog, breathless [1] |
Complications | Out of work [2], lifestyle restrictions, heart and lungs failure, post-exertional malaise, neurological problems [3] |
Usual onset | 2 to 4 weeks after or during infection from coronavirus |
Duration | Long term or lifelong [4] |
Causes | Unknown, possible autoantibodies after getting coronavirus [5] |
Treatment | None, supportive care [6] |
Frequency | 10% to 33% after getting Coronavirus [7] [8] |
Created an example of the Summary Infobox for Long Covid on talkpages as agenda before adding on Long Covid Wikipedia page. I found some sources on symptoms, comlications and causes. While Coronavirus (Covid-19) is a respiratory and infectious disease, it can lead 10% to 30% of some parents to Long Covid, mostly with moderate to severe coronavirus symptoms. Even a few with mild symptoms can go on to Long Covid. There is a bit of different between coronavirus and Long Covid. Coronavirus (Covid-19) is mainly an respiratory disease which affect the lungs and Long Covid is a secondary disease or sequelae or possible immunity disorder which is maybe cause by immune systems goes into overdrive or cause by autoantibodies. Should we Infobox for Long Covid as an summary? 80.233.59.188 ( talk) 17:15, 16 January 2021 (UTC)
References
First off, I want to thank the editors that got this article started for a problem that's been around for a while.
In the lede, there are currently two mentions of "long-haulers":
In the US, sufferers are often referred to as "long-haulers"(emphasis removed)
There have been many reports of findings of these longer-term effects from all over the world, in patients often referred to as "long-haulers".
both of which use different references.
My question is: can we combine the two sentences together? I assume the separation is either because information is being inserted as it is found or the distinction is important. — Tenryuu 🐲 ( 💬 • 📝 ) 21:48, 19 October 2020 (UTC)
I'm requesting a merge of this page and COVID-19 long haulers as I feel both pages cover similar enough ground. Americanfreedom ( talk) 01:53, 27 January 2021 (UTC)
Done by
the powers vested ... etc.
GPinkerton (
talk)
14:36, 2 February 2021 (UTC)
https://apps.who.int/iris/bitstream/handle/10665/339629/Policy-brief-39-1997-8073-eng.pdf
A lot of MEDRS information in there that can be added to the article. -- {{u| Gtoffoletto}} talk 19:26, 25 February 2021 (UTC)
Quite a few sources on long Covid mention that the fevers are intermittent or relapsing. Is this sufficiently well developed to include in the article? Abductive ( reasoning) 20:09, 2 March 2021 (UTC)
Nalbandian, A., Sehgal, K., Gupta, A. et al. Post-acute COVID-19 syndrome. Nat Med (2021). https://doi.org/10.1038/s41591-021-01283-z
2600:1000:B02A:338:B979:35BF:6026:3F3D ( talk) 13:39, 7 April 2021 (UTC)
Long COVID is a self diagnosed condition. There is no such thing in any clinical 'handbook'. "Long" viral respiratory illness is not unique to SARS-CoV-2. Post viral fatigue syndrome is not unique to this pathogen. So, why the new name for something that is old news?
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4968-2 https://pubmed.ncbi.nlm.nih.gov/2553945/ — Preceding unsigned comment added by Maximum70 ( talk • contribs)
I propose we add to the Incidence section some information from the sequalae found in a similar disease, SARS, as a point of comparison. Here is one such study. Forich ( talk) 19:36, 5 July 2021 (UTC)
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This article falls under WP:COVIDDS Arbcom discretionary sanctions. It would be unfortunate if this article was edited with misleading information, as this is an important topic. Would an edit notice be appropriate to inform users of the importance of adhering to WP:RS and/or informing them of the sanctions on this page? Thanks. – Gladamas ( talk · contribs) 21:09, 30 June 2021 (UTC)
Scientists have pointed out the relationship between long covid and ME. Some even say that some of those with long covid will develop ME (myalgic encephalomyelitis). Frenchfries124 ( talk) 10:36, 12 July 2021 (UTC)
Long Covid is definitely a physical illness but, like Chronic Fatigue Syndrome, it seems to have psychological aspects. This should be made clearer in the wiki entry:
> * Gaffney, Adam (22 March 2021). "We need to start thinking more critically — and speaking more cautiously — about long Covid". STATnews.com. > > * Ritchie, Stuart (30 June 2021). "Does Long Covid really exist?". Unherd.com.
Title should be renamed to Long-Term effects of COVID-19 as “Long COVID” is a shorthand term AlienChex ( talk) 08:28, 5 August 2021 (UTC)
I don't understand this lede sentence. As some people will still show symptoms of COVID-19 after vaccination (if they're particularly unlucky or immunocompromised, for example), are we saying that in all of those cases where people still contracted less severe cases of COVID-19 after vaccination, no long COVID resulted? How do we know that? Psiĥedelisto ( talk • contribs) please always ping! 12:33, 10 August 2021 (UTC)
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a new research in Jordan identified more risk factors for post-COVID-19 and other important characteristics. You can check the research here : https://www.researchgate.net/publication/353982632_Risk_Factors_and_Characterization_of_Post-COVID-19_Syndrome_in_Jordan 188.247.75.86 ( talk) 11:39, 19 August 2021 (UTC)
A new metanalysis published in Nature (Scientific reports) that included 80,000 children in more than 9 different countries reported that the incidente in children of long-covid is 25% and that the main signs and symptoms are mood changes, headache and sleep disorders.
[1] — Preceding unsigned comment added by FEMALEMD ( talk • contribs) 16:56, June 26, 2022 (UTC)
This could be the first comprehensive scientific review about long covid in general including research about possible treatment etc. Likely there are lots of information and overviews in it that could be used to improve the article. Please add some info about its findings to the article. Maybe the review should also be linked in the external links. It's currently featured in 2021 in science like so:
A scientific review summarizes studies about long COVID. [1] [2]
-- Prototyperspective ( talk) 20:27, 23 August 2021 (UTC)
References
There appears to be a lot of overlap with long COVID and ME/CFS if they are not the same infection triggered / post infection illness. [1] [2] [3] [4] Please add a "See Also" link on the Long Covid wiki article to Chronic Fatigue Syndrome -- INaVanDownByTheRiver ( talk) 19:41, 5 September 2021 (UTC)
References
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Please add ME/CFS Chronic Fatigue Syndrome as a link in the "See Also" section of long COVID. There is data to support overlap with long COVID and ME/CFS if they are not the same infection triggered / post infection illness. I can site more journal articles if needed but see the following. [1] [2] [3] [4] I have put this request in the talk section as well. Thank you. INaVanDownByTheRiver ( talk) 14:18, 7 September 2021 (UTC)
References
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https://recovercovid.org/ Mapsax ( talk) 02:17, 20 September 2021 (UTC)
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784918 October 13, 2021 Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection. A Systematic Review -- Sti ( talk) 14:40, 15 October 2021 (UTC)
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typo: change "fom" to "from" 209.204.199.83 ( talk) 08:12, 11 November 2021 (UTC)
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Anecdotal evidence suggest that chiropractic Atlas lower-back massage can restore sense of taste. Please add to the "treatment" section of the article.
https://www.foxnews.com/us/houston-taste-covid
There is a recent paper published in a well-known journal in the field of oncology regarding Autophagy being a potential link between SARS-CoV-2 and cancer ( https://www.mdpi.com/2072-6694/13/22/5721). Prof. Daniel Klionsky ( /info/en/?search=Daniel_J._Klionsky) a well-known scientist in the field is among the authors of this work. Should this proposed link be included in this Wikipedia page as well? -- Autophagy1962 ( talk) 09:43, 19 November 2021 (UTC)
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.Cite error: There are <ref>
tags on this page without content in them (see the
help page).
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.Cite error: There are <ref>
tags on this page without content in them (see the
help page).
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003773#pmed-1003773-g005. — Preceding
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Gracesweeney (
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contribs)
https://doi.org/10.1016/S1473-3099(21)00703-9 Kaihsu ( talk) 11:32, 7 January 2022 (UTC)
"without fully understanding the effects of the Omicron variant's effects yet"
could someone fix this, I don't have permissions Adhiyana ( talk) 11:07, 14 January 2022 (UTC)
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I'd like to suggest a new item in the "Causes" section in the bulleted list following "Other situations that might cause new and ongoing symptoms include:". New item as follows:
References
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I'd like to suggest a new item in the "Causes" section in the bulleted list following "Other situations that might cause new and ongoing symptoms include:". New item as follows:
References
Xavier-FUTURE ( talk) 15:53, 17 January 2022 (UTC)
The "Diagnosis and Treatment" section contains nothing on treatment, only talking about XenonMRI. I ask the section be renamed until information about effective treatment. I'm not familiar with any treatments that were shown as effective yet. 89.216.154.41 ( talk) 14:36, 18 January 2022 (UTC)
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In the Diagnosis section, the Journal of the American Medical Association Internal Medicine study should be cited ( https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785832), concluding from a cross-sectional study of 26,000 patients that long COVID is idiopathic and psychosomatic (i.e., has no causative relationship or existence). Jwwallace ( talk) 02:32, 22 January 2022 (UTC)
I think this can also be called Long COVID Syndrome (LCS). 173.88.246.138 ( talk) 04:01, 30 January 2022 (UTC)
The aformentioned research under Diagnosis has its preprint released. — Preceding unsigned comment added by 210.10.1.127 ( talk) 16:32, 31 January 2022 (UTC)
I suggest adding the following in the first paragraph on the US response.
The NIH Initiative is known as RECOVER (Researching COVID To Enhance Recovery), and it is funded by a $1.15 billion appropriation provided by Congress in December 2020. [1] — Preceding unsigned comment added by Yogafogie ( talk • contribs) 21:29, 4 March 2022 (UTC)
References
I've come to this article several times myself as a longhauler and have been surprised that "visual changes" has not been listed as a symptom. It is a heavily and a well documented complication ranging from blurred vision, double vision, and the likes. The mechanism is still unclear (perhaps ocular motility?) but most information points to nerve damage: https://www.livescience.com/nerve-damage-cornea-long-covid.html
Information is also increasingly highlighting neurological disorders as a main mechanism (dysautonomia, neuropathy) of long covid (ANS, vagus nerve), which is not listed as a possible cause.
I myself have vision issues and prior to being a longhauler had 20/20 vision and never wore glasses. Though anecdotal, I have read hundreds of others having the same issue post exposure.
Made an account to relay this information as I would not be as effective in scholarly sourcing as the existing editors are. But I feel it should be invested in and hopefully an addition to this article. — Preceding unsigned comment added by Unknowndust ( talk • contribs) 17:44, 12 March 2022 (UTC)
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Under the headline: "Causes", following the sentence: "It is currently unknown why most people recover fully within two to three weeks and others experience symptoms for weeks or months longer.[65] Although the exact processes that cause long COVID remain unknown, a number of mechanisms have been suggested." - newest evidence for a dysfunction of the vascular endothelium in Long COVID should be added ( https://pubmed.ncbi.nlm.nih.gov/35317812/). Template: In March 2022 a study by the Charité Berlin[ [2]] provided first evidence for peripheral endothelial dysfunction in Long COVID. [1] Martin Fredrick ( talk) 10:47, 24 March 2022 (UTC)
References
Persistence of fragments or whole virus has gained interest as a Long Covid theory over the last few months, including in a Stanford paper that suggests gastrointestinal tract persistence as long as 7 months post-infection, along with links to gastric upsets. This important pathological feature can also be included in the main SARS-CoV-2 article if possible. 210.10.0.187 ( talk) 12:36, 17 April 2022 (UTC)
To explain my reversion of the preceding edit by User:Seaweed : 'survivors' is the exact term used in the cited paper and precisely designates the cohort of subjects who were diagnosed (not "diagonised"!) with COVID-19 and lived to tell the tale. -- Jmc ( talk) 21:07, 29 April 2022 (UTC)
Per article:
As of mid-October 2021, more than 100 million people had or currently have Long COVID. [1]
WebMD is not exactly WP:MEDRS, and the study cited by WebMD ( Chen et al. 2021) is a preprint. [2] I think it the sentence should be removed for now, until a better source is found for the number. ~Desac coin tier 14:02, 8 May 2022 (UTC)
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In May 2021, a global systematic review led by researchers at Stanford University reported that a wide variety of symptoms persisted in more than 70% of COVID-19 patients months after recovering from the initial phase of the disease. A majority of the studies reviewed focused on patients who had been hospitalized with COVID-19. The most common lingering symptoms included shortness of breath, fatigue, cough, and depression and/or anxiety. The study reviewed 84 clinical signs or symptoms, including atypical chest pain, fever, loss of smell of taste, and cognitive disorders such as memory loss and difficulty concentrating. [1] 75.235.226.47 ( talk) 11:37, 5 May 2022 (UTC)
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I'd like to suggest a new paragraph in the "Causes" section. Above the paragraph that starts with 'A March 2021 review article...', I'd like to suggest a new paragraph as follows:
A May 2022 review article discusses viral fragments (RNA and protein) found in non-respiratory reservoirs like the gut for prolonged durations, and suggests that the persistence of replication-competent virus may contribute to long COVID. [1]
References
Xavier-FUTURE ( talk) 14:42, 12 May 2022 (UTC)
{{
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Dr.Pinsky (
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07:41, 22 May 2022 (UTC)Sorry, that was an inadvertent deletion of content from the page on June 23. I screwed up. Whoisjohngalt ( talk) 19:54, 23 June 2022 (UTC)
This section is full of unnecessary details on the past research made on long covid. By now, we are almost three years after the initial outbreak, and we can produce an epidemiology section that is short with solid knowledge of prevalence, incidence, morbidity, geographical distribution, etc; and a separate "Ongoing research" section with the important facts that are being discovered with new studies. Forich ( talk) 16:57, 19 July 2022 (UTC)
There are already publications regarding treatment available. Case reports, pilots and randomised trials. I would suggest to this as a topic? 194.230.148.122 ( talk) 17:32, 25 June 2022 (UTC)
References
Sequelae in the lede should be wikilinked. -- SchallundRauch ( talk) 11:26, 1 August 2022 (UTC)
Update citation on dismissal faced by patients from medical professionals who do not believe that Long Covid is real https://www.sciencedirect.com/science/article/pii/S2667321522001299 Binu112 ( talk) 22:16, 20 September 2022 (UTC)
Outcomes among confirmed cases and a matched comparison group in the Long-COVID in Scotland study Mapsax ( talk) 01:49, 14 October 2022 (UTC)
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)
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)
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)
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Causes: Mitochondria dysfunction and fatty acid metabolism changes [1] [2] IrinaPetracheMD ( talk) 12:42, 26 October 2022 (UTC)
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)
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)
"SARS-CoV-2 is associated with changes in brain structure in UK Biobank" [3] "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)
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)
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)
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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)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 9 January 2023 and 21 April 2023. Further details are available
on the course page. Student editor(s):
Ryanbrown58 (
article contribs). Peer reviewers:
Blazer GB,
Teecuee,
JamaalBurks.
— Assignment last updated by JamaalBurks ( talk) 15:07, 1 March 2023 (UTC)
A better picture for the article would be one who actually has the condition. Dianna Cowern, Physics Girl, is a well known YouTube personality. I assume she would not object to the picture her account posted on Twitter https://pbs.twimg.com/media/FqRGyTHaIAA12UQ?format=jpg&name=large Nehmo ( talk) 04:55, 5 March 2023 (UTC)
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)
I would highly recommend your consulting with patient advocacy groups on this
Addition to Causes:
Multiple peptides within the SARS-CoV-2 proteome are capable of inducing amyloidosis, a condition that could persist following infection. Amyloid peptides form aggregates and can spread throughout the human body in the absence of infection. These aggregates can disrupt biological processes ( https://www.nature.com/articles/s41467-022-30932-1) ( https://www.nature.com/articles/s41467-023-36234-4). Whether SARS-CoV-2 can trigger amyloidosis in humans is still uncertain. This is a potential mechanism that might explain post-infection sequelae such as long covid.
Phosphorylated alpha-synuclein was identified in skin biopsies in five patients with long covid
postural orthostatic tachycardia syndrome. 4/5 of these patients showed evidence of hyposmia as well. These findings are often associated with
synucleinopathies such as REM sleep behavior disorder, an early sign of Parkinson's disease, Lewy body dementia and multiple system atrophy (
https://link.springer.com/article/10.1007/s10286-022-00867-0). A seperate study (N=11) demonstrated signs of
REM sleep behavior disorder in 36% of patients after COVID-19 infection (
https://www.sciencedirect.com/science/article/pii/S138994572100068X?via%3Dihub). Larger studies are urgently needed to confirm these findings. A clinical trial is underway to determine the risk of alpha-synuclein amyloidosis and associated neurodegeneration following infection with COVID-19 (
https://clinicaltrials.gov/ct2/show/NCT05401773?term=NCT05401773&draw=2&rank=1).
MagicTheater (
talk)
15:12, 4 March 2023 (UTC)
All the references are old (a few are a year old, but many are two-three years old) ...and there is barely any mention of mental symptoms, which are among the more common ones. Nor any mention of how the risk of Long COVID is effected by the mutated variants. (which it hasn't, last I checked. Risk of death or need for intensive care seems to have gotten reduced, but not Long COVID) 155.4.221.27 ( talk) 00:53, 25 April 2023 (UTC)
A lot of them do not mention "long covid" specifically
You have to realize that makes zero sense.
Choutka, J., Jansari, V., Hornig, M. et al. Unexplained post-acute infection syndromes. Nat Med 28, 911–923 (2022). https://www.nature.com/articles/s41591-022-01810-6
Context to aid understanding:
"The observation of unexplained chronic sequelae after SARS-CoV-2 — known as post-acute sequelae of SARS-CoV-2 infection (PASC), or ‘long COVID’ — in a subset of individuals has focused attention on this previously overlooked phenomenon, bringing an opportunity for accelerated progress in biomedical research into PAISs."
"It is remarkable that PASC, especially when it occurs after mild or moderate (rather than severe) COVID-19, shares many similarities with chronic illnesses triggered by other pathogenic organisms, many of which have not been sufficiently explained. These PAISs are characterized by a set of core symptoms centering on exertion intolerance, disproportionate levels of fatigue, neurocognitive and sensory impairment, flu-like symptoms, unrefreshing sleep, myalgia/arthralgia, and a plethora of nonspecific symptoms that are often present but variably pronounced. These similarities suggest a unifying pathophysiology that needs to be elucidated to properly understand and manage post-infectious chronic disability."
This review covers a more comprehensive breadth of post-acute infection syndromes including those associated with SARS-CoV-2 (e.g. long COVID), Ebola, Dengue, Polio, SARS-CoV-1, Chikungunya, Epstein Barr (mononucleosis), West Nile, Ross River virus, Coxsackie B, H1N1 influenza, Varicella Zoster (chickenpox, shingles), Coxiella Burnetii (Q fever), Borrelia (Lyme disease, tick borne relapsing fever) and Giardia. The Wikipedia article needs to discuss long COVID from a broader perspective.
" In fact, several studies identified the association of this outbreak of giardiasis with chronic fatigue 42, irritable bowel syndrome (IBS) 43, and fibromyalgia 44 persisting for many years."
"Several epidemiological studies using health-registry data have looked for post-infection registration of a diagnosis of ME/CFS as a surrogate for chronic post-infection sequelae. One study found that infection with the pandemic H1N1/09 influenza A virus (but not receipt of vaccine) was associated with a more than twofold increase in ME/CFS diagnosis in a Norwegian health registry 57. Similarly, another longitudinal registry study identified an association between varicella zoster virus (VZV) infection and an increased risk of an ME/CFS diagnosis 58, supporting the concept that the correlation between exposure to certain infections and development of chronic sequelae is indeed not uncommon."
"The prime manifestations include an overall poor functional status, exertion intolerance, debilitating fatigue, and unrefreshing sleep. Other characteristic features include neurocognitive and sensory impairments, dysautonomia, musculoskeletal complaints, flu-like symptoms, and other feelings of illness. Irritability, mood swings, and signs of depression, as well as a wide range of other nonspecific neurological and immunological symptoms (Box 2), are frequently present."
"...long-term data from studies of [post treatment Lyme disease syndrome] show ongoing disability even after many years. A study that examined a cohort of 128 individuals after culture-confirmed Lyme disease reported that 4.7% had PTLDS at clinical examination 11–20 years after contracting erythema migrans (a typical circular rash occurring at the site of the tick bite) 83. Remarkably, a case–control study of 61 cases and 26 controls found the symptoms of PTLDS to be associated with physician- or laboratory-confirmed Lyme disease for up to 27 years 50. It was also reported that post-Borrelia symptoms mimicking fibromyalgia, such as musculoskeletal pain, tender points, dysesthesias, memory difficulties, and debilitating fatigue persisted in some individuals for at least 10 years 84. MagicTheater ( talk) 15:12, 7 May 2023 (UTC)
The Wikipedia article could use a pathology section to outline the current state of knowledge. Perhaps, some of the editors can help me put this together. Here's a Nature review from 2022 to start from.
Mehandru, S., Merad, M. Pathological sequelae of long-haul COVID. Nat Immunol 23, 194–202 (2022). https://www.nature.com/articles/s41590-021-01104-y
Summary of Article:
As of November 2021, there have been 254 million cases and 5.1 million deaths due to COVID-19. Many people who recover from the virus experience ongoing symptoms, known as "long COVID" or "post-COVID syndrome." The duration of these symptoms can vary, lasting from over 4 weeks to more than 3 months after the initial infection.
Long COVID can affect several organ systems and may cause a range of issues, including fatigue, sleep problems, memory issues, mood impairment, heart issues, and breathing difficulties. These symptoms can be experienced by people who had mild, moderate, or severe COVID-19. While lung issues are common in severe cases, those with long COVID can experience a variety of other symptoms.
Neurological and psychiatric problems can occur in long COVID, with common issues including chronic fatigue, sleep abnormalities, and headaches. Some patients may also develop cognitive issues, such as "brain fog" or even neurological disorders like Parkinson's disease. Additionally, psychiatric disorders like depression, anxiety, and post-traumatic stress disorder may arise.
Patients with long COVID may experience heart-related symptoms, such as chest pain or palpitations. Some may have ongoing inflammation or other cardiac abnormalities. Thrombotic complications, such as blood clotting, can occur during acute COVID-19 but seem less common in the post-acute phase.
Gastrointestinal symptoms, such as diarrhea, nausea, and abdominal pain, are common during acute COVID-19 and may persist in long COVID. Some patients may also develop new or worsened irritable bowel syndrome. Additionally, COVID-19 has been associated with the development of new-onset diabetes in some cases.
Other health issues related to long COVID can include kidney injury, skin rashes, and hair loss. While kidney injury in severe cases may be associated with high mortality, some patients show significant recovery. Skin rashes can occur in various forms during acute COVID-19, and a small number of patients may experience a rash during long COVID. Hair loss is also a common issue, but it typically resolves on its own.
More detail on what is known about the pathology:
In mild COVID-19 cases, a strong initial immune response leads to viral neutralization and disease resolution. However, in severe cases, uncontrolled SARS-CoV replication evades the host's immune system, resulting in increased inflammation and lung tissue damage. The link between acute COVID-19 and post-COVID-19 syndrome remains unclear, but various hypotheses exist. Factors such as persistent inflammation, immune cell activation, and cytokine elevation may contribute to lingering symptoms. Additionally, prothrombotic states and autoimmune responses can play a role in post-COVID syndrome.
A recent study found that long-haul COVID patients had persistent increases in certain immune cells and elevated interferon levels, suggesting delayed inflammation resolution. Damage to lung tissue and impaired regeneration, along with fibrotic states, may contribute to persistent lung injuries. The prothrombotic state in acute COVID-19 can also result in various organ injuries.
Persistent elevation of proinflammatory cytokines may have multiple systemic and organ-specific effects. Furthermore, recent studies have reported persistent immunological abnormalities, immune dysregulation, and autoimmune responses in COVID-19 patients. The possibility of a viral reservoir and antigen persistence in tissues such as the intestine has also been suggested.
Overall, the pathophysiology of post-COVID syndrome is complex and multifaceted, involving a range of immune and inflammatory responses, organ-specific effects, and potential viral persistence. This article highlights the need for a comprehensive and unbiased profiling of the immune system in patients with post-COVID syndrome to better understand the pathophysiological mechanisms underlying the condition. It suggests utilizing various techniques such as measuring systemic and local secreted inflammatory proteins, single-cell RNA profiling of immune cells, ex vivo imaging of diseased organs, multiplex imaging, and spatial transcriptomics analysis of tissue biopsies. Comparing these results with age- and comorbidities-matched healthy individuals and other control cohorts can help identify potential autoimmune contributions to the syndrome.
The article also discusses the importance of establishing canonical disease definitions based on objective clinical and laboratory criteria due to the heterogeneity of post-COVID syndrome manifestations. It emphasizes the need for rigorous, high-dimensional, and serial profiling of tissues and peripheral blood to better understand the multiple syndromes currently encapsulated under the term "post-COVID-19 syndrome."
Finally, the article mentions the National Institutes of Health's PASC initiative launched in February 2021, which aims to study the prevention and treatment of long-term effects of SARS-CoV-2 infection. This initiative will collect data from diverse patient cohorts, including children and adults, to ensure the findings apply to communities most affected by COVID-19. The use of cutting-edge technologies will be crucial in deciphering the molecular heterogeneity of post-COVID syndrome and identifying precise, druggable targets tailored to these defects. MagicTheater ( talk) 15:31, 7 May 2023 (UTC)
"Long COVID is considered to be caused by the persistence of chronic inflammation after acute COVID-19 infection. We found that all long COVID patients had residual inflammation in the epipharynx, an important site of coronavirus replication, and some long COVID symptoms are similar to those associated with chronic epipharyngitis. Epipharyngeal abrasive therapy (EAT) is a treatment for chronic epipharyngitis in Japan that involves applying zinc chloride as an anti-inflammatory agent to the epipharyngeal mucosa. In this study, we evaluated the efficacy of EAT for the treatment of long COVID. The subjects in this study were 58 patients with long COVID who were treated with EAT in the outpatient department once a week for one month (mean age = 38.4 ± 12.9 years). The intensities of fatigue, headache, and attention disorder, which are reported as frequent symptoms of long COVID, were assessed before and after EAT using the visual analog scale (VAS). EAT reduced inflammation in the epipharynx and significantly improved the intensity of fatigue, headache, and attention disorder, which may be related to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). These results suggest that EAT has potential as a novel method for long COVID treatment." See Abstract.-- 98.113.209.140 ( talk) 02:54, 26 May 2023 (UTC)
A 2023 study found that metformin prevents long COVID, according to a new study in The Lancet Infectious Diseases.
[1] BuffaloDoc ( talk) 16:50, 17 June 2023 (UTC)
References
@ Zefr. I'm new to medical editing, so I'm probably reading MEDRS wrongly. My reading of WP:MEDREV is that when there are large-scale clinical trials with results not yet presented in secondary sourcing, it is okay to mention them in the text (I had removed it from the lead before). When a new review is out, this should either replace it or if it's not mentioned, taken as a sign it wasn't important enough. Also happy to wait a few months, as proper reviews of long COVID are published quite a bit. —Femke 🐦 ( talk) 16:22, 16 June 2023 (UTC)
The section is very news-like. I would like to remove it almost completely and write a small section on history based on secondary sourcing. As it's a large part of the article, I'll wait for feedback here first. —Femke 🐦 ( talk) 16:16, 7 August 2023 (UTC)
Or should I try to supplement it with reviews whenever it's cited? —Femke 🐦 ( talk) 15:11, 6 August 2023 (UTC)
I think one of the highest-quality sources we have is:
the 2022 guideline for primary care published in BMJ. That paper says under the heading "What can my primary care team do for me", Making the diagnosis of long covid (which does not have to be by exclusion) and excluding alternative diagnoses
.
This seems to contradict the older source we now cite in the lead ( The Journal for Nurse Practitioners paper). Neither source gives a lot of information.
I don't understand the
2021 NICE clinical guidelines completely: The panel acknowledged that this case definition may be interpreted as a diagnosis of exclusion. However, they discussed that ongoing symptomatic COVID-19 and post-COVID-19 syndrome have many features in common with other conditions, some of which could be considered life threatening. Therefore, ongoing symptomatic COVID-19 and post-COVID-19 syndrome should not be the first conditions to be excluded for reasons of patient safety.
I think they try to say you should exclude a couple of other life-threatening conditions first, before you diagnose people with long COVID if they have the symptoms + history that makes sense.. But I'm not sure if their conclusion is that long COVID is a diagnosis of exclusion, or something "in the middle" if that exists.
Any page watchers understand this better? —Femke 🐦 ( talk) 18:28, 2 August 2023 (UTC)
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Archive 1 | Archive 2 |
While this topic is very much a 'work in progress' - as the science and medicine is moving at such speed and there are so many blanks to be filled in about the long-term consequences of COVID-19, I thought there was probably enough to start having a specific page on the topic, given the publishing of a rapid review by the National Institute of Health Research and the subsequent media coverage. It finally feels that there are enough reasonably sources to start a Wikipedia article - particularly as there's a lot of public interest and discussion on this topic.
I'm UK-based, so I have very much that view of the world, so contributions from elsewhere around the globe would be much appreciated.
Jpmaytum ( talk) 15:15, 15 October 2020 (UTC)
And thanks for your work Laterthanyouthink. I've tweaked the intro to get straight to the scale of the issue (we can leave the general articles to say that that COVID-19 is caused by the virus, and there's a pandemic) and to push the academic references up. I've also added references further down. Little by little we get there!
Jpmaytum ( talk) 10:09, 19 October 2020 (UTC)
Should we say who Elisa Perego is? We could say "of the UCL Institute of Archaeology"? Should we also move it further down? GPinkerton ( talk) 18:12, 20 October 2020 (UTC)
"Long Covid" is a patient-made term which was first used in May 2020, during the COVID-19 pandemic, as a hashtag on Twitter by Elisa Perego.
Perego is the author of the source, but it never says that she made the hashtag for it. — Tenryuu 🐲 ( 💬 • 📝 ) 19:11, 20 October 2020 (UTC)On 7 July, a BBC interviewer asked Suett about ‘this Long Covid, as they call it’ (BBC News 24, 2020a), and the Royal College of General Practitioners noted general practice was ‘preparing for an “influx” of patients with ‘long Covid’ (Royal College of General Practitioners, 2020). 8 July, New Statesman published a piece by a doctor with ‘#LongCovid’ in the standfirst: the hashtag indicated the term’s emergence through social media (Whitaker, 2020).
GPinkerton ( talk) 04:15, 21 October 2020 (UTC)Long Covid as a term gained consistency in just a few weeks. #LongCovid was first used by Elisa Perego, from Lombardy (a very hard-hit, early hotspot) on 20 May (Perego, 2020), to summarize her experience of disease as cyclical, progressive, and multiphasic. She used #LongCovid to intervene ontologically in formulations of COVID-19 in peer-reviewed papers – by integrating the ‘biphasic’ disease pathway from (Lescure et al., 2020), and pointing to multiple sequelae. In June, #LongCovid became increasingly prominent – complementing other hashtags used by emergent patient collectivities (e.g. #apresJ20 in French, #covidpersistente in Spanish; #MitCoronaLeben in German; #koronaoire in Finnish; #長期微熱組 in Korean; see also patient websites https://www.apresj20.fr and https://apuakoronaan.fi). ‘Long Covid’ moved from social to print media in late June when a newspaper described how doctor Jake Suett had joined a ‘Long Covid’ support group (Keay, 2020). This group ( https://www.longcovid.org) changed its name to ‘Long Covid Support Group’ in response to growing use of #LongCovid – having previously added #Covid1in20 to its name on 23 May in response to the COVID-19 Symptom Study prevalence data (personal communication, Claire Hastie, 19 August 2020).
I think the real challenge for this article will be to keep it simple for the casual reader - particuarly given the level of research interest in this area. I've tried to do this by simplifying the initial sections (and there was a great table in the appendix to the Yellin paper which was really helpful) - we can save the more analytical stuff about the research studies (and things like where the name Long Covid came from) for later in the article.
I hope this makes sense - I'm sure there's plenty more to come
Jpmaytum ( talk) 11:27, 21 October 2020 (UTC)
The lead will need more work, as per WP:LEADFOLLOWSBODY, after the article has more content added and undergone more copyediting to smooth the flow and reduce repetition. Boghog, many articles that I have edited have a Background section, and I added it here as a building block in a very young article. The lead as it stands is not a summary of the article, but will get there with more work. IMO opinion it's more useful to keep that "background" info in the body until such time as the article has taken shape - section headings can always be changed to something more appropriate, but the lead should cover just the most important points in a more general way, until the content has been built further. Laterthanyouthink ( talk) 13:08, 19 October 2020 (UTC)
Hopefully I've picked up some of this in my most recent edits - see the Keeping it Simple section below. Hope this fits in with your thinking.
Jpmaytum ( talk) 11:30, 21 October 2020 (UTC)
I want to add links to this article from some of the main Covid pages, the Covid-19 templates (under health issues?), maybe complications(?) in the Covid-19 infobox, but I am holding off because I'm not a medical expert and don't know to what extent this article is current suitable for wider entry points/under what sections it would belong. Could anyone here with more experience on how to properly integrate this topic maybe add in links in the appropriate templates? BlackholeWA ( talk) 15:08, 27 October 2020 (UTC)
from the given link
A report in The New York Times details anecdotal evidence that the coronavirus can cause unexpected dental problems. People have even had their teeth falling out without experiencing any kind of pain or bleeding.
A 43-year-old woman from New York lost a tooth after sensing it was loose. The tooth just flew out of her mouth one day without warning. There was no pain or blood. The woman had been experiencing Long COVID after surviving an infection in the spring. Her other symptoms included brain fog, muscle ache, and nerve pain.
The report also details the case of a 12-year-old boy who lost one of his adult teeth months after he had a mild case of COVID-19. Unlike the woman, who had a history of dental issues, the child had normal, healthy teeth. Others lost teeth similarly after being infected, describing their experiences in support groups.
That's not enough IMO. Remove it? — Preceding unsigned comment added by 79.76.143.248 ( talk) 17:26, 21 December 2020 (UTC)
Some people have changed the spelling of COVID to Covid - in line with style guides used by some press agencies.
Please ensure the capitalized spelling is used, in line with the World Health Organization spelling. — Preceding unsigned comment added by EpicChefUK ( talk • contribs) 20:14, 15 December 2020 (UTC)
As written, this would only be applicable to any mention of COVID-19. "Long Covid" could be considered to be a separate term that describes longstanding symptoms of COVID-19, and can be argued to not fall under item 1. — Tenryuu 🐲 ( 💬 • 📝 ) ( 🎁 Wishlist! 🎁) 01:50, 17 December 2020 (UTC)Coronavirus disease 2019 is the full name of the disease and should be used for the main article. COVID-19 (full caps) is preferable in the body of all articles, and in the title of all other articles/category pages/etc.
This article remains full of weak sourcing. It has improved some since its initial creation, but it still has many primary sources and poor assertions. I would make edits but I'd chop out half the article and imagine I'd risk an edit war. Can you guys review WP:MEDRS and make edits to your sections of interest? MartinezMD ( talk) 21:25, 22 December 2020 (UTC)
History sections often cite older work.which I guess in this very new instance means that a History section here would be mentioning (if not citing) reports and studies that are newer than would usually appear in older diseases' articles. GPinkerton ( talk) 23:21, 27 December 2020 (UTC)
References
talk-reflist template added by boud Boud ( talk) 20:32, 27 December 2020 (UTC)
There have been a few recent study that Long Covid is may have been cause by Autoantibodies as immune goes overdrive after getting Coronavirus, but it is unclear if cause by virus itself. But Long Covid could be a separate diseases as it could be an Autoimmune disease, while Covid 19 is mainly a respiratory disease. It is probably a secondary diseases which usually happened around few week after getting Coronavirus. Autoimmune disease is a condition in which your immune system mistakenly attacks your body. I think Long COVID could be an autoimmune disease due to Immune goes overdrive and it affect other part of body. I left the sources below to help to explain more details about it from www.theguardian.com/science below:
[1] 80.233.63.170 ( talk) 09:33, 30 December 2020 (UTC)
References
If you follow the link from the BMJ source you'll find that that 10% figure comes from a website (not a paper), and that the website is KCL data which is the basis of the subsequent - unreliable source for the 2% figure. I don't see how one can argue that the 10% figure is reliable and the 2% figure is not given that they likely come from the same dataset (and the 10% figure does not even come from a paper). I'm open to arguments though ... Talpedia ( talk) 23:12, 30 December 2020 (UTC)
;-)
WhatamIdoing (
talk)
04:03, 24 January 2021 (UTC)Long Covid | |
---|---|
Other names |
|
Specialty | Sequelae * immunology |
Symptoms | Fatigue, chronic cough, brain fog, breathless [1] |
Complications | Out of work [2], lifestyle restrictions, heart and lungs failure, post-exertional malaise, neurological problems [3] |
Usual onset | 2 to 4 weeks after or during infection from coronavirus |
Duration | Long term or lifelong [4] |
Causes | Unknown, possible autoantibodies after getting coronavirus [5] |
Treatment | None, supportive care [6] |
Frequency | 10% to 33% after getting Coronavirus [7] [8] |
Created an example of the Summary Infobox for Long Covid on talkpages as agenda before adding on Long Covid Wikipedia page. I found some sources on symptoms, comlications and causes. While Coronavirus (Covid-19) is a respiratory and infectious disease, it can lead 10% to 30% of some parents to Long Covid, mostly with moderate to severe coronavirus symptoms. Even a few with mild symptoms can go on to Long Covid. There is a bit of different between coronavirus and Long Covid. Coronavirus (Covid-19) is mainly an respiratory disease which affect the lungs and Long Covid is a secondary disease or sequelae or possible immunity disorder which is maybe cause by immune systems goes into overdrive or cause by autoantibodies. Should we Infobox for Long Covid as an summary? 80.233.59.188 ( talk) 17:15, 16 January 2021 (UTC)
References
First off, I want to thank the editors that got this article started for a problem that's been around for a while.
In the lede, there are currently two mentions of "long-haulers":
In the US, sufferers are often referred to as "long-haulers"(emphasis removed)
There have been many reports of findings of these longer-term effects from all over the world, in patients often referred to as "long-haulers".
both of which use different references.
My question is: can we combine the two sentences together? I assume the separation is either because information is being inserted as it is found or the distinction is important. — Tenryuu 🐲 ( 💬 • 📝 ) 21:48, 19 October 2020 (UTC)
I'm requesting a merge of this page and COVID-19 long haulers as I feel both pages cover similar enough ground. Americanfreedom ( talk) 01:53, 27 January 2021 (UTC)
Done by
the powers vested ... etc.
GPinkerton (
talk)
14:36, 2 February 2021 (UTC)
https://apps.who.int/iris/bitstream/handle/10665/339629/Policy-brief-39-1997-8073-eng.pdf
A lot of MEDRS information in there that can be added to the article. -- {{u| Gtoffoletto}} talk 19:26, 25 February 2021 (UTC)
Quite a few sources on long Covid mention that the fevers are intermittent or relapsing. Is this sufficiently well developed to include in the article? Abductive ( reasoning) 20:09, 2 March 2021 (UTC)
Nalbandian, A., Sehgal, K., Gupta, A. et al. Post-acute COVID-19 syndrome. Nat Med (2021). https://doi.org/10.1038/s41591-021-01283-z
2600:1000:B02A:338:B979:35BF:6026:3F3D ( talk) 13:39, 7 April 2021 (UTC)
Long COVID is a self diagnosed condition. There is no such thing in any clinical 'handbook'. "Long" viral respiratory illness is not unique to SARS-CoV-2. Post viral fatigue syndrome is not unique to this pathogen. So, why the new name for something that is old news?
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4968-2 https://pubmed.ncbi.nlm.nih.gov/2553945/ — Preceding unsigned comment added by Maximum70 ( talk • contribs)
I propose we add to the Incidence section some information from the sequalae found in a similar disease, SARS, as a point of comparison. Here is one such study. Forich ( talk) 19:36, 5 July 2021 (UTC)
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This article falls under WP:COVIDDS Arbcom discretionary sanctions. It would be unfortunate if this article was edited with misleading information, as this is an important topic. Would an edit notice be appropriate to inform users of the importance of adhering to WP:RS and/or informing them of the sanctions on this page? Thanks. – Gladamas ( talk · contribs) 21:09, 30 June 2021 (UTC)
Scientists have pointed out the relationship between long covid and ME. Some even say that some of those with long covid will develop ME (myalgic encephalomyelitis). Frenchfries124 ( talk) 10:36, 12 July 2021 (UTC)
Long Covid is definitely a physical illness but, like Chronic Fatigue Syndrome, it seems to have psychological aspects. This should be made clearer in the wiki entry:
> * Gaffney, Adam (22 March 2021). "We need to start thinking more critically — and speaking more cautiously — about long Covid". STATnews.com. > > * Ritchie, Stuart (30 June 2021). "Does Long Covid really exist?". Unherd.com.
Title should be renamed to Long-Term effects of COVID-19 as “Long COVID” is a shorthand term AlienChex ( talk) 08:28, 5 August 2021 (UTC)
I don't understand this lede sentence. As some people will still show symptoms of COVID-19 after vaccination (if they're particularly unlucky or immunocompromised, for example), are we saying that in all of those cases where people still contracted less severe cases of COVID-19 after vaccination, no long COVID resulted? How do we know that? Psiĥedelisto ( talk • contribs) please always ping! 12:33, 10 August 2021 (UTC)
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a new research in Jordan identified more risk factors for post-COVID-19 and other important characteristics. You can check the research here : https://www.researchgate.net/publication/353982632_Risk_Factors_and_Characterization_of_Post-COVID-19_Syndrome_in_Jordan 188.247.75.86 ( talk) 11:39, 19 August 2021 (UTC)
A new metanalysis published in Nature (Scientific reports) that included 80,000 children in more than 9 different countries reported that the incidente in children of long-covid is 25% and that the main signs and symptoms are mood changes, headache and sleep disorders.
[1] — Preceding unsigned comment added by FEMALEMD ( talk • contribs) 16:56, June 26, 2022 (UTC)
This could be the first comprehensive scientific review about long covid in general including research about possible treatment etc. Likely there are lots of information and overviews in it that could be used to improve the article. Please add some info about its findings to the article. Maybe the review should also be linked in the external links. It's currently featured in 2021 in science like so:
A scientific review summarizes studies about long COVID. [1] [2]
-- Prototyperspective ( talk) 20:27, 23 August 2021 (UTC)
References
There appears to be a lot of overlap with long COVID and ME/CFS if they are not the same infection triggered / post infection illness. [1] [2] [3] [4] Please add a "See Also" link on the Long Covid wiki article to Chronic Fatigue Syndrome -- INaVanDownByTheRiver ( talk) 19:41, 5 September 2021 (UTC)
References
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Please add ME/CFS Chronic Fatigue Syndrome as a link in the "See Also" section of long COVID. There is data to support overlap with long COVID and ME/CFS if they are not the same infection triggered / post infection illness. I can site more journal articles if needed but see the following. [1] [2] [3] [4] I have put this request in the talk section as well. Thank you. INaVanDownByTheRiver ( talk) 14:18, 7 September 2021 (UTC)
References
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https://recovercovid.org/ Mapsax ( talk) 02:17, 20 September 2021 (UTC)
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784918 October 13, 2021 Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection. A Systematic Review -- Sti ( talk) 14:40, 15 October 2021 (UTC)
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typo: change "fom" to "from" 209.204.199.83 ( talk) 08:12, 11 November 2021 (UTC)
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Anecdotal evidence suggest that chiropractic Atlas lower-back massage can restore sense of taste. Please add to the "treatment" section of the article.
https://www.foxnews.com/us/houston-taste-covid
There is a recent paper published in a well-known journal in the field of oncology regarding Autophagy being a potential link between SARS-CoV-2 and cancer ( https://www.mdpi.com/2072-6694/13/22/5721). Prof. Daniel Klionsky ( /info/en/?search=Daniel_J._Klionsky) a well-known scientist in the field is among the authors of this work. Should this proposed link be included in this Wikipedia page as well? -- Autophagy1962 ( talk) 09:43, 19 November 2021 (UTC)
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.Cite error: There are <ref>
tags on this page without content in them (see the
help page).
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.Cite error: There are <ref>
tags on this page without content in them (see the
help page).
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003773#pmed-1003773-g005. — Preceding
unsigned comment added by
Gracesweeney (
talk •
contribs)
https://doi.org/10.1016/S1473-3099(21)00703-9 Kaihsu ( talk) 11:32, 7 January 2022 (UTC)
"without fully understanding the effects of the Omicron variant's effects yet"
could someone fix this, I don't have permissions Adhiyana ( talk) 11:07, 14 January 2022 (UTC)
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I'd like to suggest a new item in the "Causes" section in the bulleted list following "Other situations that might cause new and ongoing symptoms include:". New item as follows:
References
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I'd like to suggest a new item in the "Causes" section in the bulleted list following "Other situations that might cause new and ongoing symptoms include:". New item as follows:
References
Xavier-FUTURE ( talk) 15:53, 17 January 2022 (UTC)
The "Diagnosis and Treatment" section contains nothing on treatment, only talking about XenonMRI. I ask the section be renamed until information about effective treatment. I'm not familiar with any treatments that were shown as effective yet. 89.216.154.41 ( talk) 14:36, 18 January 2022 (UTC)
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In the Diagnosis section, the Journal of the American Medical Association Internal Medicine study should be cited ( https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785832), concluding from a cross-sectional study of 26,000 patients that long COVID is idiopathic and psychosomatic (i.e., has no causative relationship or existence). Jwwallace ( talk) 02:32, 22 January 2022 (UTC)
I think this can also be called Long COVID Syndrome (LCS). 173.88.246.138 ( talk) 04:01, 30 January 2022 (UTC)
The aformentioned research under Diagnosis has its preprint released. — Preceding unsigned comment added by 210.10.1.127 ( talk) 16:32, 31 January 2022 (UTC)
I suggest adding the following in the first paragraph on the US response.
The NIH Initiative is known as RECOVER (Researching COVID To Enhance Recovery), and it is funded by a $1.15 billion appropriation provided by Congress in December 2020. [1] — Preceding unsigned comment added by Yogafogie ( talk • contribs) 21:29, 4 March 2022 (UTC)
References
I've come to this article several times myself as a longhauler and have been surprised that "visual changes" has not been listed as a symptom. It is a heavily and a well documented complication ranging from blurred vision, double vision, and the likes. The mechanism is still unclear (perhaps ocular motility?) but most information points to nerve damage: https://www.livescience.com/nerve-damage-cornea-long-covid.html
Information is also increasingly highlighting neurological disorders as a main mechanism (dysautonomia, neuropathy) of long covid (ANS, vagus nerve), which is not listed as a possible cause.
I myself have vision issues and prior to being a longhauler had 20/20 vision and never wore glasses. Though anecdotal, I have read hundreds of others having the same issue post exposure.
Made an account to relay this information as I would not be as effective in scholarly sourcing as the existing editors are. But I feel it should be invested in and hopefully an addition to this article. — Preceding unsigned comment added by Unknowndust ( talk • contribs) 17:44, 12 March 2022 (UTC)
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Under the headline: "Causes", following the sentence: "It is currently unknown why most people recover fully within two to three weeks and others experience symptoms for weeks or months longer.[65] Although the exact processes that cause long COVID remain unknown, a number of mechanisms have been suggested." - newest evidence for a dysfunction of the vascular endothelium in Long COVID should be added ( https://pubmed.ncbi.nlm.nih.gov/35317812/). Template: In March 2022 a study by the Charité Berlin[ [2]] provided first evidence for peripheral endothelial dysfunction in Long COVID. [1] Martin Fredrick ( talk) 10:47, 24 March 2022 (UTC)
References
Persistence of fragments or whole virus has gained interest as a Long Covid theory over the last few months, including in a Stanford paper that suggests gastrointestinal tract persistence as long as 7 months post-infection, along with links to gastric upsets. This important pathological feature can also be included in the main SARS-CoV-2 article if possible. 210.10.0.187 ( talk) 12:36, 17 April 2022 (UTC)
To explain my reversion of the preceding edit by User:Seaweed : 'survivors' is the exact term used in the cited paper and precisely designates the cohort of subjects who were diagnosed (not "diagonised"!) with COVID-19 and lived to tell the tale. -- Jmc ( talk) 21:07, 29 April 2022 (UTC)
Per article:
As of mid-October 2021, more than 100 million people had or currently have Long COVID. [1]
WebMD is not exactly WP:MEDRS, and the study cited by WebMD ( Chen et al. 2021) is a preprint. [2] I think it the sentence should be removed for now, until a better source is found for the number. ~Desac coin tier 14:02, 8 May 2022 (UTC)
References
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In May 2021, a global systematic review led by researchers at Stanford University reported that a wide variety of symptoms persisted in more than 70% of COVID-19 patients months after recovering from the initial phase of the disease. A majority of the studies reviewed focused on patients who had been hospitalized with COVID-19. The most common lingering symptoms included shortness of breath, fatigue, cough, and depression and/or anxiety. The study reviewed 84 clinical signs or symptoms, including atypical chest pain, fever, loss of smell of taste, and cognitive disorders such as memory loss and difficulty concentrating. [1] 75.235.226.47 ( talk) 11:37, 5 May 2022 (UTC)
References
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I'd like to suggest a new paragraph in the "Causes" section. Above the paragraph that starts with 'A March 2021 review article...', I'd like to suggest a new paragraph as follows:
A May 2022 review article discusses viral fragments (RNA and protein) found in non-respiratory reservoirs like the gut for prolonged durations, and suggests that the persistence of replication-competent virus may contribute to long COVID. [1]
References
Xavier-FUTURE ( talk) 14:42, 12 May 2022 (UTC)
{{
edit extended-protected}}
template.
Dr.Pinsky (
talk)
07:41, 22 May 2022 (UTC)Sorry, that was an inadvertent deletion of content from the page on June 23. I screwed up. Whoisjohngalt ( talk) 19:54, 23 June 2022 (UTC)
This section is full of unnecessary details on the past research made on long covid. By now, we are almost three years after the initial outbreak, and we can produce an epidemiology section that is short with solid knowledge of prevalence, incidence, morbidity, geographical distribution, etc; and a separate "Ongoing research" section with the important facts that are being discovered with new studies. Forich ( talk) 16:57, 19 July 2022 (UTC)
There are already publications regarding treatment available. Case reports, pilots and randomised trials. I would suggest to this as a topic? 194.230.148.122 ( talk) 17:32, 25 June 2022 (UTC)
References
Sequelae in the lede should be wikilinked. -- SchallundRauch ( talk) 11:26, 1 August 2022 (UTC)
Update citation on dismissal faced by patients from medical professionals who do not believe that Long Covid is real https://www.sciencedirect.com/science/article/pii/S2667321522001299 Binu112 ( talk) 22:16, 20 September 2022 (UTC)
Outcomes among confirmed cases and a matched comparison group in the Long-COVID in Scotland study Mapsax ( talk) 01:49, 14 October 2022 (UTC)
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)
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)
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)
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Causes: Mitochondria dysfunction and fatty acid metabolism changes [1] [2] IrinaPetracheMD ( talk) 12:42, 26 October 2022 (UTC)
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)
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)
"SARS-CoV-2 is associated with changes in brain structure in UK Biobank" [3] "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)
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)
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)
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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)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 9 January 2023 and 21 April 2023. Further details are available
on the course page. Student editor(s):
Ryanbrown58 (
article contribs). Peer reviewers:
Blazer GB,
Teecuee,
JamaalBurks.
— Assignment last updated by JamaalBurks ( talk) 15:07, 1 March 2023 (UTC)
A better picture for the article would be one who actually has the condition. Dianna Cowern, Physics Girl, is a well known YouTube personality. I assume she would not object to the picture her account posted on Twitter https://pbs.twimg.com/media/FqRGyTHaIAA12UQ?format=jpg&name=large Nehmo ( talk) 04:55, 5 March 2023 (UTC)
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)
I would highly recommend your consulting with patient advocacy groups on this
Addition to Causes:
Multiple peptides within the SARS-CoV-2 proteome are capable of inducing amyloidosis, a condition that could persist following infection. Amyloid peptides form aggregates and can spread throughout the human body in the absence of infection. These aggregates can disrupt biological processes ( https://www.nature.com/articles/s41467-022-30932-1) ( https://www.nature.com/articles/s41467-023-36234-4). Whether SARS-CoV-2 can trigger amyloidosis in humans is still uncertain. This is a potential mechanism that might explain post-infection sequelae such as long covid.
Phosphorylated alpha-synuclein was identified in skin biopsies in five patients with long covid
postural orthostatic tachycardia syndrome. 4/5 of these patients showed evidence of hyposmia as well. These findings are often associated with
synucleinopathies such as REM sleep behavior disorder, an early sign of Parkinson's disease, Lewy body dementia and multiple system atrophy (
https://link.springer.com/article/10.1007/s10286-022-00867-0). A seperate study (N=11) demonstrated signs of
REM sleep behavior disorder in 36% of patients after COVID-19 infection (
https://www.sciencedirect.com/science/article/pii/S138994572100068X?via%3Dihub). Larger studies are urgently needed to confirm these findings. A clinical trial is underway to determine the risk of alpha-synuclein amyloidosis and associated neurodegeneration following infection with COVID-19 (
https://clinicaltrials.gov/ct2/show/NCT05401773?term=NCT05401773&draw=2&rank=1).
MagicTheater (
talk)
15:12, 4 March 2023 (UTC)
All the references are old (a few are a year old, but many are two-three years old) ...and there is barely any mention of mental symptoms, which are among the more common ones. Nor any mention of how the risk of Long COVID is effected by the mutated variants. (which it hasn't, last I checked. Risk of death or need for intensive care seems to have gotten reduced, but not Long COVID) 155.4.221.27 ( talk) 00:53, 25 April 2023 (UTC)
A lot of them do not mention "long covid" specifically
You have to realize that makes zero sense.
Choutka, J., Jansari, V., Hornig, M. et al. Unexplained post-acute infection syndromes. Nat Med 28, 911–923 (2022). https://www.nature.com/articles/s41591-022-01810-6
Context to aid understanding:
"The observation of unexplained chronic sequelae after SARS-CoV-2 — known as post-acute sequelae of SARS-CoV-2 infection (PASC), or ‘long COVID’ — in a subset of individuals has focused attention on this previously overlooked phenomenon, bringing an opportunity for accelerated progress in biomedical research into PAISs."
"It is remarkable that PASC, especially when it occurs after mild or moderate (rather than severe) COVID-19, shares many similarities with chronic illnesses triggered by other pathogenic organisms, many of which have not been sufficiently explained. These PAISs are characterized by a set of core symptoms centering on exertion intolerance, disproportionate levels of fatigue, neurocognitive and sensory impairment, flu-like symptoms, unrefreshing sleep, myalgia/arthralgia, and a plethora of nonspecific symptoms that are often present but variably pronounced. These similarities suggest a unifying pathophysiology that needs to be elucidated to properly understand and manage post-infectious chronic disability."
This review covers a more comprehensive breadth of post-acute infection syndromes including those associated with SARS-CoV-2 (e.g. long COVID), Ebola, Dengue, Polio, SARS-CoV-1, Chikungunya, Epstein Barr (mononucleosis), West Nile, Ross River virus, Coxsackie B, H1N1 influenza, Varicella Zoster (chickenpox, shingles), Coxiella Burnetii (Q fever), Borrelia (Lyme disease, tick borne relapsing fever) and Giardia. The Wikipedia article needs to discuss long COVID from a broader perspective.
" In fact, several studies identified the association of this outbreak of giardiasis with chronic fatigue 42, irritable bowel syndrome (IBS) 43, and fibromyalgia 44 persisting for many years."
"Several epidemiological studies using health-registry data have looked for post-infection registration of a diagnosis of ME/CFS as a surrogate for chronic post-infection sequelae. One study found that infection with the pandemic H1N1/09 influenza A virus (but not receipt of vaccine) was associated with a more than twofold increase in ME/CFS diagnosis in a Norwegian health registry 57. Similarly, another longitudinal registry study identified an association between varicella zoster virus (VZV) infection and an increased risk of an ME/CFS diagnosis 58, supporting the concept that the correlation between exposure to certain infections and development of chronic sequelae is indeed not uncommon."
"The prime manifestations include an overall poor functional status, exertion intolerance, debilitating fatigue, and unrefreshing sleep. Other characteristic features include neurocognitive and sensory impairments, dysautonomia, musculoskeletal complaints, flu-like symptoms, and other feelings of illness. Irritability, mood swings, and signs of depression, as well as a wide range of other nonspecific neurological and immunological symptoms (Box 2), are frequently present."
"...long-term data from studies of [post treatment Lyme disease syndrome] show ongoing disability even after many years. A study that examined a cohort of 128 individuals after culture-confirmed Lyme disease reported that 4.7% had PTLDS at clinical examination 11–20 years after contracting erythema migrans (a typical circular rash occurring at the site of the tick bite) 83. Remarkably, a case–control study of 61 cases and 26 controls found the symptoms of PTLDS to be associated with physician- or laboratory-confirmed Lyme disease for up to 27 years 50. It was also reported that post-Borrelia symptoms mimicking fibromyalgia, such as musculoskeletal pain, tender points, dysesthesias, memory difficulties, and debilitating fatigue persisted in some individuals for at least 10 years 84. MagicTheater ( talk) 15:12, 7 May 2023 (UTC)
The Wikipedia article could use a pathology section to outline the current state of knowledge. Perhaps, some of the editors can help me put this together. Here's a Nature review from 2022 to start from.
Mehandru, S., Merad, M. Pathological sequelae of long-haul COVID. Nat Immunol 23, 194–202 (2022). https://www.nature.com/articles/s41590-021-01104-y
Summary of Article:
As of November 2021, there have been 254 million cases and 5.1 million deaths due to COVID-19. Many people who recover from the virus experience ongoing symptoms, known as "long COVID" or "post-COVID syndrome." The duration of these symptoms can vary, lasting from over 4 weeks to more than 3 months after the initial infection.
Long COVID can affect several organ systems and may cause a range of issues, including fatigue, sleep problems, memory issues, mood impairment, heart issues, and breathing difficulties. These symptoms can be experienced by people who had mild, moderate, or severe COVID-19. While lung issues are common in severe cases, those with long COVID can experience a variety of other symptoms.
Neurological and psychiatric problems can occur in long COVID, with common issues including chronic fatigue, sleep abnormalities, and headaches. Some patients may also develop cognitive issues, such as "brain fog" or even neurological disorders like Parkinson's disease. Additionally, psychiatric disorders like depression, anxiety, and post-traumatic stress disorder may arise.
Patients with long COVID may experience heart-related symptoms, such as chest pain or palpitations. Some may have ongoing inflammation or other cardiac abnormalities. Thrombotic complications, such as blood clotting, can occur during acute COVID-19 but seem less common in the post-acute phase.
Gastrointestinal symptoms, such as diarrhea, nausea, and abdominal pain, are common during acute COVID-19 and may persist in long COVID. Some patients may also develop new or worsened irritable bowel syndrome. Additionally, COVID-19 has been associated with the development of new-onset diabetes in some cases.
Other health issues related to long COVID can include kidney injury, skin rashes, and hair loss. While kidney injury in severe cases may be associated with high mortality, some patients show significant recovery. Skin rashes can occur in various forms during acute COVID-19, and a small number of patients may experience a rash during long COVID. Hair loss is also a common issue, but it typically resolves on its own.
More detail on what is known about the pathology:
In mild COVID-19 cases, a strong initial immune response leads to viral neutralization and disease resolution. However, in severe cases, uncontrolled SARS-CoV replication evades the host's immune system, resulting in increased inflammation and lung tissue damage. The link between acute COVID-19 and post-COVID-19 syndrome remains unclear, but various hypotheses exist. Factors such as persistent inflammation, immune cell activation, and cytokine elevation may contribute to lingering symptoms. Additionally, prothrombotic states and autoimmune responses can play a role in post-COVID syndrome.
A recent study found that long-haul COVID patients had persistent increases in certain immune cells and elevated interferon levels, suggesting delayed inflammation resolution. Damage to lung tissue and impaired regeneration, along with fibrotic states, may contribute to persistent lung injuries. The prothrombotic state in acute COVID-19 can also result in various organ injuries.
Persistent elevation of proinflammatory cytokines may have multiple systemic and organ-specific effects. Furthermore, recent studies have reported persistent immunological abnormalities, immune dysregulation, and autoimmune responses in COVID-19 patients. The possibility of a viral reservoir and antigen persistence in tissues such as the intestine has also been suggested.
Overall, the pathophysiology of post-COVID syndrome is complex and multifaceted, involving a range of immune and inflammatory responses, organ-specific effects, and potential viral persistence. This article highlights the need for a comprehensive and unbiased profiling of the immune system in patients with post-COVID syndrome to better understand the pathophysiological mechanisms underlying the condition. It suggests utilizing various techniques such as measuring systemic and local secreted inflammatory proteins, single-cell RNA profiling of immune cells, ex vivo imaging of diseased organs, multiplex imaging, and spatial transcriptomics analysis of tissue biopsies. Comparing these results with age- and comorbidities-matched healthy individuals and other control cohorts can help identify potential autoimmune contributions to the syndrome.
The article also discusses the importance of establishing canonical disease definitions based on objective clinical and laboratory criteria due to the heterogeneity of post-COVID syndrome manifestations. It emphasizes the need for rigorous, high-dimensional, and serial profiling of tissues and peripheral blood to better understand the multiple syndromes currently encapsulated under the term "post-COVID-19 syndrome."
Finally, the article mentions the National Institutes of Health's PASC initiative launched in February 2021, which aims to study the prevention and treatment of long-term effects of SARS-CoV-2 infection. This initiative will collect data from diverse patient cohorts, including children and adults, to ensure the findings apply to communities most affected by COVID-19. The use of cutting-edge technologies will be crucial in deciphering the molecular heterogeneity of post-COVID syndrome and identifying precise, druggable targets tailored to these defects. MagicTheater ( talk) 15:31, 7 May 2023 (UTC)
"Long COVID is considered to be caused by the persistence of chronic inflammation after acute COVID-19 infection. We found that all long COVID patients had residual inflammation in the epipharynx, an important site of coronavirus replication, and some long COVID symptoms are similar to those associated with chronic epipharyngitis. Epipharyngeal abrasive therapy (EAT) is a treatment for chronic epipharyngitis in Japan that involves applying zinc chloride as an anti-inflammatory agent to the epipharyngeal mucosa. In this study, we evaluated the efficacy of EAT for the treatment of long COVID. The subjects in this study were 58 patients with long COVID who were treated with EAT in the outpatient department once a week for one month (mean age = 38.4 ± 12.9 years). The intensities of fatigue, headache, and attention disorder, which are reported as frequent symptoms of long COVID, were assessed before and after EAT using the visual analog scale (VAS). EAT reduced inflammation in the epipharynx and significantly improved the intensity of fatigue, headache, and attention disorder, which may be related to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). These results suggest that EAT has potential as a novel method for long COVID treatment." See Abstract.-- 98.113.209.140 ( talk) 02:54, 26 May 2023 (UTC)
A 2023 study found that metformin prevents long COVID, according to a new study in The Lancet Infectious Diseases.
[1] BuffaloDoc ( talk) 16:50, 17 June 2023 (UTC)
References
@ Zefr. I'm new to medical editing, so I'm probably reading MEDRS wrongly. My reading of WP:MEDREV is that when there are large-scale clinical trials with results not yet presented in secondary sourcing, it is okay to mention them in the text (I had removed it from the lead before). When a new review is out, this should either replace it or if it's not mentioned, taken as a sign it wasn't important enough. Also happy to wait a few months, as proper reviews of long COVID are published quite a bit. —Femke 🐦 ( talk) 16:22, 16 June 2023 (UTC)
The section is very news-like. I would like to remove it almost completely and write a small section on history based on secondary sourcing. As it's a large part of the article, I'll wait for feedback here first. —Femke 🐦 ( talk) 16:16, 7 August 2023 (UTC)
Or should I try to supplement it with reviews whenever it's cited? —Femke 🐦 ( talk) 15:11, 6 August 2023 (UTC)
I think one of the highest-quality sources we have is:
the 2022 guideline for primary care published in BMJ. That paper says under the heading "What can my primary care team do for me", Making the diagnosis of long covid (which does not have to be by exclusion) and excluding alternative diagnoses
.
This seems to contradict the older source we now cite in the lead ( The Journal for Nurse Practitioners paper). Neither source gives a lot of information.
I don't understand the
2021 NICE clinical guidelines completely: The panel acknowledged that this case definition may be interpreted as a diagnosis of exclusion. However, they discussed that ongoing symptomatic COVID-19 and post-COVID-19 syndrome have many features in common with other conditions, some of which could be considered life threatening. Therefore, ongoing symptomatic COVID-19 and post-COVID-19 syndrome should not be the first conditions to be excluded for reasons of patient safety.
I think they try to say you should exclude a couple of other life-threatening conditions first, before you diagnose people with long COVID if they have the symptoms + history that makes sense.. But I'm not sure if their conclusion is that long COVID is a diagnosis of exclusion, or something "in the middle" if that exists.
Any page watchers understand this better? —Femke 🐦 ( talk) 18:28, 2 August 2023 (UTC)