Long COVID Risks Have Been Exaggerated by Misleading Data: BMJ

New research suggests epidemiologic research has distorted data on long COVID, raising undue concern over symptoms and conditions researchers say are common to other respiratory viruses.

In a paper published in BMJ Evidence-Based Medicine (pdf) on Sept. 25, 2023, researchers said high rates of long COVID continue to be reported in academic journals, but these scientific publications are overestimating the prevalence of the condition due to overly broad definitions, lack of proper control groups, and other methodological flaws.

The epidemiologic research on long COVID "has been misleading" and has "created widespread misunderstanding," according to the paper. Poorly conducted systematic reviews and meta-analyses that overstate the risks of long COVID are “being fed to the public” by the media and on social media.

According to the authors, unintended consequences of distorted data about long COVID may contribute to increased societal anxiety and health care spending, a failure to diagnose treatable conditions misdiagnosed as long COVID, and directs funds and awareness away from those actually experiencing chronic conditions brought on by COVID-19.

The Centers for Disease Control and Prevention (CDC), for example, recently stated on its website that “nearly one in five American adults who have had COVID-19 still have long COVID.” A recently published survey using 2022 data from the National Center for Health Statistics says long COVID may have affected as many as 962,000 children and 17.9 million adults. This is consistent with other CDC surveys but conflicts with data showing long COVID in children is exceedingly rare, mild, and of short duration, typically resolving within one to five months. According to a study published in the European Journal of Pediatrics (pdf), only 0.8 percent of children who tested positive for COVID-19 reported symptoms lasting longer than four weeks—which is necessary to meet the CDC's definition of long COVID—when compared to the control group.
Coauthor Dr. Tracy Høeg stated on a social media post that what the CDC really means is that one-fifth reported a new symptom they didn’t have before getting COVID that lasted months. In her recent Substack article, Dr. Høeg elaborated: “Adults get new chronic health issues all the time. Why should we automatically attribute them to COVID?"

“Høeg et al. confirm what has been apparent since late 2020, and certainly by early to mid-2021: Other than transient anosmia (loss of sense of smell) that may have persisted in some persons with non-hospitalized mild to moderate SARS-CoV-2, for months, so-called 'long-covid' in such individuals is more aptly described as ‘long pandemic syndrome,’” epidemiologist Dr. Andrew Bostom told The Epoch Times in an email.

“This psychosomatic affliction—NOT to be dismissed, let alone ridiculed—appears to have been engendered by the sadly hysterical pandemic response, not SARS-CoV-2 infection,” he added.

Dr. Bostom says the lingering respiratory tract involvement in severe COVID-19 infection that results in hospitalization cases mirrors what happens with other severe lower respiratory infectious and other viruses, bacteria, fungi, or parasites and is not unique to SARS-CoV-2.

There Is No Clear Definition for 'Long COVID'

One of the issues plaguing long COVID studies is that there's no clear or consistent definition for the condition among international health organizations and none require a causal link between COVID-19 infection and new symptoms, according to the paper.

Organizations with inconsistent definitions for long COVID include the CDC, the World Health Organization, the National Institute for Health and Care Excellence, the Scottish Intercollegiate Guidelines Network, and the Royal College of General Practitioners.

A 2021 study published in PLOS Medicine, for example, found that 40 percent of patients with long COVID didn’t report any symptoms until more than 90 days after infection.

The CDC defines long COVID as "new, recurring, or ongoing health problems that occur four or more weeks after infection with SARS-CoV-2," but researchers say this definition could create a "misclassification bias" increasing the likelihood that a temporally unrelated symptom or condition after COVID-19 infection is improperly labeled "long COVID."

For purposes of their paper, the authors define long COVID as a “syndrome or individual symptoms which are direct sequelae of the virus, SARS-CoV-2, and last at least 12 weeks.” The authors say the definition should include persistent or contiguous symptoms confirmed after COVID-19 infection and include the individual attributes of the patient that may contribute to a person's post-COVID experience.

Most Studies Lack Proper Control Groups

According to the paper, proper studies on long COVID require, at a minimum, a comparison between individuals reporting symptoms attributed to long COVID and a control group with similar characteristics.
Yet a systematic review published in the Lancet in 2023 showed proper control groups in only 22 of 194 long COVID studies. About 45 percent of those with COVID-19 had an unresolved symptom four months after diagnosis, but the prevalence among the control groups in the 22 studies was not determined. Another review found a long COVID prevalence of 25 percent in children but failed to consider symptom prevalence among controls.

“Not only did they not compare cases with controls, but they also included studies with a short median follow-up of only one month, studies that did not specify the length of follow-up, and studies that included abnormal laboratory results as ‘symptoms,’” the BMJ researchers wrote.

A CDC Morbidity and Mortality Report in May 2022 found that among all patients older than 18 years of age, 38 percent experienced an incident condition within a year of COVID-19 diagnosis compared with 16 percent of controls. However, the agency failed to acknowledge that those diagnosed with COVID-19 in healthcare settings are usually less healthy than those who do not seek COVID-19 testing, which could have caused more severe cases in the post-COVID group compared to the control group.

The study also didn't provide information on the underlying health status of participants, link the timing of symptoms with infection, or disclose the previous history of infection in the control group.

“Inappropriate definitions and flawed methods do not serve those whom medicine seeks to help," the authors concluded. "Improving standards of evidence generation is the ideal method to take long COVID seriously, improve outcomes, and avoid the risks of misdiagnosis and inappropriate treatment."

Reposted from: https://www.theepochtimes.com/health/long-covid-risks-have-been-exaggerated-by-misleading-data-new-analysis-5499751

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