Long COVID
This (long) report from StatCan says that people who reported two COVID-19 infections were 1.7 times more likely to have Long COVID than people who only had one infection; people who had more than two were 2.6 times more likely to have Long COVID than those who had one infection.
COVID-19 is not the flu! This paper from Taiwan (20231205) compared people who had been hospitalized with influenza or with COVID-19. They found that the risk of post-illness symptoms, ED visits, re-hospitalization, and death (especially death!) was higher from COVID-19 than from influenza:
| Symptom | Increased risk |
| abnormal breathing | 51% |
| abdominal symptoms | 31% |
| fatigue | 49% |
| cognitive symptoms | 81% |
| later ED visit | 24% |
| later hospitalization | 30% |
| later death | 340% |
This paper from USA (20231214) also looked at aftereffects of COVID-19 hospitalization and influenza hospitalization. It found that people who had been hospitalized for COVID-19 were 51% more likely to die in the 18 months afterwards than people who had been hospitalized for influenza. (It also found that Long Flu really is a thing, but it’s not as bad as Long COVID.)
This paper from India (20231204) found that a quarter of men who had recovered from COVID-19 infections had low testosterone.
This paper from USA (20231208) found that 4.79% of veterans with a positive COVID-19 test had Long COVID six months after infection and 5.28% had it 12 months after infection.
This paper from Spain (20231214) found that patients with Long COVID had significantly lower maximal fatty acid oxidation during exercise. As best I can understand, this means their mitochondria are screwed up.
This article from US (20230623) talks about unpublished research in progress says that they found that arterial stiffness was implicated in Long COVID, and that women’s arterial stiffness was way higher than men’s.
COVID-Related Excess Deaths and Sickness
How do I decide what goes into the Long COVID bucket and what goes into the COVID-Related Excess Deaths and Sickness bucket? Mostly it’s “do people think of this when I say ‘Long COVID’?” So mostly it’s papers which talk about elevated risks of getting a diagnosis of something else. Maybe I should just call it “elevated risks”.
This preprint from USA (20231205) used a very large data set to look at new diagnoses of schizophrenia and psychotic disorders in three groups: those who had acute respiratory distress syndrome (ARDS), those who were COVID-positive but did not have ARDS, and those who were COVID-negative. The COVID-positive group had a WAY higher risk of getting a new diagnosis of schizophrenia or psychotic disorders than either of the other groups, although it went down significantly over time:
| Time | Increased Risk |
| 0-21 days | 360% |
| 22-90 days | 190% |
| over 90 days | 70% |
This paper from Sweden (20231121) found that the risk of cardiac arrhythmias was WAY higher in the first 30 days after getting COVID-19:
| Arrhythmia Type | Times-higher Risk |
| atrial tachycardias | 12.28x |
| paroxysmal supraventricular tachycardias | 5.26x |
| bradyarrhythmias | 3.36x |
Vaccines
This article reports that the World Health Organization decided to recommend the XBB 1.5 vaccine to continue to be the basis of the next round of COVID-19 vaccines. Why not switch to the next up-and-coming strain? Basically, because XBB 1.5 seems to be doing pretty well against what’s circulating now, and they aren’t really sure what strain is coming next. (They did note that they didn’t have a lot of information about JN.1, which is slowly starting to take over.)
(This preprint from Netherlands (20231213) found that between 9 October and 5 December 2023, the vaccine effectiveness of the XBB 1.5 against what was circulating then was 70.7% against hospitalization and 73.3% against ICU admission compared to people who did not get a booster (but who might have gotten previous vaccinations or COVID-19 infections).
I wonder if maybe the reason why strains haven’t evolved to become more vaccine-resistant is because not many people are getting the XBB 1.5 vaccination. This article says that in the US, only 17.2% of adults have gotten a fall booster as of 14 Dec 2023. Even in BC, which has IMHO done a very good job of getting vaccinated, only 23% had gotten an XBB 1.5 vax as of 10 Dec 2023, according to this article.
Testing
This paper found that healthcare worker-collected samples from the throat were slightly more accurate than swabs from the nose. However, patient-collected throat samples were much less accurate than patient-collected nose samples. For both HCW-collected and patient-collected samples, doing both throat and nose was more accurate (by ~21% and ~15% respectively).