2024-04-05 General – Pandemics in British Columbia

Long COVID

This paper from Sweden (2024-04-04) found that patients with Long COVID didn’t have a worse time after exercise than controls. This is, on its face, a surprising finding because other studies (like this one) have definitely found that post-exertional malaise (PEM) (i.e. crashing after exertion) is a real thing. I have two observations: 1) there were only 31 participants and 2) participants had to do this willingly. Long COVID has many different manifestations, and it could be that people who have PEM took one look at the study and said, “uh-uh, not me!”

This paper from USA (2024-03-25) says that voice disorders are about twice as common in people with Long COVID than controls.

This study from Norway (2024-03-26) found 13 different gene expressions in adolescents and young adults which were expressed differently in long haulers. The genes were related to interferon-signalling and anti-viral immune processes.

Vaccines

This press release (2024-03-11) reports that there is going to be a placebo-controlled human challenge trial in the UK to help speed development of mucosal vaccine development. While I’m all for developing better vaccines, I think it’s highly unethical to deliberately infect people with COVID-19, given how much we know now about how COVID-19 messes with all kinds of different bodily systems. However, they didn’t ask me and I don’t make the rules in the UK. 🙁

NACI has advised spring boosters for people over 65, but I wasn’t sure if that meant that someone under 65 (like, oh, say me) was not allowed to get a booster, or if that just meant that the government would not pay for it. I called my local pharmacy, who said that under-65s were not allowed to get a booster. I called a US pharmacy, and they say that if they know you’ve gotten an XBB 1.5, they won’t sell you a second one if you are under 65.

Pathology

This paper from USA (2024-04-04) found that patients hospitalized with (not for, as near as I can tell) COVID-19 early in the pandemic who had neurological manifestations were 2.3 times as likely to die as those who did not have neurological issues.

This paper from UK (2024-01-11) found twelve different measures of immune system ageing which were worse in people who had been hospitalized for COVID-19 compared to healthy controls. (They did not find any appreciable difference in mild cases and only a few differences in moderate cases compared to controls.) NB: We can’t tell if people who started out with crappier immune systems got sicker, or if COVID-19 damaged hospitalized people’s immune systems.

This paper from Italy (2024-01-26) found that people who had been hospitalized with COVID-19 earlyish in the pandemic had changes in their eyes compared to controls, and those changes persisted for at least a year. People who had been hospitalized for COVID-19 had fewer blood vessels in the superficial capillary plexus of the eye (which I think is the most visible layer at the back of the eye) and the foveal avascular zone (which is an area in the area responsible for “central vision”, where your vision is sharper) was bigger.

COVID-Related Excess Sickness and Death

This paper from Brazil (2024-01-19) found that a significant number of patients who had had mild cases of COVID-19 tested more poorly on cognitive tests than controls at a median time of 79 days post-diagnosis. The percentage of participants who tested poorly on various measures were:

fatigue – 83%;
excessive sleepiness – 35%
impaired phonemic verbal fluency (e.g. “give as many words as you can think of which start with the letter P”) – 21%;
impaired verbal category fluency (e.g. “give as many words as you can think of for different foods”) – 13%
impaired immediate recall – 16%.

Treatments

This paper from Iran (2024-01-16) found that Amantadine (a drug used for movement disorders like Parkinson’s) significantly reduced fatigue in Long COVID patients. NB: The wikipedia page for amantadine says that it is a nicotinic antagonist, which I find interesting given that there is a community of long haulers that says they have gotten relief from nicotine patches (and one case studies paper).

This paper from USA (2024-04-03) declared that adults who got Paxlovid didn’t really profit from it. They did see a one-day reduction in recovery times and a halving of the hospitalization rate in participants in the Paxlovid arm (vs. the placebo arm), but they said it was not statistically significant. (NOTE: The USA gives Paxlovid to younger people than BC does. The median age was 42.)

Participants were one of the following:

fully vaccinated with at least one co-morbidity or
no vaccine in the prior twelve months with no cormobidities or
completely unvaccinated with no cormobidities.

The paper said that 56% were vaccinated, but they didn’t split out recently-vaccinated from vaccinated-at-least-a-year-ago in their results.

Me, looking at the study, I believe they didn’t have enough participants to be able to say Paxlovid was not helpful. I think they only said that they couldn’t prove that it was.

Mitigation Measures

This paper from USA (2024-04-03) found that at a school for developmentally and/or intellectually disabled people, the number of COVID cases correlated with the amount of time spent at a “moderate” CO2 level. (In this case, “moderate” means ~1000 ppm — about twice as high as outside air, so higher than you’d like, but below OSHA thresholds.) They also found that students in the one building that used MERV-13 filters had fewer cases than buildings with older MERV-11 filters.