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'Long Covid': Why are Some People not Recovering?

posted by Fnord666 on Monday October 12 2020, @02:59PM   Printer-friendly

takyon writes:

'Long Covid': Why are some people not recovering?

For most people, Covid-19 is a brief and mild disease but some are left struggling with symptoms including lasting fatigue, persistent pain and breathlessness for months.

The condition known as "long Covid" is having a debilitating effect on people's lives, and stories of being left exhausted after even a short walk are now common.

So far, the focus has been on saving lives during the pandemic, but there is now a growing recognition that people are facing long-term consequences of a Covid infection.

Yet even basic questions - such as why people get long Covid or whether everyone will fully recover - are riddled with uncertainty.

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  • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @02:29AM (7 children)

    by Anonymous Coward on Tuesday October 13 2020, @02:29AM (#1063835)

    What sentence had anything to do with them having scurvy.

  • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @02:50AM (6 children)

    by Anonymous Coward on Tuesday October 13 2020, @02:50AM (#1063840)

    They don't go into the symptoms at all in those covid papers. Just report that once in the ICU the vitamin C levels were low. Symptoms of scurvy are very common in covid patients though. Strange how they have low vitamin C and symptoms of scurvy but you don't want to check their vitamin C levels or try correcting that deficiency.

    Scurvy:

    Examination showed gingival inflammation (Appendix 1, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.190934/-/DC1) and diffuse lower-extremity nonpalpable purpura in a perifollicular distribution (Figure 1). Laboratory investigations showed microcytic anemia, with normal platelet count and coagulation studies. Serologic testing for vasculitides, hepatitis B and C viruses, HIV and cryocrit were negative. A skin biopsy showed erythrocyte extravasation, hemosiderin deposition, and fibrin thrombi within small blood vessels; there was no evidence of dermatitis or vasculitis.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6989015/ [nih.gov]

    One of the striking observations in the older literature is of death being quite sudden in apparently stable individuals. One of the best descriptions of this was in a passage from Ansons’ A Voyage Around the World (1740–1744): “For many of our people, though confined to their hammocks, appeared to have no unconsiderable share of health; for they ate and drank heartily, were cheerful, and talked with much seeming vigor, and with a loud strong tone of voice; and yet on being the least moved, though it was only from one part of the ship to the other, and that in their hammocks, they have immediately expired. And others, who have confided in their seeming strength, and have resolved to get out of their hammocks, have died before they could well reach the deck. And it was no uncommon thing for these who would do some kind of duty, and walk the deck, to drop down dead in an instant on any endeavors to act with their utmost vigour.” 42 Lind also commented that “they are apt, upon being moved, or exposed to fresh air, suddenly to expire.” 4 It is recorded that only 4 men died from enemy action during Anson’s voyage, with more than 1300 dying of disease, which was primarily scurvy. 4

    [...]

    In a forensic context, scurvy may mimic inflicted injuries and may be responsible for sudden death by mechanisms that remain unclear. Cardiac failure and rhythm disturbances with chest pain, hypotension, cardiac tamponade, and dyspnea are associated with vitamin C deficiency. In addition, syncope and seizures may occur.

    [...]

    The first manifestation of scurvy is lassitude with other psychological manifestations including depression, hypochondriasis, psychomotor retardation, “personality change,” and confusion, possibly associated with disturbances in the function of the basal motor nuclei.2,34

    https://pubmed.ncbi.nlm.nih.gov/30422823/ [nih.gov]

    In 80% of cases, the manifestations of scurvy include musculoskeletal symptoms consisting of arthralgia, myalgia, hemarthrosis, and muscular hematomas.

    https://pubmed.ncbi.nlm.nih.gov/15797491/ [nih.gov]

    ###############################################3
    Covid:

    1) gingival inflammation

    In summary, almost half of patients with mild to moderate COVID-19 admitted in a field-hospital during a two-week period show mucocutaneous findings. Oral cavity is frequently involved and deserves specific examination under the appropriate circumstances to avoid contagion risk.

    https://pubmed.ncbi.nlm.nih.gov/32969503/ [nih.gov]

    Reddness an swelling of the hands and feet, fine palmoplantar desquamation and reddish-to-brown macules can help us to diagnose COVID-19 infection and should be routinely checked.

    https://pubmed.ncbi.nlm.nih.gov/32969503/ [nih.gov]

    2) diffuse lower-extremity nonpalpable purpura in a perifollicular distribution

    Other maculopapules (47%). Some of them showed perifollicular distribution and varying
    degrees of scaling (Fig 2a). Some had been described as similar to pityriasis rosea. Purpura may
    also be present, either punctiform or on larger areas. A few cases showed infiltrated papules in
    the extremities, mostly dorsum of the hands, that look pseudovesicular (Fig 2b) or resemble
    erythema elevatum diutinum or erythema multiforme (Fig 2c).

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267236/ [nih.gov]

    3) microcytic anemia
    mean corpuscular volume appears normal:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414516/ [nih.gov]

    4) erythrocyte extravasation

    Additional frequent findings included erythrocyte extravasation (82%) (Fig 3); papillary dermis edema (76%), which was massive in 4 cases, resulting in the formation of subepidermal pseudobullae (Fig 1); endothelial cell swelling (65%) (Fig 3); and moderately increased interstitial mucin deposition (41%). Less frequent, although remarkable, findings included the presence of vascular microthrombi within superficial dermal capillaries and more rarely in dermal venules

    https://www.sciencedirect.com/science/article/pii/S0190962220310227 [sciencedirect.com]

    5) hemosiderin deposition

    Hemosiderin-laden macrophages (4/8), hemorrhage (4/8), mucus aspiration (3/8), emphysema (2/8), and microthrombi (1/8) were seen (Figure 2).

    https://wwwnc.cdc.gov/eid/article/26/9/20-2095_article [cdc.gov]

    6) fibrin thrombi within small blood vessels

    “The extent of thrombosis we are seeing with covid is extraordinary,” Roopen Arya, clinical director for haematology at King’s College Hospital, told The BMJ. “I would say that one third of those severely affected with covid in critical care is a conservative estimate.”

    https://www.bmj.com/content/369/bmj.m2058 [bmj.com]

    7,8,9,10)

    However, the most common feature is crippling fatigue.

    Others symptoms include: breathlessness, a cough that won't go away, joint pain, muscle aches, hearing and eyesight problems, headaches, loss of smell and taste as well as damage to the heart, lungs, kidneys and gut.

    Mental health problems have been reported including depression, anxiety and struggling to think clearly.

    https://www.bbc.com/news/health-54296223 [bbc.com]

    11)

    The results of autopsy studies indicate the presence of pulmonary endothelial damage and microthrombosis. In a case series of 4 autopsies of COVID-19-infected patients from New Orleans with sudden respiratory decompensation, it was shown that there were no thromboembolisms in the major pulmonary arteries, but small thrombi were present in sections of the peripheral lung parenchyma.41 Furthermore, the microscopic findings confirmed that small vessels contained thromboembolisms and small thrombi together with scattered areas of diffuse alveolar damage, indicating that small vessels can a be affected by microthrombosis. d-dimers determined near the time of death were elevated in only 2 of the 4 patients.

    https://journals.sagepub.com/doi/10.1177/1076029620938149 [sagepub.com]

    • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @04:01AM (5 children)

      by Anonymous Coward on Tuesday October 13 2020, @04:01AM (#1063863)

      I actually read all of that. Let me say, That's a lot to put just to say "I just ignore everything that I don't think matches with my conclusion."

      And next time you want to claim what I want to do with COVID patients or those presenting any vitamin deficiency, you may want to check the treatment guidelines and standard of care in general.

      But please, put even more copypasta.

      • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @04:06AM (3 children)

        by Anonymous Coward on Tuesday October 13 2020, @04:06AM (#1063864)

        I actually read all of that. Let me say, That's a lot to put just to say "I just ignore everything that I don't think matches with my conclusion."

        What was ignored?

        • (Score: -1, Troll) by Anonymous Coward on Tuesday October 13 2020, @06:28AM (2 children)

          by Anonymous Coward on Tuesday October 13 2020, @06:28AM (#1063902)

          About 80% of the paper corpus cited and a basic understanding of medical research, diagnostic methods, and statistics.

          • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @01:22PM (1 child)

            by Anonymous Coward on Tuesday October 13 2020, @01:22PM (#1063966)

            So you got nothing then. Just dogmatic believe that vitamin c deficiency shouldn't be treated with vitamin c for some reason. Probably learned from a textbook written before the internet existed.

            • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @09:13PM

              by Anonymous Coward on Tuesday October 13 2020, @09:13PM (#1064161)

              You are the one who started this by claiming that they had scurvy. Scurvy is not the same thing as Vitamin C deficiency and it doesn't have the same symptoms as COVID-19, long or short, acute or chronic. If they have a Vitamin C deficiency, then treat it. It is easy to spot because it is so obvious and fix because there are almost no side effects or adverse events. That's why hospitals are giving patients Vitamin C and D and others despite your claim that they aren't and such action is in the guidelines despite your claims its not. But not everything is a Vitamin C deficiency. The fact that the papers you cited disagree with your conclusion of scurvy on a basic analysis, if not on their face, and you don't see it speaks volumes. And a number of them says that patients don't have a symptom that you say they do and instead sound similar on their face. That probably comes from you not knowing your jargon and medical terms.

              But if you aren't, prove it instead of just relying on your feeling and focusing on where they look the same. Do the 2-way frequency table. You could do the statistical testing. Even better establish estimates of what the sensitivity and specificity of your diagnostic signs are. You could save tens of thousands of lives through your efforts, especially if you got it in a big journal or in the blogosphere. You could be a household name for making the connection between "long COVID" and Vitamin C deficiency despite the evidence being against you.

      • (Score: 0) by Anonymous Coward on Tuesday October 13 2020, @04:16AM

        by Anonymous Coward on Tuesday October 13 2020, @04:16AM (#1063868)

        Anyway, I was going to encrypt it but not worth the effort at the moment.

        Everything you say I am ignoring is going to be symptoms counteracted by the hypoxemia.