What causes Long Covid? Here are the three leading theories | Hacker News Reader

What causes Long Covid? Here are the three leading theories

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51 pointssohkamyung24 comments

I have no doubt long covid is a real thing that legitimately affects a number of people. My own sister still hasn't regained her sense of smell and taste fully, months after otherwise recovering from covid.

But it's not like our society is devoid of hypochondriacs either, and I find this situation in particular especially problematic when it comes to them. Normally we seem to just ignore hypochondriacs as if they don't exist. But when a pandemic happens, and there's this airborne novel virus pretty much everyone is going to catch eventually, wouldn't we predict the existing hypochondriacs in the population would report stuff resembling long covid?

The signal:noise ratio must be horrible, what a mess.

To attempt to legitimize something and then bring up hypochondriacs in the next breath doesn’t seem like an attempt to legitimize the thing at all, IMO.

No one thought cholera from drinking water was a thing until John Snow pointed out some patterns in the irregularities.

No, the OP was clearly trying to identify the rather vast middle ground.

As someone who deals with health anxiety and psychogenic symptoms regularly, the mention of it does not inherently deny the reality of immediate pathologies and symptoms existing also.

There can be a genuine residual disorder initiated by covid infection and also a clouding of its prevalence and presentation by psychogenic symptoms. In fact, it’s very hard to imagine otherwise.

It’s a hard problem to sort out medicinally, culturally, politically, and personally — going hard to either end doesn’t help on any measure.

While what you state is undoubtedly true regarding reporting I think it’s fair to say that there is a defined pattern of people reporting a constant constellation of symptoms in medicine, being dismissed as hypochondriacs, and then only later being validated for having legitimate claims when a researcher eventually connects the dots. CFS is an example - broad, and just nebulous enough for physicians to be technically dismissive because it doesn’t match up with an existing diagnosis.

But that just makes the situation even more complicated.

I wasn't aware I was making any attempts to legitimize anything, I wasn't aware I had such authority in the subject. My intention was to make clear that I'm not a denier of this phenomenon.

Normally hypochondriacs are just mildly annoying, or at most waste some shared medical resources.

In this scenario they're likely making it substantially harder to identify root causes of long covid.

It's not helpful to act like they don't exist. I wonder what tools medical science has at its disposal to separate the noise from the signal, without getting into a situation John Snow must rescue us from.

That analogy doesn't seem to hold. People understood that cholera was a real disease. They weren't sure how it was spreading. With long COVID it's the reverse: people are pretty certain about how it spreads, but not to what extent it's a real disease.

The challenges for isolating what long COVID really is are very real. You have problems like a significant number of sufferers not having had any positive tests or antibody results. You have the incoherent list of symptoms that captures all possible illness. You have incidence of long COVID going from 25% at two months after infection to 50% after 4 months in meta-studies [1] and various other things that strongly imply that whatever long COVID is, the data set must be seriously distorted by other things. Of those things, hypochondria is a very plausible explanation.

[1] https://academic.oup.com/jid/advance-article/doi/10.1093/inf...

Maybe we are slowly discvering what hypochondriacs are actually suffering from? Typical symptoms are vague symptoms, and symptoms that fit to almost any diagnosis. Whereas thus far doctors had no real way to accurately diagnose, let alone remedy them, they would, also motivate by the low severity, try to get patients to brush it off.

Wouldn't it be great if we can actually improve the diagnosis of those people by increasing our understanding and ability to discriminate those sublter symptoms?

I was under the impression that hypochondria is a relatively well understood thing in that we know for certain that it is a mental disorder and not some as of yet understood illness like fibromyalgia or chronic fatigue syndrome.

Are you suggesting that all hypondriacs have some sort of underlying physical ailment and not a mental disorder?

The use of the category mental disorder is dated; disorders often have mental components but since the body has no clear separation of the brain and body, it's falling out of use. Also, it wouldn't be the first time a mental disorder turned into a 'regular' disorder, or that is was more of a stigma than an actual diagnosis. Which is why I think find it an interesting option.

As I said, the type of symptoms is broad, so it's unlikely to be one thing. But, I do believe medicine is slowly getting more serious about analyzing also the not clearly apparent symptoms.

I took their meaning to be that people with undiagnosed health issues which might be hard to diagnose/understand/treat are frequently dismissed as hypochondriacs. The implication being that it’s the assignment of “hypochondriac” by lay people distant from the actual medical situation is the ignorant jump to conclusions, not the people seeking medical attention despite being ignored and dismissed.

I thought hypochondria was mostly manifesting symptoms by the power of suggestion

Your sister might want to give smell training a try

https://medicalxpress.com/news/2021-04-steroids-treatment-co...

There is no actual proof that long covid exists as something distinct from normal virus recovery. There is no test for it, and people manage to contract it without having covid at all, shockingly. All we have are anecdotal reports that conflict wildly about the symptoms aside from loss of taste. There's not even any reason to think it would exist from a biological perspective, any more than 'long cold' exists.

Anecdotally, on top of this, the only people I've heard of who claim to have long covid are of the neurotic type that is typically hypochondriac.

RT infections take a while to go away. You can have lung issues, mucus, loss of taste for months sometimes. I had an illness six years ago and it took two years to stop having overly thick mucus. This has nothing to do with covid and is nothing new. The other symptoms are likely psychosomatic or just something else.

As someone affected by this for 16 months now (unable to work). I think it’s the immune system overreacting with auto-antibodies. I tried many things but I only got some relief from treatments like cold therapy or ozone therapy that are known to alter immune responses. Anti-coalgulation did not do anything for me.

Have you tried antihistamines? The two mentioned in the article are available over the counter in the U.S.: famotidine is Pepcid and loratidine is Claritin. Pretty sure both are available as cheap generics too.

Yes, I have tried Pepcid, Loratidin, Certirizin and also Montelukast with no avail.

Everybody needs to read this article. "Long Covid" is a real thing and people need to monitor their own health condition and get medical advice if they notice something is not ok.

1) Cases of ‘Long COVID’ frustrate patients, puzzle scientists : https://archive.is/QWiYi

2) After death, COVID-19 victims fight the disease by donating their brains : https://www.latimes.com/science/story/2021-11-05/how-does-co...

No, they don't.

If you have symptoms of an illness consult your medical professional. The only thing that everybody reading this article will result in is waiting rooms full of the worried well.

Agreed. "Look at these two articles. We need to take tons of resources away from all of the other problems society has to make sure that everyone lives their lives to accommodate this one!"

The article does not mention organ damage or nerve damage as theories. The virus may not linger but while it is there it may damage things that cause long term problems.

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