Long Covid May Physically Damage the Nerves That Control the Stomach
90 points
4 hours ago
| 5 comments
| ijidonline.com
| HN
flextheruler
3 hours ago
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8 people as the entire control group... yeah I'd say "may" is the operative word in the title. My takeaway from long covid is that it's probably as severe as the much more deadly pandemic of the Spanish Flu. Considering there's now a newfound interest in "long flu", I think a spotlight has now been placed on the impact of severe respiratory illness. Whether that illness be covid or one of the any other respiratory illnesses.
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jambalaya8
3 hours ago
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Yeah, twelve patients and eight in the control group isn't really a study.
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thenerdhead
2 hours ago
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is a small proof of concept study not a study anymore? gastric biopsies aren’t exactly easy to obtain at scale.
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Fomite
2 hours ago
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They are studies, and frankly, without something like this, doing things like the appropriate power calculations and risk assessments for larger studies would be hard to do.
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thenerdhead
3 hours ago
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severity is only one factor in developing long covid.

https://www.thelancet.com/journals/laninf/article/PIIS1473-3...

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naturalmovement
3 hours ago
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Funny that reactive arthritis has been around for decades but no one dares call it "long chlamydia" I guess it doesn't sell YouTube clicks as well.
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dmix
3 hours ago
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Usually they add “chronic” like chronic Lyme disease https://en.wikipedia.org/wiki/Chronic_Lyme_disease
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fsckboy
1 hour ago
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wikipedia:

Reactive arthritis, previously known as Reiter's syndrome,[1] is a form of inflammatory arthritis[2] that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease.[3] By the time a person presents with symptoms, the "trigger" infection has often been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.

The most common triggers are intestinal infections (with Salmonella, Shigella or Campylobacter) and sexually transmitted infections (with Chlamydia trachomatis);[8] however, it also can happen after group A streptococcal infections.[9][10]

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jMyles
3 hours ago
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It's strange that the phrase "long covid" has suddenly jumped into our lexicon, when there has been a similar tiny minority of patients reporting similar symptoms from the other coronaviruses for decades now.

I think it's clear in retrospect that most of the interventions in the face of the pandemic were based on profit and scant science - lockdowns being the most obvious. But increased study and awareness of post-infection syndromes without the kind of high-brow dismissal that these patients have received up until now... well, that's certainly an acceptable silver lining.

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Izkata
22 minutes ago
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Yeah, it's a rebranding of what we used to call "post-viral fatigue" or "post-viral syndrome", except specific to this one virus.
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kranke155
3 hours ago
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hopefully we will get somewhere with these studies. The lack of solid research on a disease that affects millions (likely a good percentage undiagnosed) is really tough for patients - and myself really, as I've found i likely suffer from this.

Finding out about autonomic dysfunction and small fiber neuropathy as I researched my own fatigue and finding out I likely have this has been very challenging.

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naturalmovement
2 hours ago
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> as I researched my own fatigue and finding out I likely have this

Please don't do this. It's the medical equivalent of copy/pasting shit you don't understand from Stack Overflow.

Go see a doctor who has a degree and training.

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derektank
1 hour ago
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As someone who has gone in to doctors for issues with fatigue, it’s incredibly draining (both emotionally and financially) to be batted around between a PCP and specialists that are unable to provide you with a diagnosis. I don’t blame anyone for just sitting down and trying to learn whatever they can by reading.

I agree with your general thrust of course, you’re much more likely to incorrectly diagnose yourself doing this than correctly, and walking around with a false belief is worse than walking around with uncertainty. But simply saying, “go see a doctor,” is rarely helpful. I’ve never heard of someone who tried to diagnose themselves without first presenting the issue to a physician.

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ksenzee
1 hour ago
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Autonomic neurologists are the relevant specialists. I invite you to look for one in your local area and see how rare they are. The last I checked, the Seattle metro area (and in fact the whole state of Washington) had precisely one board-certified autonomic neurologist. Diagnostic delay is, unsurprisingly, around six years. Combine that with the fact that all the equipment you need to do a basic POTS test is a pulse oximeter and a blood pressure cuff, and yeah, you're going to have people self-diagnosing, for good reason.
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hombre_fatal
2 hours ago
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If there's no test for it, then what is the doctor going to do for something as nebulous as long covid?
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zx8080
3 hours ago
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It's probably more profitable to treat symptoms.
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jambalaya8
3 hours ago
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Hard to treat symptoms with immunological conditions. I mean, there are vitamins and supplements, but noone is gonna generally hand out economy-sized bottles of controlled substances for exhaustion, etc.

These sorts of conditions are systemic, and the causes and ways of dealing with the accompanying syndromes are probably always going to be different from individual to individual (well, likely the exact physiological causes anyway).

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J0nL
2 hours ago
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It's true, this is why there are so many government agencies focused on healthcare. The medical field lacks a healthy profit motive. Healthcare CEOs use their fiduciary responsibilities as an excuse and say they'll get sued if they don't exploit situations.

There was a SARS vaccine as far as back 2016 which could have changed everything but was ignored. Pharmaceutical execs told them they were, "waiting to see if it comes back yearly" first

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jph00
3 hours ago
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Wow mucosal innervation was around half in long covid patients - that's super worrying and would have nasty symptoms in practice.

The findings also support the hypothesis that SARS-CoV-2 may cause structural nerve damage, which is perhaps the even bigger worry. :(

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RandomTisk
3 hours ago
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What kind of symptoms? I have insane stomach issues since early 2021 that only this year started to largely subside.
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peab
3 hours ago
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i noticed a thing with headlines like these: "x may cause y". Whenever it's "may" or "might", it's almost always meaningless
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Fomite
2 hours ago
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There has been a shift - an understandable one, and one I by and large support (absent some edge cases) - to move away from causal language for observational studies.
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thenerdhead
3 hours ago
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small study yes, meaningless no
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naturalmovement
3 hours ago
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Not to worry, there's three dozen commenters on the way to attest long COVID is definitely the source of their many nonspecific ailments that could easily be ascribed to various other illnesses.
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jambalaya8
3 hours ago
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Problem with those conditions and long COVID and CFS are generally similar: No really reliable guaranteed test for most of them, just a series of symptomatic diagnoses and years of ruling out conditions. No offense, but while some people might be full of crap, you sound really insensitive.
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naturalmovement
3 hours ago
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If you suppose it's all malarkey and conjecture, what is the problem?

When your doctor says that you're wrong, do you accept his advice or tell him he should be more like Dale Carnegie?

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jambalaya8
2 hours ago
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Most logical, rational adults would seek a second opinion, at least in places where those are available; they usually are. Interesting that I said 'some people' and you generalised.

FWIW, if my doctor were unfriendly enough, though, I might do that also.

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shiggydump
3 hours ago
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Only the Sith deal in absolutes.
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remarkEon
3 hours ago
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Is there a test for long covid?
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nradov
3 hours ago
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There's no such thing as "long COVID" specifically. Any serious viral infection has the potential to cause sequalae in susceptible patients for reasons that are still not well understood. Some of those are detectible in lab tests to an extent but there's no single clear diagnostic test.
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J0nL
2 hours ago
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It's long as in persistent viral colonization, often in immune privileged areas where the virus can hide from the immune system.

One theory is that the immune system doesn't always produce a strong enough antibody response to flush the virus from all these areas but the truth is that's likely only a subset of total cases.

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thenerdhead
3 hours ago
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they are pretty well understood now with growing evidence of viral persistence in the gut and immune cells, and immune dysfunction causing autoantibodies.

they are also distinct from other conditions like ME/CFS or other sequelae although they may share overlapping symptoms. A lot of research is going into different PAIS post acute infection syndromes

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remarkEon
1 hour ago
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Interesting, then I guess the obvious next question is … is there a test for being a susceptible patient? We’ve been talking about long COVID for years now. Surely there’s some commonalities amongst the people who suffer from it.
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thenerdhead
3 hours ago
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not quite. A grab bag of biomarkers being validated in research labs across the USA though
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LorenPechtel
2 hours ago
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Think of AIDS before the immune system dysfunction was found. That's where we are with Long Covid. One cause, a myriad of apparently unrelated effects--that's not how biology tends to work. Rather, there's something deeper we haven't found. And we certainly can't test for what we haven't found.
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naturalmovement
2 hours ago
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This is nothing like AIDS.
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