Can someone knowledgeable explain the current understanding of Covid’s long time effects? I thought it was still a big unknown and long COVID was still debated as to even having a clear definition.
The WHO [1] has a clinical definition of the disease and some basic data on chance of Covid infections turning into Long Covid. Then the meta study by Eric Topol and Zayad Ali-al from last year is probably a good primer into what is known about the disease that is well established science [2].
Its not a big unknown anymore, its very prevalent, it has a lot of symptoms, it has a clinical definition but its problematic and there are many diagnostic tests that can detect parts of the condition but none has yet reached sufficient prominence to be adopted by healthcare. Healthcare is largely ignoring that Long Covid exists so you can't get diagnosed with it but its very much a real thing and a lot of people have it.
The first link is not a clinical definition, the second link is not a "meta study" (it's a substack article with absolutely no rigor). Moreover, the first link cites prevalence numbers wildly in conflict with the second link:
> Approximately 6 in every 100 people who have COVID-19 develop post COVID-19 condition
vs., for example:
> From one center in Wuhan, 1,359 survivors completed 3-year follow up and 54% had at least one persistent symptom of Long Covid
This only underscores the lack of clinical definition. Both of these suffer from the same fundamental error, which, again, is that there's no precise definition of the syndrome. They include symptoms that are common amongst healthy people, mix them with less-common things that are associated with Covid (e.g. anosmia) and try to call this a disease state. See the WHO's grab-bag list of possible inclusion criteria:
> Over 200 different symptoms have been reported by people with post COVID-19 condition. Common symptoms include: fatigue, aches and pains in muscles or joints, feeling breathless, headaches, difficulty in thinking or concentrating, alterations in taste.
So literally having "headaches" or "aches and pains" is enough to claim Long Covid, according to the WHO.
The Topol/Aly substack engages in the same logic, and you will see that the referenced charts and graphs cover everything from fatigue to heart attack. Aly, in particular, has based his entire long covid research on a single dataset of (largely elderly, unhealthy prior to infection) VA patients that he refuses to release, and routinely engages in statistical fishing expeditions for new "symptoms" within that dataset.
I did read the article. It only talks about detecting long covid in children, which is different to understanding its effect on adults and the long terms effect of COVID in general (vs long COVID, which if understand correctly it’s a different syndrome to just “ long term expected outcomes from having had COVID”).
