Hello, and welcome to my channel Medicine with Dr. Moran.
Cdc's new study in their journal MMWR claims that one in five people have long Covid,
but is that true and does it make sense? Let's take a look at their research. First I want to
say that prolonged symptoms after Covid is a real thing. We commonly in medicine see post-viral
syndromes where people continue to struggle with symptoms long after the virus has actually gone.
We see with many viruses and I see people every year in my consultative internal medicine
practice with persistent symptoms many of which typically do go away with the tincture of time.
Now here is their summary graphic of the CDC's report. There's a link below to the study. The
most important thing on this graphic that is true is that you should talk to your healthcare
provider if you have symptoms after Covid-19. That's an important thing that I tell people in
the videos on my channel and that's when you have symptoms please go and see your doctor.
If you have symptoms don't go on the internet or YouTube and try treatments that are proposed by
non-physicians without first going and seeing your doctor. Proper physician evaluation is important.
I've seen too many people over the years with symptoms who have not come to medical attention
who have tried numerous home-based things on their own based on what they saw on the internet
and of course this has delayed serious diagnoses such as cancer and you just don't want to do that.
You at least want your doctor to rule out potentially serious diagnoses first.
Now getting back to the CDC slide it states that approximately one in five adults
in other words 20% over the age of 18 years of age have a health condition that might be related
to Covid-19 illness and they list a number of conditions on the slide. In my experience and
the experience of many physicians I've seen several hundred people who have had Covid and
it's obvious to myself and others that 20% of people do not have long Covid symptoms.
I would guess that many people watching this video may know 25 or 50 people or even more who have had
Covid and of course a personal experience that 20% do not have persistent symptoms.
That's obviously anecdotal experience so we like to see good observational studies to give
us an idea of the true frequency of a post-viral syndrome secondary to this coronavirus. This CDC
study does not do that in comparison in the Uk their office for national statistics indicate as
of early April 2020 2.8% of the population were experiencing self-reported long Covid symptoms
of those 73 had symptoms for at least 12 weeks and 44 had symptoms for at least a year.
The challenge with long Covid symptoms is that there's nothing objective to find on examination
or testing from a physician's standpoint just subjective symptoms that patients feel
and many of the symptoms that people complain of actually are symptoms the people in the general
population without getting Covid have. This makes it more difficult to know the true incidence of
long-covered symptomatology. Now having said that when I look at the CDC study I always ask myself
does the conclusion make sense when I look at a study. This one obviously does not. Now the
grave limitations to this study many of which are actually listed in their discussion of their study
report but unfortunately again the conclusion and the pretty graphic are getting pushed in the media
when it's obviously not true. On YouTube all Covid videos have a banner at the bottom including this
one allowing you to link to your country's health organization for further information.
So if you're in the U.S. clicking on that link will take you to the CDC.
There you can find their research that they published in their journal which is not externally
peer reviewed. I've talked about a number of CDC research studies on this channel highlighting
serious limitations of their studies which ultimately lead to erroneous non-practice changing
conclusions. In the description below there is a playlist of some of the other CDC studies.
Now some might call this study propaganda but I would say that this is simply not good research,
that does not change medical practice, and frankly it's not worth reading fully.
So what's really wrong with their study? Well they looked at people from a large electronic
health database from March 2020, through November 2021, which was 63.4 million adults patients who'd
received a diagnosis of Covid-19 or a positive test in an inpatient emergency department or
outpatient setting were reviewed. They found 353,164 case patients which is only 0.5%. Now
we know that more than 0.5% of people in a large database like this got Covid during this 18-month
period that's obvious. So they didn't count people who did home testing and they didn't count people
who had Covid who simply didn't get tested they only counted people that went to the doctor. There
were many people who had typical symptoms that obviously couldn't get a test during this time. So
as you can see the true number of people in this population getting Covid was much higher. They
then tried to compare this group who had Covid to a number of control patients that had a visit
in the same time period but they did not match the groups with respect to things like race, or
ethnicity, sex, or even region, and other things. They say they matched in the study but they don't
show or comment on anything that they matched for other than the fact that the control patients had
a visit at the same time to the doctor. Now this would obviously skew the data. They did point out
at least five limitations in their discussion. This of course is never mentioned when the media
or others tell you about a study. Media have a wide audience whereas my channel and other small
channels have a very small one so the word doesn't always get out the way truth should.
One of the other relevant things that they point out is that the incidence of new conditions after
Covid might be biased towards a population who were seeking care meaning that the people seeking
care after their Covid diagnosis would clearly be a sicker group looking for answers to their
symptoms and expecting further evaluation in other words tests. So if you've had Covid and you feel
well afterwards you're not going to your doctor but if you've had Covid and you have symptoms
you're much more likely after the fact to come and see your doctor because of these symptoms.
So if you do go to your doctor the doctor is more likely to run tests and possibly
make diagnoses which would then be associated with Covid. It falsely makes it look like the
diagnoses you have on the test have an association with previous Covid but of course the people who
didn't have covet and didn't go to the doctor did not get these tests done to see if they had some
of the same problems that the other group had. So clearly these two groups are not properly matched.
So the CDC study is not helpful and of course not practice changing. If you're a U.S. taxpayer well
these are your taxpayer dollars at work. High quality research into long Covid is important.
Studies will be published over the next few months which will give us insights into this condition.
Now there was one well done paper published in peer-reviewed Annals of Internal Medicine recently
actually this week on investigation of patients with long Covid. It was done to see if they could
find clues to the mechanism behind the long Covid symptoms that so many people do struggle with.
They want to see whether potential treatments could be explored based on their research.
What they did was compare 189 people with Covid of whom 12 were hospitalized and they
chose 120 participants who never had Covid for comparison. Now after extensive history taking
physical examination and quite an enormous battery of diagnostic tests there was nothing abnormal to
suggest persistent viral infection autoimmunity or any kind of abnormal immune activation in people
with long Covid. The only risk factors that increase the chance of someone getting long Covid
was female sex and those with a history of anxiety disorder.
The odds ratio for female sex was 2.34 meaning that females are 2.34 times more likely to get
long Covid symptoms and the odds ratio for anxiety disorder was 2.78. None of
the physical examination or the extensive battery of tests that they did and I mean extensive tests
predicted long Covid. I will leave a link to that study below if you're interested. Thanks a lot
for watching and joining me today on Medicine with Dr. Moran. Remember get healthy and stay healthy.