Image sourced from @flavia_feijo_epi@med-mastodon.com and upscaled
Last reviewed: 2024/04/12. Most recent entry: #8.9.1.1 (MedComm, 2024)
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SARS-CoV-2 is airborne.
(Nature, 2022; WHO, 2024)-
"Transmission of COVID-19 from inhalation of virus in the air can occur at distances greater than six feet. Particles from an infected person can move throughout an entire room or indoor space. The particles can also linger in the air after a person has left the room â they can remain airborne for hours in some cases."
(EPAÂ as of 2021) -
The CDC has recommended "at least 5 air changes per hour of clean air in occupied spaces" and published a table of cost considerations for various ventilation and air filtration strategies.
(CDCÂ as of May, 2023) -
Transmission is overwhelmingly airborne.
(Springer Nature Group, 2024)
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It can spread without symptoms.
(JAMA: Infectious Diseases, 2021; Public Health, 2022; CDC, 2022) -
Between 1 in 3 and over half (56%) of people infected with an Omicron subvariant didn't show symptoms.
(Vaccines, 2022;Â JAMA: Infectious Diseases, 2022)-
Asymptomatic infections have caused silent damage.
(JAMA: Infectious Diseases, 2020; Pathogens, 2021)- 52% of the people who remained asymptomatic after being infected on the Diamond Princess cruise ship in 2020 still experienced lung abnormalities that were visible on a CT scan.
(Lancet: Infectious Diseases, 2020)
- 52% of the people who remained asymptomatic after being infected on the Diamond Princess cruise ship in 2020 still experienced lung abnormalities that were visible on a CT scan.
- An unpublished study led by the Department of Developmental Biology and Cancer Research at the Institute for Medical Research, Israel-Canada found that vascular damage and red blood cell turnover occurred in patients without symptoms.
(bioRxiv, 2023)
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- The FDA recommends repeat testing in 48 hour intervals following a negative at-home/rapid test to reduce the risk of a false negative result.
(FDAÂ as of November, 2022)-
At-home/rapid tests that rely on nasal swabs have been prone to false negatives early in infection.
(Microbiology Spectrum via Caltech, 2023) -
"[Test] sensitivity estimates were 30.0-60.0% on the first day, 59.2-74.8% on the third day, and 80.0-93.3% on the fourth day of symptoms."
(Clinical Infectious Diseases, 2023) -
"Health professionals and the public should be aware that package inserts for SARS-CoV-2 RATs might provide an overly optimistic picture of the sensitivity of a test. Regulatory bodies should strengthen their requirements for the reporting of diagnostic accuracy data in package inserts and policy makers should demand independent validation data for decision making."
(The Lancet Microbe, 2023)
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- Vaccinated and/or previously infected individuals have remained highly infectious upon reinfection, while individuals without any history of vaccination or infection have been the most infectious.
(Nature Medicine, 2023) - "The primary goal of the COVID-19 vaccination program is to prevent severe illness and death" and "symptomatic SARS-CoV-2 infection," not asymptomatic infection.
(CDC as of March, 2023)-
Vaccines have helped prevent endothelial dysfunction in hospitalized patients.
(Current Pharmaceutical Design, 2022) -
Vaccination has been far safer than infection.
(Lancet: Infectious Diseases, 2022; Nature, 2023)
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SARS-CoV-2 can establish asymptomatic persistence, regardless of vaccination status. "Factors that differentiate SARS-CoV-2 persistence in PASC from persistence in asymptomatic individuals should be explored."
(Nature Immunology, 2023)-
There is no available evidence that the immune system is capable of fully clearing SARS-CoV-2, regardless of vaccination status. One study demonstrated asymptomatic persistence and "clearance" after vaccination, though their definition of clearance was when the patient stopped shedding detectable amounts, which doesn't mean the virus wasn't persisting in other locations.
(Signal Transduction and Targeted Therapy, 2023)
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âMildâ covid (NIH, 2023: "any of the various signs and symptoms of COVID-19 [e.g., fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, loss of taste and smell"]) has caused:
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Immune dysfunction & dysregulation
(Journal of Clinical Investigation, 2021; Signal Transduction and Targeted Therapy, 2021; PLOS Pathogens, 2021; Nature Immunology, 2022)-
Prior infection has limited the benefit of mRNA vaccination.
(Immunity, 2023) -
The immune system is not analogous to a muscle that needs to be used to be kept in shape ("immunity debt"), and there is no material benefit to any amount of viral infections.
(Financial Times via archive.today, 2022; Global News, 2022; JAMA, 2024) -
"Sweden made global headlines for its decision to combat the spread of the virus with mostly non-coercive measures while the rest of Europe went into varying degrees of lockdown."
(The Local, 2021)-
The Public Health Agency of Sweden reported for the week of May 8-21, 2023, that "people under the age of 18 without underlying disease or condition have been very seriously ill with complications such as myocarditis or encephalitis."
(Folkhälsomyndigheten, 2023)
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An unpublished UCSF study found that "even remote, clinically mild SARS-CoV-2 infection could have long-term consequences on tissue-based immune homeostasis," notably chronic T cell activation for at least 2 years
(medRxiv, 2023) -
"Throughout the pandemic, scientific evidence has mounted that even mild COVID infections may be doing something to our immune systems, as well as our collective immunity."
(Memorial Sloan Kettering Cancer Center Library, 2023)
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Capillary clottingÂ
(Biochemical Journal, 2022) -
Arterial stiffness
(Journal of Clinical Medicine, 2023) -
Pro-atherogenic (arterial plaque) inflammatory responses
(Nature Cardiovascular Research, 2023) -
Chronic pro-inflammatory gene expression
(Genome Medicine, 2023) -
Accelerated biological aging
(International Journal of Molecular Sciences, 2021; Nature Communications, 2022)-
The equivalent of 7 years of brain aging
(PNAS, 2023)
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Cognitive and memory deficitsÂ
(New England Journal of Medicine, 2024) -
Infection of the brainÂ
(PNAS, 2022) -
Damage to:
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The brain & nervous system
(International Journal of Molecular Sciences, 2021; Nature Medicine, 2022; Signal Transduction and Targeted Therapy, 2022; Neuroscience and Biobehavioral Reviews, 2023; Neurology, 2023; Cell Death Discovery, 2023; Journal of Magnetic Resonance Imaging, 2023 [unvaccinated cohort]; Computers in Biology and Medicine, 2024; Nature Scientific Reports, 2024 [includes vaccinated, asymptomatic cohort]; Cell Stem Cell, 2024)- The blood-brain barrier
(Journal of Neuroinflammation, 2022; Journal of Neuroinflammation, 2023; Nature Neuroscience, 2024; MedComm, 2024) - The vagus nerve
(PLOS One, 2023) - Microstructural networks
(Radiological Society of North America, 2023)
- The blood-brain barrier
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The heart
(Journal of Virology, 2022; Circulation Research, 2023; Nature Cardiovascular Research, 2023) -
The lungs
(The Journal of Infectious Diseases, 2024) -
The kidneys
(Nature Reviews Nephrology, 2021) -
The liver
(Nature Reviews Gastroenterology & Hepatology, 2021; Nature Scientific Reports, 2021; Virology Journal, 2021; World Journal of Gastroenterology, 2021) -
The inner ear
(Communications Medicine, 2021) -
Mechanisms that play a crucial role in preventing cancer
(Nature Scientific Reports, 2021;Â Biochimie, 2023)
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Cumulative damage upon reinfection
(Nature Medicine, 2022) -
Lasting multi-organ impairment
(Journal of the Royal Society of Medicine, 2023) -
"Substantial health and economic burden during the year after acute illness"
(BMC Medicine, 2024) -
An increased risk of:
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Heart disease and strokeÂ
(Nature Medicine, 2022) -
Diabetes, including pediatric
(CDC, 2022;Â JAMA, 2022; Lancet: Diabetes and Endocrinology, 2022; JAMA: Infectious Diseases, 2023) -
AutoimmunityÂ
(Nature Reviews Rheumatology, 2023) -
Serious health complications and premature death
(JAMA: Health Forum, 2023) -
Psychiatric disordersÂ
(Nature Human Behavior, 2024)
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Between August 1, 2021 and July 31, 2022, "among children and young people aged 0 to 19 years in the US, COVID-19 ranked eighth among all causes of deaths, fifth in disease-related causes of deaths, and first in deaths caused by infectious or respiratory diseases," accounting for 2%, or 1 in 50 deaths in this age group.
(JAMA: Public Health, 2023) -
Out of 40 studies worldwide that assessed "the prevalence of any symptom" among 12,424 children and adolescents, as of December 11th, 2022, 15% suffered at least 1 symptom at least 1 year after infection.
(Journal of Infection and Public Health, 2023) -
Out of 31 studies worldwide (including preprints) that assessed "more than 20 persistent symptoms and clinical features" among 15,000 children and adolescents, as of December 2022, 16% suffered at least 1 symptom at least 3 months after infection.
(Pediatrics, 2023) -
Between January 2021 and April 2022, 7.8% (1 in 13, or 6 in 77) of asymptomatic children suffered at least one symptom at least 3 months after follow-up.
(Clinical Infectious Diseases via CIDRAP, 2024 -
The rate of long covid symptoms at 6 months among a vaccinated, post-Omicron subcohort of adults (median age 47) with 1 infection was 16%, while the rate for individuals with more than 1 infection was 21%.
(JAMA, 2023) -
Between October 2019 and October 2022, 70.4% of household transmissions in the US were sourced back to children.
(JAMA, 2023) -
As of August 2022, according to medical billing records from Japan, the reinfection rate for the Omicron lineage has been 3.7 months, or about 3 times a year.
(Kyodo News, 2023) -
Australia reported an excess mortality rate of 7% for the first six months of 2023.
(Actuaries Institute, 2023) -
The US Department of Health and Human Services considers "Long COVID" a disability under the ADA.
(HHSÂ as of July, 2021) -
The CDC is no longer tracking reported cases, focusing instead on hospitalizations and deaths.
(CDCÂ as of May, 2023)-
In September 2022, the number of reported cases were a quarter of what they were at their peak the winter before. The director of the Institute for Health Metrics and Evaluation estimated that only 4% to 5% of infections were being reported, because many of the infections uncovered through at-home tests either weren't reported to public health departments, or weren't detected at all.
(NBC News, 2022)
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Among outpatients in the US between December 30, 2020 and January 28, 2022, treatment with metformin â a drug used to treat type 2 diabetes â reduced the incidence of long COVID by ~41% in a decentralized, randomized, quadruple-blind, parallel-group, phase 3 trial.
(Lancet: Infectious Diseases, 2023) -
The Memorial Sloan Kettering Cancer Center Library has compiled "detailed information and resources on the long-term health consequences of COVID-19 infection and the broad social impacts of the COVID-19 pandemic."
(Memorial Sloan Kettering Cancer Center as of September, 2023)