Almost third of UK Covid hospital patients readmitted within four months • Hacker News Board

Re: Almost third of UK Covid hospital patients readmitted within four months

#201

Post by incrudible » Sat, Apr 03, 2021, 9:44 AM UTC

morsch wrote: post #137

incrudible wrote: post #128

Earlier quoted context omitted.

It is, my point is that the study presents it as an outcome of COVID-19, next to outcomes like "death" and "re-hospitalizations".

I can see how you could read it that way, but I think they're just confirming the increased rates of covid with the three named pre-existing conditions. It never occured to me to understand it otherwise when I read it first.

> I can see how you could read it that way, but I think they're just confirming the increased rates of covid with the three named pre-existing conditions.

No, because that is in literally the objective: "To quantify rates of organ specific dysfunction in individuals with covid-19 after discharge from hospital compared with a matched control group from the general population."

I wouldn't even rule out that COVID causes diabetes, but at the same time diabetes is commonly underdiagnosed, as is heart or liver disease.

Re: Almost third of UK Covid hospital patients readmitted within four months

#202

Post by incrudible » Sat, Apr 03, 2021, 9:56 AM UTC

azakai wrote: post #196

peytn wrote: post #175

Earlier quoted context omitted.

Given the discussion generated here and probably elsewhere, why do you believe the authors chose not to present a matched hospitalization control group alongside their control group? It’s pretty standard: that’s why they included a sentence saying they chose not to (albeit without any justification). Why deviate?

As mentioned in the discussion above, their control group answers the question "if a person got COVID and was hospitalized because of it, how much worse off are they than had those things not happened?" They do justify their choice in the actual paper (e.g. see the end of the "Study population" section). (It's also interesting to compare COVID hospitalizations to other ones, say from a heart attack or allergic reacti…

> "if a person got COVID and was hospitalized because of it, how much worse off are they than had those things not happened?"

How do you then control for those with a chronic condition that is undiagnosed? If somebody is hospitalized, they'll perform all sorts of tests on them, that's how many people get their diabetes diagnosis in the first place.

Looking at the charts, you might get the idea that there's a staggering increase in new-onset diabetes following COVID infection, which doesn't seem plausible to me. Yet, right next to that, you see damage in heart, liver and kidneys, and this gets picked up uncritically as an outcome of COVID. The hypothesis that COVID causes organ damage is already well-established, so this just confirms what we expect. What we don't expect, we just ignore, even though it might point to a flaw in our methodology.

Re: Almost third of UK Covid hospital patients readmitted within four months

#203

Post by tim333 » Sat, Apr 03, 2021, 10:55 AM UTC

hiisukun wrote: post #186

notahacker wrote: post #143

Earlier quoted context omitted.

> feeling of 'heaviness' behind my breastbone. You may already be aware of this but there's an organ there called the thymus which is a core part of the immune system (especially in younger people) Seems to be a symptom with relatively little discussion even in medical journals but can confirm I also had it for months after a relatively mild case, tending to reemerge due to tiredness or exercise.

I think you might mean there "was" an organ there! The thymus (the favourite organ of a friend of mine) is quite unusual, being replaced by regular boring fatty tissue after childhood.

...gradually replaced by fatty tissue. Nevertheless, some T cell development continues throughout adult life. (wikipedia)

Re: Almost third of UK Covid hospital patients readmitted within four months

#204

Post by tim333 » Sat, Apr 03, 2021, 11:06 AM UTC

godmode2019 wrote: post #135

In my opinion the 'long covid' was a line thrust into the spotlight from the media to justify continued restrictions. Person A: 'We should open up' Person B: 'Have you not heard most people have serious health problems after covid?' When we talk about proportional reporting I think of the book 'Thinking fast and slow'.

There could be elements of that as well as it being a real thing.

Re: Almost third of UK Covid hospital patients readmitted within four months

#205

Post by tomhoward » Sat, Apr 03, 2021, 1:26 PM UTC

mdoms wrote: post #89

dnautics wrote: post #82

Earlier quoted context omitted.

you can't say it would have worked. There are places that locked down harder than the US and still fared worse. I'll remind you that the EU had 1.5x the population adjusted mortality of the US, before their immunization shenanigans; and that's despite the US having an irresponsible science-denier president.

Half a million dead Americans. Fair to say what you're doing didn't work.

It's not really cool to make nationalistic attacks like this here.

FWIW I'm from Australia (Melbourne), which mostly eradicated the virus last May, then had a resurgence in Jun-Aug, and it took hard lockdown from early August to November to get the outbreak fully under control - effectively four months of pretty strict lockdown. We managed to beat it but it was hugely costly.

Australia, like NZ, is an island with a relatively (compared to US and Europe) small, compliant population, so it's much easier for our governments to control our international borders and internal movement. But it was still incredibly hard, and slow.

We did it, which I'm pleased about, but I understand why what Australia and NZ have done is not possible in the US and Europe; they have much denser populations and many different jurisdictions and cultures all meshed together, so it's much harder to restrict movement and apply restrictions consistently enough from one place to another.

So, sure, take comfort that we live in places that were able to avoid major outbreaks, but resist preaching that any other country/continent could have done it just as easily, as it really isn't that simple.

Re: Almost third of UK Covid hospital patients readmitted within four months

#206

Post by azakai » Sat, Apr 03, 2021, 2:46 PM UTC

incrudible wrote: post #202

azakai wrote: post #196

Earlier quoted context omitted.

As mentioned in the discussion above, their control group answers the question "if a person got COVID and was hospitalized because of it, how much worse off are they than had those things not happened?" They do justify their choice in the actual paper (e.g. see the end of the "Study population" section). (It's also interesting to compare COVID hospitalizations to other ones, say from a heart attack or allergic reacti…

> "if a person got COVID and was hospitalized because of it, how much worse off are they than had those things not happened?" How do you then control for those with a chronic condition that is undiagnosed? If somebody is hospitalized, they'll perform all sorts of tests on them, that's how many people get their diabetes diagnosis in the first place. Looking at the charts, you might get the idea that there's a staggeri…

You're right that that's a possibility. A completely undiagnosed underlying condition would be missed by that type of control group.

But we know that COVID admittances caused a big increase in the total number of people hospitalized - to the point of overwhelming some health care systems. That strongly suggests that underlying conditions would not have sent as many people to the hospital anyhow if COVID had never appeared and infected them.

It is possible you explain the mechanism, though. Perhaps there are lots of people with undiagnosed underlying conditions, and getting a serious case of COVID is enough to worsen those conditions into life-threatening ones. (Perhaps this only hastens the inevitable for some of them.) If this is the mechanism then both you and the article's hypotheses would be correct.

Re: Almost third of UK Covid hospital patients readmitted within four months

#207

Post by [deleted] » Sat, Apr 03, 2021, 2:54 PM UTC

mattmanser wrote: post #200

timr wrote: post #114

Earlier quoted context omitted.

> Ok, but the UK has a large, integrated, health care system, with an office of national statistics that is following the disease and published this data. Having an office of national statistics does not mean that this particular paper is being reported correctly by the mass media, it doesn't mean that the paper itself supports the discussion of "long covid" amongst otherwise healthy people, and it certainly doesn't…

You can go read their report yourself if you want and see that what you've claimed is factually incorrect. Plus, all the data is there, in CSV or XLS format if you want to check their maths: https://www.ons.gov.uk/peoplepopulationandcommunity/healthan... To me, they seem to be trying to make it as accessible and clear as possible with most news articles taking the salient points directly from the ONS's own summary. A…

[deleted]

Re: Almost third of UK Covid hospital patients readmitted within four months

#208

Post by dang » Sat, Apr 03, 2021, 5:52 PM UTC

mdoms wrote: post #66

The only reason you've had to endure this for over a year is because you never once tried to do it properly. 6 weeks of hard (proper) lockdown followed by sensible plans to manage outbreaks and boom you'd have been done. But no, Americans absolutely refuse to work together, to pull in the same direction, to achieve something.

Please don't take HN threads into nationalistic flamewar, regardless of which nation you have a problem with. It's emphatically not what this site is for. Moreover, we've had to warn you about it at least once in the past (as well as about guidelines breakage in general). That's not cool; please don't do it again.

We detached this subthread from https://news.ycombinator.com/item?id=26673398.

Edit: your account has been breaking the HN guidelines a ton lately. If you keep doing that we will have to ban you. Please review https://news.ycombinator.com/newsguidelines.html and fix this.

Re: Almost third of UK Covid hospital patients readmitted within four months

#209

Post by watwut » Sat, Apr 03, 2021, 6:05 PM UTC

mlyle wrote: post #136

watwut wrote: post #125

Earlier quoted context omitted.

The long haulers I know have long symptoms that would be impossible to ignore previously too. The doctors won't care about tiny symptoms either.

Some of the things that cause concern are studies finding depression, fatigue, brain fog, etc. But if you screened any population of lower health you'd find a fair number of instances of these... and historical baselines are probably not valid because we've had a weird year. So-- the exact incidence of some of the milder end of long COVID is hard to pin down.

The fatigue here is not vaguely feeling fatigue. It is "I can't work full time as before and need to take nap twice a day fatigue. Same with brain fog and depression. Vaguely noticeable symptoms are basically ignored.

Re: Almost third of UK Covid hospital patients readmitted within four months

#210

Post by mlyle » Sat, Apr 03, 2021, 7:14 PM UTC

watwut wrote: post #209

mlyle wrote: post #136

Earlier quoted context omitted.

Some of the things that cause concern are studies finding depression, fatigue, brain fog, etc. But if you screened any population of lower health you'd find a fair number of instances of these... and historical baselines are probably not valid because we've had a weird year. So-- the exact incidence of some of the milder end of long COVID is hard to pin down.

The fatigue here is not vaguely feeling fatigue. It is "I can't work full time as before and need to take nap twice a day fatigue. Same with brain fog and depression. Vaguely noticeable symptoms are basically ignored.

Again, the studies that have looked at cohorts of people infected to estimate incidence have not had this strict of a definition of fatigue or depression.

Certainly some people have these symptoms and they are very very likely to be from the COVID infection itself.

But other people have more minor symptoms and these are included in many estimates of post-COVID syndrome, and discerning whether they were related at all to COVID and caused by COVID itself is more complicated, because if you were to screen a normal population with these criteria you'd find a fair incidence of these symptoms.