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Covid and the Heart: It Spares No One – Johns Hopkins

publichealth.jhu.edu

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Re: Covid and the Heart: It Spares No One – Johns Hopkins

#151

Post by kragen »

timr wrote: post #145
dash2 wrote: post #47

Earlier quoted context omitted.

I now feel much less happy than I did. "Significant increase" could mean anything. A risk ratio of 1.49-1.85 is a huge increase. These conditions are rare but not that rare. Now I should be twice as worried about them? Oosh. Will someone at least tell me that Omicron's not so bad?

1.5 is a small increase, particularly when the baseline probabilities are small (as they are here). For context, a "big" increase would be something like smoking, where the effect sizes are measured in HR multiples of ten.

I think it matters a lot whether we're talking about a relative hazard of 1.5 over a lifetime or, as in this case, over a year.

If, year after year, people who suffered covid in 02020 and 02021 continue to have 1½–2× the risk of developing pericarditis or stroke or congestive heart failure or all these other health problems, or if people keep getting covid every year, well, because of the high lifetime base rates of those problems, that would be a bigger health problem than anything since before AIDS, bigger than smoking, maybe bigger than anything since the Black Plague.

On the other hand, if, say, 1.8% of people develop ischemic heart disease in the year following covid, while 1.1% of people without covid do, and then in the following years they don't get covid again and the hazard rate declines to the base rate of 1.1% per year or whatever, that's still a significant public health problem, but it's not nearly as big as the people covid killed outright.

(Those numbers are from Supplementary Table 3 in https://static-content.springer.com/esm/art%3A10.1038%2Fs415...: "COVID-19 burden" of 18.47 cases of "Ischemic heart disease" at 12 months, and "Contemporary control burden" of 11.19. The other supplementary information is at https://static-content.springer.com/esm/art%3A10.1038%2Fs415... and https://github.com/yxie618/longCVD.)

Though I'm no virologist, I don't know of a plausible mechanism by which covid could cause people to get ischemic heart disease, pulmonary embolisms, etc., after 5 or 10 or 20 years of not having covid. More likely, what's happening is that people who haven't fully recovered from covid are getting blood clots, and that's damaging their organs and sometimes killing them, but after a few months they do fully recover and so these problems stop — unless they get covid again.

Given that we now have numerous effective vaccines and a few effective palliatives, it seems likely that even though covid has become endemic, people will be able to avoid suffering this level of damage year after year. But I have to admit it's an open question.

Re: Covid and the Heart: It Spares No One – Johns Hopkins

#152

Post by Fargoan »

wolverine876 wrote: post #90
Fargoan wrote: post #72

My friend died 2 days ago. Heart attack at 31 years old. He had some unhealthy eating habits, but nothing out of the ordinary and he was at most slightly overweight. I wouldn't be surprised if him having covid a couple months ago was a major factor in his death.

I'm very sorry about your friend. That's incredible - 31 years old. How heart-breaking it must be.

Thank you. It's a shock to everyone. Been a weird week

Re: Covid and the Heart: It Spares No One – Johns Hopkins

#153

Post by Retric »

TrevorJ wrote: post #144
Retric wrote: post #94

Earlier quoted context omitted.

It is the study’s author referring to damage, he wasn’t willing to say what kind. “even in people who were previously healthy and had no risk factors or problems with the heart—COVID-19 affected them in such a way that manifested the higher risk of heart problems than people who did not get COVID-19. It was really eye-opening that the risk was also evident in people who did not have severe COVID-19 that necessitated…

I'm not calling the author's conclusions unscientific. At. All. He does not refer to damage, he does not draw conclusions about the mechanism which leads the cohort to have a higher risk of heart problems, and he certainly doesn't draw conclusions about individuals within the cohort, only the cohort as a whole. Other people reading into the study things that aren't there is what I am calling out.

>He does not refer to damage

“Why would SARS-CoV-2, the virus that causes COVID 19, which we all thought about as a respiratory virus, attack the heart”

“Why would SARS-CoV-2, … attack the heart”

Are you suggesting attack the heart doesn’t mean to cause damage to it? I have trouble reading that as meaning anything else, how do you read it?

Re: Covid and the Heart: It Spares No One – Johns Hopkins

#154

Post by timr »

kragen wrote: post #151
timr wrote: post #145

Earlier quoted context omitted.

1.5 is a small increase, particularly when the baseline probabilities are small (as they are here). For context, a "big" increase would be something like smoking, where the effect sizes are measured in HR multiples of ten.

I think it matters a lot whether we're talking about a relative hazard of 1.5 over a lifetime or, as in this case, over a year. If, year after year, people who suffered covid in 02020 and 02021 continue to have 1½–2× the risk of developing pericarditis or stroke or congestive heart failure or all these other health problems, or if people keep getting covid every year, well, because of the high lifetime base rates of…

Yes, if you see the same thing for many years you gain more certainty over the signal, regardless of the strength of the signal. But a small signal is still small, regardless. And it's always incorrect to average together a high-risk group and a low-risk group and claim that everyone is at medium risk.

> More likely, what's happening is that people who haven't fully recovered from covid are getting blood clots, and that's damaging their organs and sometimes killing them, but after a few months they do fully recover and so these problems stop — unless they get covid again.

That's one hypothesis. Here's another: people (especially older people) deferred medical care throughout 2020 and 2021. They are seeking that medical care now. Undiagnosed heart problems are now being diagnosed. And oh yeah...they got a Covid test somewhere along the way. Often for (wait for it...) hospital admission.

I'm not in love with this hypothesis; it's just the first one I thought of. There are actually a ton of plausible reasons why you'd see slightly elevated rates of whatever in a group of older, less-healthy people. Claiming that the virus caused it through a mystery mechanism is a wild leap to conclusions.

Re: Covid and the Heart: It Spares No One – Johns Hopkins

#155

Post by wolverine876 »

cf141q5325 wrote: post #138
wolverine876 wrote: post #124

Earlier quoted context omitted.

> Its a leaky vaccine (meaning you still get sick and spread it just as much) No vaccine is perfect, but it greatly reduces your chances of becoming infected.

Relative to somebody not vaccinated with the same NPI. Just look at any of those studies, they are almost exclusively done on hospital staff which have among the strictest NPI. Once you drop those the difference doesnt mean much. Especially with the new mutations. So again, herd immunity is not an option for the current vaccines and variants of covid. This is not a controversial statement.

Can you provide some expertise that says these things? Or are you an expert? Again, we don't need more people on the Internet speculating.

Re: Covid and the Heart: It Spares No One – Johns Hopkins

#156

Post by wolverine876 »

MisterMower wrote: post #126
wolverine876 wrote: post #93

Earlier quoted context omitted.

Sorry about the chest pain, but I don't think a guess that vaccines caused chest pains - something that many people have experienced long before Coronavirus and vaccines - informs the conversation.

Did the guys who did the study control for vaccination status? Seems very relevant to the conversation. It’s a proven fact a small portion of recipients experience heart issues after getting one of the mRNA vaccines.

> Did the guys who did the study control for vaccination status?

Did they?

> It’s a proven fact a small portion of recipients experience heart issues after getting one of the mRNA vaccines.

How many? It's a proven fact that a small portion of people drown in their bathtubs, die of lightening strikes, and win the lottery.

Re: Covid and the Heart: It Spares No One – Johns Hopkins

#157

Post by stjohnswarts »

aakresearch wrote: post #118
stjohnswarts wrote: post #84

Earlier quoted context omitted.

The lockdowns were not ineffective. They were only less effective because of people who cried "muh freedumbs". Masks have repeatedly shown to be effective, especially the N95/KN95 variety. Vaccines were shown to be very effective, if not 100% preventative. Big Tech is not a publisher and expects you to be skeptical of things you read that don't come from mainstream sources. Mainstream sources, other than Fox, tend to…

Your response is the perfect example why I no longer try to discuss this topic with any covid-response-enthusiasts. You're, obviously, entitled to your beliefs, and must consider them well-backed by your knowledge, life experiences and values. Just as six-days creationists are entitled to theirs. I do not judge either. But this response is so typical that I'll use it to point most problematic issues. First, it contai…

Your response is also why I do bother to comment sometimes. I don't want people to see the your side without seeing the other side. I'm a skeptic by nature, that's why I trust scientists and not internet "facts" that have almost nothing to back them up other than alt-right qanon sources. I automatically dismiss those sources as a default. Conservative media prints 100 to 1 (at least) unsupported to supported facts as opposed to more traditional liberal/moderate sources. I can go to fox or breitbart on any given day and find dozens of pieces of outright misinformation on display between their news reports and opinion shows. It's ludicrous. The only right wing mag that I can think of who regularly does a decent job is Reason magazine. If you want to deny basic physics and medical knowledge that masks block viruses and reduce viral load then go ahead. I wish you all the best and have a nice life.

Re: Covid and the Heart: It Spares No One – Johns Hopkins

#158

Post by TrevorJ »

Retric wrote: post #153
TrevorJ wrote: post #144

Earlier quoted context omitted.

I'm not calling the author's conclusions unscientific. At. All. He does not refer to damage, he does not draw conclusions about the mechanism which leads the cohort to have a higher risk of heart problems, and he certainly doesn't draw conclusions about individuals within the cohort, only the cohort as a whole. Other people reading into the study things that aren't there is what I am calling out.

>He does not refer to damage “Why would SARS-CoV-2, the virus that causes COVID 19, which we all thought about as a respiratory virus, attack the heart” “Why would SARS-CoV-2, … attack the heart” Are you suggesting attack the heart doesn’t mean to cause damage to it? I have trouble reading that as meaning anything else, how do you read it?

He's asking the same question I'm asking: "Why"? The scientist who conducted the study is saying his findings raises more questions, as any good study is likely to do. - I'm not sure why so many people want to read between the lines versus picking up the line of inquiry and doing further studies. There are any number of reasons why we could see heart issues from covid. Simply saying 'well, it must be direct damage to the heart, case closed' is completely reductive.

Re: Covid and the Heart: It Spares No One – Johns Hopkins

#159

Post by Retric »

TrevorJ wrote: post #158
Retric wrote: post #153

Earlier quoted context omitted.

>He does not refer to damage “Why would SARS-CoV-2, the virus that causes COVID 19, which we all thought about as a respiratory virus, attack the heart” “Why would SARS-CoV-2, … attack the heart” Are you suggesting attack the heart doesn’t mean to cause damage to it? I have trouble reading that as meaning anything else, how do you read it?

He's asking the same question I'm asking: "Why"? The scientist who conducted the study is saying his findings raises more questions, as any good study is likely to do. - I'm not sure why so many people want to read between the lines versus picking up the line of inquiry and doing further studies. There are any number of reasons why we could see heart issues from covid. Simply saying 'well, it must be direct damage to…

I agree he doesn’t know what specific method of action(s) or type of damage(s) is involved.

I suspect multiple different things result from getting COVID that directly or indirectly cause harm. The study only looks at the effects without digging into the proximate causes.

Re: Covid and the Heart: It Spares No One – Johns Hopkins

#160

Post by kortilla »

zzzeek wrote: post #140
kortilla wrote: post #127

Earlier quoted context omitted.

That doesn’t really work if people around you do not. One less trip out of your house so you only leave 4 times a week instead of 5 is several orders of magnitude better than going out with an N95 the 5 times. If you actually care about Covid the answer is to not leave the house. Putting an n95 on when the mandates are gone so nobody else is wearing one is just a religious act at this point.

that's quite an exaggeration, and it hurts me personally to think that when I go out and im the only one wearing a mask, people are looking at me as though I'm engaged in a "religious act". For people who aren't immunocompromised, the N95 will grant a significant level of protection even if others aren't masked, especially if you're outdoors or in an otherwise well ventilated space, if you have short interactions fro…

> especially if you're outdoors or in an otherwise well ventilated space

Citation needed that it’s not being outdoors or a well-ventilated space that is doing all of the work and not the mask.

> but a properly worn N95 combined with up-to-date vaccination goes pretty far for someone who is fortunate enough to not be already immunocompromised and is fine avoiding places like concerts, clubs and bars.

You’re all over the place here. I’m talking specifically about avoiding all of those things as well but just skipping the mask. The risk profiles between those two are so negligible that skipping a single trip out to an enclosed space is orders of magnitude better than the difference between them.

That’s why what you’re doing is just a “religious act” at this point. There is no good medical reason for you to wear it if you’re already going out. 99.999% of the risk comes from the “going out” part if everyone else is unmasked, so wtf are you doing at a grocery store/restaurant/whatever if you are actually worried about getting COVID?

It’s no different than bringing a parachute on a commercial flight. The chance of you crashing on a flight are tiny and the probability of you being able to use a parachute if you are in one of those scenarios and surviving are less than 1% as well.

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