Reacción a "Reactions: persistent covid studies have created misunderstandings because of their limitations, says analysis"

I agree with the first message of this paper, which is that we need well designed studies to provide a valid measure of the long-term effects of acute COVID-19 infection (Long COVID).

Such studies need robust case definitions, adequate duration of follow-up, and suitable comparison groups. Now that the pandemic has been with us for more than three years, we should expect such high-quality studies. Ultimately, these studies should provide us with consistent evidence about key aspects of the epidemiology of Long COVID – including its prevalence, severity, and duration. The published literature is not yet giving us this clear consistent picture.

“The second message of this paper appears to be that there is a negligible risk of Long COVID, based on the selection of papers they have quoted.  That message is concerning and does not fit with mainstream scientific evidence, nor the experience of the large population of people living with Long COVID and the clinicians caring for them.  There is now overwhelming evidence that SARS-CoV-2 carries a significant risk of long-term effects.  This evidence doesn’t just come from epidemiological studies, but also from studies looking at the severe and lasting pathological changes that occur following SARS-CoV-2 infection.

“Even if the risk of Long COVID from a single infection is now relatively low with Omicron subvariants, and with vaccination fortunately pushing it down even further, it remains a serious problem that we need to manage. COVID-19 has infected most of world’s population and is continuing to cause multiple reinfections for many. Consequently, the population level impact of infection is large and growing. There is also the potential that some of the long-term effects of infection with this virus may take years to manifest themselves, as we have seen with other viral infections.

One remarkable feature of this paper severely damages its credibility. It includes a section titled The most well-designed studies provide reassuring estimates.  In it the authors include just two studies to support that sweeping statement: one was in children, and in the other they reported and commented on the analysis of findings for people younger than 50 years. In doing this highly selective ‘mini meta-analysis’ they are contradicting the core message of their paper. This very biased treatment of the subject suggests that these authors have an underlying view of Long COVID, rather than the evidence-informed perspective they are promoting.