A 2021 medical research article was titled "Impact of persistent D-dimer elevation following recovery from COVID-19." This is what it dealt with: "One hundred fifty COVID-19 patients were reviewed at St James's Hospital Dublin between May and September 2020 at a median of 80.5 (range 44-155) days after initial diagnosis. These included patients hospitalized during initial illness (n = 69) and others managed entirely as out-patients (n = 81)." It concluded: "In 15% of the patients recovered from COVID-19, persistent D-dimer elevation was observed after a median of 3 months following COVID-19. These patients had experienced a more severe COVID and still presented more frequently a lower mean [oxygen level]."
Another medical research article titled "Impact of persistent D-dimer elevation following recovery from COVID-19" said: "Increased D-dimer levels (>500 ng/ml) were observed in 25.3% patients up to 4 months post-SARS-CoV-2 infection. On univariate analysis, elevated convalescent D-dimers were more common in COVID-19 patients who had required hospital admission and in patients aged more than 50 years (p 90% of convalescent patients. Elucidating the biological mechanisms responsible for sustained D-dimer increases may be of relevance in long COVID pathogenesis and has implications for clinical management of these patients. "
It must be emphasized that the D-dimer test has also been used to understand varying levels of COVID illness and death for hospitalized patients. From a study at a major New York hospital system in 2020 these findings show how important D-dimer test data are, and they give the levels of test results that correlate with the worst conditions:
"After controlling for variables as listed above (age, sex, gender etc), it was evident that the magnitude of D-dimer elevation at admission is independently associated with risk of death. Irrespective of age, gender, ethnicity and pre-existing co-morbidity, death was found to be 1.7 times more likely if D-dimer was in the range 0.23-0.50 ÃŽ ¼g/ml (230-500 ng/ml) at admission, than if it were normal (, 2.3 times more likely if D-dimer was in the range 0.5-2.0 ÃŽ ¼g/ml (500-2000 ng/ml) and 4.2 times more likely if D-dimer was > 2.0 ÃŽ ¼g/ml (2000 ng/ml)."
"A similar pattern was seen for peak D-dimer levels: magnitude of peak D-dimer (at day 5 of hospital admission) was shown to be independently associated with risk of death. Of those 301 patients with highest peak D dimer (> 10.0 ÃŽ ¼g/ml (10,000 ng/ml)), 182 (60.5%) had died or been transferred for terminal care at study end. In discussion of their study, the authors summarize the results of other similar studies and briefly review current understanding of the pathophysiology of COVID-19 related coagulopathy and associated D-dimer elevation."
"This study provides the most robust evidence to date that D-dimer is predictive of serious illness and death due to SARS-CoV-2 infection, and thereby provides further support for the notion that point of care D-dimer testing might be a helpful tool for the early triaging of COVID-19 patients presenting to the hospital emergency department and for monitoring patients during the first week of hospital admission."
There is great potential that D-dimer test data for long COVID patients could be as significant as for COVID patients, not for correlating with death, but with severity of long COVID conditions. It is plausible to think that those with the highest levels would be suffering with the worst long COVID health problems. Getting effective medical help could be helped by knowing D-dimer test data.
Yale University research found that for long COVID victims "much of the time extreme fatigue from exercising has to do with the inability of the muscles to take up oxygen from the blood. When cardiopulmonary tests don't reveal a problem with the heart or lungs, 'it's not that they're making things up,' said Dr. Inderjit Singh, a pulmonologist at Yale New Haven Hospital "It may be that the muscles are unable to extract oxygen from the blood." This finding is consistent with micro clots impeding oxygen flow. Indeed, "There's some thought COVID can cause some chronic clots or micro-clots in the lungs," said Dr. Phillip Joseph, also a pulmonologist at Yale New Haven Hospital."
Scope of long COVID problem
A key question is this: How many people are suffering with long COVID? Is long COVID really a major health problem that deserves more serious attention by the medical establishment?
One 2021 study found that more than half of those infected with the virus become long COVID victims. It said: "More than half of the 236 million people who have been diagnosed with COVID-19 worldwide since December 2019 will experience post-COVID symptoms -- more commonly known as 'long COVID' -- up to six months after recovering, according to researchers. The research team said that governments, health care organizations and public health professionals should prepare for the large number of COVID-19 survivors who will need care for a variety of psychological and physical symptoms."
Another 2021 article titled "Exactly How Many People Have Long Covid?" said: "One report from Imperial College London, called React-2, gives a much higher estimate of the prevalence of long Covid. The study surveyed over 500,000 participants between September 2020 and February 2021, asking them whether they thought they had had Covid-19, whether they had any symptoms from a list of 29, and if so, for how long. It estimated that almost 40 percent of people who definitely had or thought they had Covid-19 still had at least one symptom lasting 12 weeks or more. That's an estimated 2 million people in England living with the condition between those two dates."
A recent 2022 article said: "About 1 in 3 COVID patients have long-haul symptoms after getting COVID-19, even if their initial infection was mild, according to researchers from University of California at Davis. About 100 million Americans ages 18 to 65 have gotten COVID-19 since the pandemic began, according to the U.S. Centers for Disease Control and Prevention. Using the UC Davis figure, that means about 30 million people may have developed long COVID since the pandemic began, with many of them recovering enough to resume work." But far from all.
New research from Cambridge University found this:
"Around two-thirds of the COVID-19 cohort experienced symptoms of long COVID, defined as a symptom lasting longer than 12 weeks beyond initial date of diagnosis. Among those experiencing long COVID the new research found 78 percent had difficulty concentrating, 69 percent suffered brain fog, 68 percent reported forgetfulness and around 40 percent displayed a condition known as semantic disfluency (saying or typing the wrong word). The study also found those subjects with long COVID experienced significant disruptions to their daily lives. More than half the long COVID cohort were unable to work for extended periods of time and one-third lost their job due to their illness."
It is important to note that many Americans not in the working class also are victims, including children and the elderly. A study in Israel of children aged 3-18 who had recovered from the virus found that 11.2% reported symptoms of long COVID; that translates to over 20,000 victims.
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