I would read it if you argued the article, but only do it if it helps you get out your frustration at the bad article!

@Steve, facts are important for understanding the truth, outdated facts are... <enter expletive>... if you know what i mean

Even before 2020’s first horrific wave of COVID-19 deaths subsided, reports surfaced warning of a brutal second punch: Instead of recovering quickly after a mild infection, some people were suffering from symptoms that lingered or even intensified in the weeks and months that followed.

The condition came to be called long COVID.

September 3, 2020

A few weeks ago, we wrote a BMJ Opinion piece about the long term impacts of Covid and called for patients’ experiences of Long Covid to be included in any initiatives to explore the experience of “long-haulers.” This opinion piece foregrounded a video called “message in a bottle” made by the LongCovidSOS patient group, which caught the attention of the World Health Organisation’s covid-19 response team. The LongCovidSOS team were then invited to organise a meeting. This opportunity to present the existing evidence and highlight patients’ experiences of having Long Covid took place on Friday 21 August 2020. The meeting was attended by Maria Van Kerkhove, (WHO Covid Technical Lead) and Janet Diaz (WHO Head of Clinical Care) from the central WHO team.
At the meeting, two of us, Clare Rayner and Amali Lokugamage, both doctors who are experiencing long term impacts of covid-19, discussed their perspective of having Long Covid.

After a couple of months, my recovery was tested. I developed acute dengue fever while on holiday. The acute illness settled, I returned home, but multiple stresses meant the chronic fatigue symptoms recurred: the muggy headaches, aching muscles, and severe exhaustion. I now knew that I wasn’t physically ill, and with some friendly reminders I knew what to do. One afternoon, I felt as though I had been drugged, and felt so heavy I thought I could not raise my arms from the bed. I knew the symptoms were real, but I needed to distract my brain from them. So I thought, let’s do it: I will either die or recover, I got out of bed and went to Sefton Park to join a military fitness session. It was fabulous, and the exercise pushed the aches and fatigue aside. I slept well and felt better the following day. I was back on track.

Symptoms and case definition
Long covid may be diagnosed late or not at all,111213 so both generalists and specialists should be alert to it as a differential, while also being aware that patients can develop other persistent symptoms following acute covid-19 that are not necessarily caused by covid-19. Long covid is characterised by a constellation of general and organ specific symptoms, the commonest of which are summarised in the infographic. These multiple manifestations lead to difficulties with daily activities such as washing and dressing, low exercise tolerance, and impaired ability to work (either at all or partially), and result in reduced quality of life.5141516171819... continues and edited for emphasis

The complaints of early “long-haulers” were then picked up and amplified by activists, whose lobbying persuaded the government to allocate more than $1 billion in research funds...

As vaccines rolled out across the country in 2021, researchers at the Mayo Clinic analyzed the symptoms of 108 patients who’d come for post-COVID care. Their results suggested that these patients fell into two main camps. Some, mostly men, suffered severe illness and were still being plagued by symptoms like chest pain and shortness of breath. Then there were others, mostly women, who had experienced relatively mild illness, or no symptoms at all, but were subsequently dogged by “widespread pain, fatigue,” and “cognitive impairment, including the commonly reported ‘brain fog.’ ” The authors noted that this cluster of symptoms resembled a class of broadly similar conditions like chronic fatigue syndrome, fibromyalgia, and POTS (postural orthostatic tachycardia syndrome), all of which can leave sufferers incapacitated for years at a time.

How long could long COVID symptoms be expected to last? Researchers in Australia tried to answer that question by conducting phone interviews with every single person who was diagnosed with COVID-19 in the state of New South Wales between January and May 2020. They found that recovery followed a curve, with 80 percent of patients fully recovered after 30 days and 91 percent recovered after 60 days. Thereafter, the population of symptomatic patients continued to slowly dwindle, with 4 percent of the original patient population still suffering symptoms after four months. Their most common complaints were coughing and fatigue.

"Thereafter, the population of symptomatic patients continued to slowly dwindle, with 4 percent of the original patient population still suffering symptoms after four months. Their most common complaints were coughing and fatigue."

There is no evidence that any of this has actually happened. Not only did disability claims not rise during the pandemic, they fell.

I want to be clear about this: Long COVID is a real illness that has dramatically affected many people’s lives. But its prevalence does seem significantly less worrisome than originally thought.

Indeed, even patients who suffer the most debilitating form of long COVID can find themselves improving after weeks and months, not years. In January 2021, eight months after his first essay ran in the BMJ, Paul Garner published a follow-up article in which he described how he had achieved a total recovery through a process that included plenty of exercise. “I’m back to normal,” he told me. Today he believes that the perception of a long COVID public health crisis—one his own experience helped to fuel—is overblown. “The predicted long-term disability from tissue damage simply has not materialized,” he said. “The public narrative has morphed into continued catastrophic thought.”

Update, March 20, 2023: This article has been updated to clarify that research has identified biological changes that can occur in association with symptoms present following a COVID infection.

Long covid—an update for primary care
https://doi.org/10.1136/bmj-2022-072117

As an side, i emailed my medical practice tonight to ask (make sure) if my medical file has the electronic code that this sentence mentions:

I want to make sure it does because if anything else pops in the years to come that might be related to Covid i damn well want to make sure they look at it in the right way!

An update on my medical file having the electronic code for Long Covid, when my GP called me last week about joining a group therapy session that she felt might benefit me she also said she'd spoken to the lead doctor within the medical practice about the coding... neither my GP nor the the lead knew about the BMJ recommendation but they both thought it was an excellent idea, sadly their software doesn't yet support that function, they are in the process of upgrading the software and will make sure that the Long Covid code is added to all their Long Covid patient files as soon as is possible.
My GP has promised to let me know when the coding is added to my file, i trust her but i'll believe it when i get the phone call saying it's added, in the meantime i'll be waiting and watching.

I take that as a massive step forward not just for me but for everyone else like me, it just may save a lot of mis-diagnosis and premature death in the future.

Ian Sample hears from Scotland’s Astronomer Royal Catherine Heymans about her experience of long Covid and how it has impacted her life. He also speaks to Professor Danny Altmann, an immunologist at Imperial College London, about the current scientific understanding of the condition, and whether we’re any closer to a treatment.

I've saved that podcast link to listen to when I have a chance -- I subscribe to The Guardian digitally here in the US. I've never accessed their podcasts before, though.

Although COVID-19 cases and hospitalizations have decreased, long COVID remains a constant presence in the lives of many Americans.

Long COVID has affected millions of people globally, with individuals reporting a range of symptoms including fatigue, lung issues and neurological problems like brain fog.

While evidence indicates that most individuals substantially recover within a year, recent CDC data showed it has played a role in over 3,500 deaths in the U.S. from January 2020 through the end of June 2022.

Treva Taylor has been facing an uphill battle since her coronavirus diagnosis in January 2021, which nearly took the 57-year-old's life.

"It was scary because I remember my eyes being open, but everything was black," Taylor said. "I remember the nurse saying to me, 'You have to fight. The person next to you is dying. And if you don't, you're going to be in this body bag. You have to fight.'"

Now, she wants others who are suffering to know that long COVID is "very real."... continues

Post-acute COVID-19 syndrome (PASC) is a global public health crisis in which patients experience lingering and debilitating symptoms beyond 4 weeks after the acute onset of SARS-CoV-2 infection. Sleep disturbance has a reported prevalence of 34–50% in PASC, but only a few studies have identified associated risk factors, and these have primarily described sleep quality and not symptom severity. Likewise, studies to date have not investigated the interaction of mood disorders and fatigue with sleep disturbance severity or the association of objective sleep study indices in PASC.

...Many cases of long COVID have been associated with signs of illness that are difficult to observe. Patients are often struck by persistent fatigue and difficulty concentrating (commonly known as “brain fog”), along with other non-specific ailments including palpitations, dizziness, headache, insomnia, and mood dysregulation. This constellation of symptoms is non-specific and common to other distressing syndromes and chronic illnesses from across the medical spectrum. Patients who are suffering debilitating symptoms in the absence of verifiable, objective signs of illness can understandably feel insulted and/or dismissed when doctors suggest their condition may be “psychosomatic” (traditionally viewed, too simplistically, as a physical ailment caused by mental distress as opposed to a physical condition.)...

Abstract

Melatonin has been recognized for its therapeutic potential as a chronobiotic cytoprotective drug to combat the effects of COVID-19 infection. Melatonin may be unique in mitigating the symptoms of SARS-CoV-2 infection due to its wide-ranging actions as an antioxidant, anti-inflammatory, and immunomodulatory chemical. Furthermore, melatonin is an efficient chronobiotic drug in treating delirium and reversing the circadian disturbance caused by social isolation. Melatonin is a cytoprotector that helps to treat various comorbidities, including diabetes, metabolic syndrome, and ischemic and nonischemic cardiovascular disease, all of which increase COVID-19 illness. As the COVID-19 pandemic continues, it has become known that clinical sequelae and symptoms for a considerable number of patients may linger for weeks to months beyond the acute stage of SARS-CoV-2 infection (long COVID). Based on indications of neurological sequelae in COVID-19-infected individuals, there is another possible use of melatonin based on its documented neuroprotective properties. Melatonin is an excellent agent for controlling cognitive deterioration (brain fog) and pain in myalgic encephalomyelitis (i.e., chronic fatigue syndrome); therefore, its therapeutic importance for the neurological consequences of SARS-CoV-2 infection should be investigated.

The post-coronavirus disease 2019 (COVID-19) condition, commonly known as “long COVID,” is defined by the World Health Organization (WHO) as the continuation or development of new symptoms 3 months after the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with these symptoms lasting for at least 2 months with no other explanation [1, 2].

Studies have widely clarified that “long COVID” after discharge from hospital include a mixture of neuropsychiatric complaints, such as defective instant verbal memory and learning, deferred verbal memory difficulties, verbal fluency problems, working memory issues, anxiety, depression, and post-traumatic stress disorder (PTSD) [1, 2]. These complaints can persist for at least 1 year [2]. In some COVID-19 patients, cognitive impairments can even deteriorate over time [2]. Although several pathological mechanisms have been proposed by the author [1], the pathological basis of these symptoms remains unknown.

The hippocampus has imperative functions in spatial and episodic memory [3] as well as learning [4]. In addition, the hippocampus plays an accompanying imperative role in neurogenesis [5] by self-reproducing multipotent adult neural stem cells (NSCs) located in the subgranular zone (SGZ) of the dentate gyrus (DG) [5, 6]. However, the hippocampus, as a vulnerable configuration, can be upset by various neurological and psychiatric disorders [4]. Since the hippocampus is predominantly susceptible to injuries caused by COVID-19 [1], there is increasing evidence indicating the possibility of post-infection memory loss [2, 7].

To explore the etiology of post-infection memory loss in “long COVID,” the role of activated microglial cells has already been highlighted by the author [1, 2]. In this regard, COVID-19 can activate microglia in the hippocampus and induce a central nervous system (CNS) cytokine storm, leading to loss of hippocampal neurogenesis [1, 2]. The activation of microglia in the hippocampus of deceased patients with “long COVID” and cognitive impairments as well as mild COVID-19 animal model was shown to be due to elevated levels of C–C motif chemokine ligand 11 (CCL11), leading to inhibited neurogenesis [8]. Activated pro-inflammatory microglia through inflammatory mediators, such as tumor necrosis factor alpha (TNF-α), interleukin-1 alpha (IL-1α), complement component 1q, and IL-1β, can then activate pro-inflammatory astrocytes and fuel a secondary inflammatory response [1, 2]. Consequently, this disturbs hippocampal neuronal cells, leading to memory difficulties and neuronal apoptosis. These pathological pathways can explain the potential damaging consequences of SARS-CoV-2-linked glial activation, neuroinflammation, and apoptosis [1, 2]. This can eventually disturb hippocampal neuronal cells, leading to memory difficulties and neuronal apoptosis [1, 2].

Therefore, the reduced neurogenesis, which was shown in the COVID-19 group [9], could be due to microglial activation and the subsequent production of inflammatory cytokines, such as TNF-α, IL-6, and IL-1β, causing neuroinflammation and the resultant impaired neurogenesis [1, 2, 9]. This eventually results in cognitive decline due to the destruction of spatial memory and learning [1, 2, 9]. These implications on the hippocampus, especially the loss of hippocampal neurogenesis in the brains of COVID-19 patients, elucidate learning, memory, and executive impairments in COVID-19 patients compared with uninfected healthy controls [10].

As a result, memory loss in patients with “long COVID” can be due to reduced hippocampal neurogenesis. This negative consequence is mediated by inflammatory mediators secreted by activated microglia in the hippocampus, which can induce a cytokine storm in the CNS. This highlights the specific susceptibility of the hippocampus to neuroinflammation. A better perspective of the cellular features of COVID-19 brain injury could assist in interventions to ease long-term neuropsychiatric complaints. In addition, the neuropathology of COVID-19 may provide a replica for decoding the neurodegenerative mechanisms related to neuroinflammation in other brain diseases and for developing new therapeutic strategies.

Yes, it's a long quote, but certainly an interesting one. The first article, pointing out the potential benefits of Melatonin as a treatment is very interesting. You had some success with that, I recall.

Thanks for continuing to share this information.

Summary: People with long COVID have abnormal brain activity during memory tests, months after their initial COVID-19 infection, with less activity in the regions normally used for memory tasks, but more activity in other areas of the brain.

Although people who had COVID-19 had cognitive test scores similar to those who never had a history of coronavirus, those who had long COVID had greater brain activation on a working memory task compared to people without prior COVID-19 infections.

Key Facts:

1. People with long COVID who have persistent neuropsychiatric symptoms showed abnormal brain activity months after COVID-19 infection during memory tests.
2. People who had COVID-19 had cognitive test scores similar to those who never had a history of COVID-19, but people who had long COVID had greater brain activation on a working memory task compared to people without prior COVID-19 infections.
3. The study does not prove that COVID-19 caused the brain changes, and a limitation of the study was that it was conducted mainly during the delta variant phase of the pandemic in the United States, so the results do not necessarily show whether newer coronavirus variants may affect the brain similarly.

continues...

A limitation of the study was that it was conducted mainly during the delta variant phase of the pandemic in the United States, so the results do not necessarily show whether newer coronavirus variants may affect the brain similarly.
Edited for emphasis.

The 12 symptoms of long covid

To meet the study’s definition of long covid, a participant needed to score a total of 12 points once all their symptoms were added up. The 12 key symptoms and their corresponding scores are:

Loss of smell or taste: 8 points.
Post-exertional malaise: 7 points.
Chronic cough: 4 points.
Brain fog: 3 points.
Thirst: 3 points.
Heart palpitations: 2 points.
Chest pain: 2 points.
Fatigue: 1 point.
Dizziness: 1 point.
Gastrointestinal symptoms: 1 point.
Issues with sexual desire or capacity: 1 point.
Abnormal movements (including tremors, slowed movements, rigidity, or sudden, unintended and uncontrollable jerky movements): 1 point.
...