Dr David Tuller: What is Recovery Norway’s Role in the JAMA Network Open Study of Long Covid in Young People?


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What is Recovery Norway’s Role in the JAMA Network Open Study of Long Covid in Young People?

By David Tuller, DrPH
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As I wrote earlier this week, a new study of adolescents and young adults from Norway, published by JAMA Network Open, purports to show that “persistent symptoms in this age group are related to factors other than SARS-CoV-2 infection.” It didn’t actually show that, of course. What it showed is that if you use an expansive case definition that identifies everyone with any single unexplained symptom as having what the World Health Organization has called post-Covid-19 condition (PCC), you will come up with pretty useless data—that is, if you want to understand anything about patients reporting actual disabling conditions.

I also pointed out something that seemed odd to me. As a current template for what they call post-infective fatigue syndrome, the authors were trying to resuscitate a zombie case definition for chronic fatigue syndrome—the abandoned 1994 Fukuda criteria. Since Fukuda has largely been dropped for research and clinical care and has been superseded by other criteria, the attempt to promote it without mentioning its acknowledged drawbacks and lack of present relevance is perplexing.

Not surprisingly, the study drew online criticism as soon as it was published. Beyond the fact that you could drive a tractor-trailer through the porous WHO criteria for PCC, it was noted that adolescents and young adults are less impacted overall from coronavirus infection and that extrapolating the findings to older populations would be unwarranted—even if the study were robust and well-designed, which it isn’t........................