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Blood test detecting Long Covid in kids with 94% accuracy microclots

https://www.researchsquare.com/article/rs-7483367/v1
62•thenerdhead•2h ago

Comments

kace91•1h ago
Can someone knowledgeable explain the current understanding of Covid’s long time effects? I thought it was still a big unknown and long COVID was still debated as to even having a clear definition.
dmd•1h ago
If only there were some sort of link here with that sort of information!
kace91•51m ago
I did read the article. It only talks about detecting long covid in children, which is different to understanding its effect on adults and the long terms effect of COVID in general (vs long COVID, which if understand correctly it’s a different syndrome to just “ long term expected outcomes from having had COVID”).
diffeomorphism•1h ago
94% accuracy sounds extremely bad, no?

https://www.ssph-journal.org/journals/public-health-reviews/...

> Prevalence estimated (...) 2%–3.5% in primarily non-hospitalized children.

So a fake test always saying "No" would be more accurate at 96.5% accuracy.

mouse_•1h ago
Sample size of 59 also seems worse than useless; I'm no researcher so maybe there's something I'm missing here but, doesn't seem very good.

Junk science?

mapontosevenths•20m ago
It's just an early study, not junk.

The primary conclusion of this research was basically just "this looks like it would be worth doing more research on." Which is a fair conclusion for a study this small.

resoluteteeth•1h ago
If you read the actual link I don't think they're saying that using it as a covid test with some specific threshold of microclots has a 94% accuracy but just that the raw microclot count has a 94% accuracy.

The title on hn which implies that seems to be inaccurate and it's not the original title of the article.

diffeomorphism•19m ago
No, that does not seem to be what they are saying.

> We evaluated the diagnostic power of the device in a cohort of 45 LC patients and 14 healthy pediatric donors. We estimated a 94% accuracy for the microclot count using the devices, significantly higher than the traditional counting of microclots on slides (66% accuracy).

They are comparing the predictive power and using accuracy (instead of sensitivity, recall, F1, etc.). For their method "using the devices", they compute an accuracy of the predictive power, not of the count, of 94%. For the previous method they say the accuracy is 66%.

Basic questions: Is accuracy even a good metric for this? Is 94% a good value or just the difference between bad and very bad?

It might very well be that their improvement is from bad to really good, but the point is that a raw stat of "94% accuracy" is useless without context and so is the headline.

Zak•59m ago
The sensitivity of such a test would be 0. This test had a sensitivity of 91% versus 61% for the glass slide count method, which is a large improvement.

The sample size is pretty small here and the control group even smaller. The paper concludes that a larger study is necessary to confirm the result.

diffeomorphism•39m ago
That is exactly why I gave that example. Why does the headline focus on accuracy then?
porridgeraisin•11m ago
To get you to click on it :-)
shawabawa3•36m ago
Accuracy is a nonsense word in this context

Tests have a sensitivity (1 - percentage of false negatives) and specificity (1 - percentage of false positives)

"Accuracy" usually refers to sensitivity. If specificity is near 100% and the test is cheap/fast even low sensitivity can be good

On the other hand you could have sensitivity of 100% but the test could be useless if specificity is low and the condition is rare

diffeomorphism•11m ago
No, it is a well defined term in this context and does not refer to sensitivity.

https://pmc.ncbi.nlm.nih.gov/articles/PMC4614595/#:~:text=Ac...

That is exactly why I gave the trivial example of an "always No" test. It has perfect specificity (zero false positives) and has accuracy corresponding to prevalence. The sensitivity is zero, however, which is the point.

Wintamute•1h ago
Can they disambiguate between spike protein microclots produced by natural infection vs. those generated by the vaccines.
notrealyme123•1h ago
I am curious about the working hypothesis leading to this question.
zacharachnia•50m ago
Hypothesis: microclots are caused by the viral spike protein. The mRNA vaccine produces the viral spike protein. Therefore, a non-zero percentage of microclots are caused by spike protein originating from the vaccine.
DaSHacka•50m ago
One of the working theories on people suffering long COVID-like symptoms after receiving an mRNA COVID vaccine may apparently be related to spike proteins found in the patient's blood far longer than is typical/intended. This is apparently similar to long COVID patients.

At least, that's my layman's understanding when I was following it some years ago. I'm not sure if there's been more recent studies that have found more concrete links since then, but I suspect GP is in the same boat, which is why they asked.

Tarsul•1h ago
This is (probably) not a Long Covid story but I found that bloodletting (for which I even received money!) gave me back the energy that I was missing for the last few years (e.g. it was impossible to build stamina). I also read about a study about the positive effects of bloodletting[1] that somehow is not all the rage in mainstream news, which I find perplexing. If it might be so easy to improve your health (for some of us), why isn't this discussed or studied more broadly?

[1]https://www.sciencedaily.com/releases/2012/05/120529211645.h...

"the patients who gave blood had a significant reduction in systolic blood pressure (from 148 mmHg to 130 mmHg) as well as reduction in blood glucose levels and heart rate, and an improvement in cholesterol levels (LDL/HDL ratio)."

spockz•1h ago
The lower blood pressure I can explain by having a lower volume of blood. But the glucose and cholesterol have to go somewhere. Where do they go? Are they filtered in the process after blood letting?
mort96•45m ago
If it's in the blood, doesn't it just leave the body together with the blood?
aesh2Xa1•38m ago
Yes, but the relative amount per volume blood should be the same. I think that's why he's asking.

If so, the answer is that the body replenishes plasma in a day and red cells in six weeks (redcrossblood.org FAQ). The relative amount does change quickly.

mkoubaa•1h ago
If this were the case you could do a natural study on this by comparing menstruating women with the rest of the population
jtbayly•1h ago
This has been done. Women seem to have certain health benefits that stop after menopause. Reading about it was the first time I wondered whether blood letting made sense.
Thorrez•42m ago
When people donate blood, on average they donate about 10x as much as a woman typically loses during menstruation.
aesh2Xa1•36m ago
I looked up the amount of blood lost due to a menstruation cycle, and the answer is around 50 ml.

OP's linked paper has "the iron-reduction patients had 300ml of blood removed at the start of the trial and between 250 and 500ml removed four weeks later."

A blood donation removes 500 ml, so about a year of menstruation all at once. You can donate every two months, besides.

So, yes, if there is an effect then we might expect the magnitude of the effect to differ. Or else we'd expect a paper cut to also have the same effect.

Sex biological difference could matter as well.

jfengel•16m ago
Menstruating women don't lose nearly that much blood.

Even if they did, the hormonal effects would likely swamp anything else. Which is a huge problem: women are routinely excluded from studies to avoid that, meaning we have no idea what the effects are on women.

jeremy151•49m ago
I live in an area with PFAS contaminated ground water (which I now aggressively filter.) To me giving blood just kind of makes sense, if there is a class of things that can enter your blood and never leave, and does not replicate on its own, why not perform a regular "oil change" and hopefully help some people at the same time. Some study has been done:

https://pmc.ncbi.nlm.nih.gov/articles/PMC8994130/

The study specifically does not look at the effect on recipients, though the donation centers do not disallow such donations. My presumption is that the donation is a net positive all around. If study comes to show the contrary, I'll certainly revise my approach.

tgsovlerkhgsel•1h ago
The paper claims that 1/5 of people experience Long COVID after an infection. Given that approximately everyone has caught COVID by now, this does not track with how rarely I've heard of people with it.

Wikipedia lists much lower numbers on https://en.wikipedia.org/wiki/Long_COVID (6–7% in adults, ~1% in children, less after vaccination.) and seems to use a more liberal definition than this paper, as it mentions "Most people with symptoms at 4 weeks recover by 12 weeks" (while the paper only considers it "long COIVD" if symptoms last past 3 months).

I've found studies (peer reviewed, as far as I can tell) claiming anything from well under 10% to well over 30%.

What's going on here?

victorbjorklund•1h ago
Could it be that you can have different severity of long covid? Someone with very severe symptoms will notice it but someone with small symptoms might not realise it (and instead think they are just less fit)
Thorrez•47m ago
>after an acute SARS-CoV-2 infection.

Maybe not all infections are considered "acute".

DrewADesign•31m ago
Acute, in this context, just means the infection had a finite (and usually relativity short) duration. The opposite is a chronic condition, which is what “long covid” would be in this case.
cheschire•47m ago
A lot of symptoms of long covid mirror the symptoms of unhealthy living, which may make it so people either dismiss their own symptoms and don't seek diagnosis, or their complaints are dismissed by others for needing to simply needing to improve externalities.
Ozzie_osman•40m ago
The paper says "One in five children." I wouldn't be surprised at all. Children are very dynamic, changing often as they grow and go through different developmental stages (which may include periods where they seem more tired or more cranky, etc) . They also often lack the language and agency to explain what's going on with their bodies.

I don't see how you'd know the exact number without a solid diagnostic check.

tiahura•20m ago
I'm an ambulance chaser. I look at medical records all day. I've never seen anyone complaining of long covid.
rr808•13m ago
I have a 87 year old uncle who says he has long covid because he gets tired and needs a nap in the afternoon. I'm half the age and felt the same even before 2020.
Llamamoe•11m ago
It takes very severe disability for it not to be brushed off as depression, anxiety, burnout, or blamed on lifestyle.

Additionally, a lot of those numbers are based on earlier strains of COVID, which were much more severe.

I suspect the 1/5 figure is largely true for "has some degree of cardiovascular damage and worsened general health after COVID", but the number of people actually disabled by the condition is much lower.

That said, any loss of ability is a sad thing, and I am incredibly disappointed that we did not introduce any shared indoor space air quality legislation post-pandemic.

notmyjob•3m ago
And the lipid nanoparticle based Covid prevention shots caused myocarditis in some younger males, so earlier incidence of cardiovascular complications vs. the present (when most people especially younger healthy males are choosing not to take updated boosters) would correlate with that as well.
clanky•5m ago
The numbers in the range of 1/5 usually include in the definition things like "a cough that lasts six weeks after the acute phase of infection and then goes away," which is not what most people think of when they hear the term Long COVID (and is not even unique to SARS-CoV-2).

For a variety of reasons, hyping the threat of infection has been a pretty widespread practice among the medical and scientific community since COVID began. There's no way on earth 1 out of 5 kids are still experiencing symptoms 3 months out.

djtango•4m ago
After covid I suffered from intermittent brain fog for years and also felt like my heart was maybe struggling more than usual when I was training at the gym.

Never enough to warrant going to a doctor unless I was being super paranoid (and spend a long time convincing them I wasn't paranoid) but just enough to always wonder if there was something more to the story.

ipsento606•1h ago
The title should be edited. It sounds as if the test is 94% accurate at detecting long covid, but in fact it's 94% accurate at counting microclots

> We estimated a 94% accuracy for the microclot count using the devices, significantly higher than the traditional counting of microclots on slides (66% accuracy)

diffeomorphism•5m ago
No, you are parsing this wrong.

> We evaluated the diagnostic power (...). We estimated a 94% accuracy for (our method), significantly higher than the (traditional method) (66% accuracy).

Both methods have counting in their name, but they are comparing the diagnostic power.

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