Can you die from long COVID? The answer is not so simple
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Nearly five years into the pandemic, COVID is feeling less central to our daily lives.
But the virus, SARS-CoV-2, is still around, and for many people the effects of an infection can be long-lasting. When symptoms persist for more than three months after the initial COVID infection, this is generally referred to as long COVID.
In September, Grammy-winning Brazilian musician Sérgio Mendes died aged 83 after reportedly having long COVID.
Australian data show 196 deaths were due to the long-term effects of COVID from the beginning of the pandemic up to the end of July 2023.
In the United States, the Centers for Disease Control and Prevention reported 3,544 long-COVID-related deaths from the start of the pandemic up to the end of June 2022.
The symptoms of long COVID – such as fatigue, shortness of breath and “brain fog” – can be debilitating. But can you die from long COVID? The answer is not so simple.
How could long COVID lead to death?
There’s still a lot we don’t understand about what causes long COVID. A popular theory is that “zombie” virus fragments may linger in the body and cause inflammation even after the virus has gone, resulting in long-term health problems. Recent research suggests a reservoir of SARS-CoV-2 proteins in the blood might explain why some people experience ongoing symptoms.
We know a serious COVID infection can damage multiple organs. For example, severe COVID can lead to permanent lung dysfunction, persistent heart inflammation, neurological damage and long-term kidney disease.
These issues can in some cases lead to death, either immediately or months or years down the track. But is death beyond the acute phase of infection from one of these causes the direct result of COVID, long COVID, or something else? Whether long COVID can directly cause death continues to be a topic of debate.
Of the 3,544 deaths related to long COVID in the US up to June 2022, the most commonly recorded underlying cause was COVID itself (67.5%). This could mean they died as a result of one of the long-term effects of a COVID infection, such as those mentioned above.
COVID infection was followed by heart disease (8.6%), cancer (2.9%), Alzheimer’s disease (2.7%), lung disease (2.5%), diabetes (2%) and stroke (1.8%). Adults aged 75–84 had the highest rate of death related to long COVID (28.8%).
These findings suggest many of these people died “with” long COVID, rather than from the condition. In other words, long COVID may not be a direct driver of death, but rather a contributor, likely exacerbating existing conditions.
‘Cause of death’ is difficult to define
Long COVID is a relatively recent phenomenon, so mortality data for people with this condition are limited.
However, we can draw some insights from the experiences of people with post-viral conditions that have been studied for longer, such as myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS).
Like long COVID, ME/CFS is a complex condition which can have significant and varied effects on a person’s physical fitness, nutritional status, social engagement, mental health and quality of life.
Some research indicates people with ME/CFS are at increased risk of dying from causes including heart conditions, infections and suicide, that may be triggered or compounded by the debilitating nature of the syndrome.
So what is the emerging data on long COVID telling us about the potential increased risk of death?
Research from 2023 has suggested adults in the US with long COVID were at greater risk of developing heart disease, stroke, lung disease and asthma.
Research has also found long COVID is associated with a higher risk of suicidal ideation (thinking about or planning suicide). This may reflect common symptoms and consequences of long COVID such as sleep problems, fatigue, chronic pain and emotional distress.
But long COVID is more likely to occur in people who have existing health conditions. This makes it challenging to accurately determine how much long COVID contributes to a person’s death.
Research has long revealed reliability issues in cause-of-death reporting, particularly for people with chronic illness.
So what can we conclude?
Ultimately, long COVID is a chronic condition that can significantly affect quality of life, mental wellbeing and overall health.
While long COVID is not usually immediately or directly life-threatening, it’s possible it could exacerbate existing conditions, and play a role in a person’s death in this way.
Importantly, many people with long COVID around the world lack access to appropriate support. We need to develop models of care for the optimal management of people with long COVID with a focus on multidisciplinary care.
Dr Natalie Jovanovski, Vice Chancellor’s Senior Research Fellow in the School of Health and Biomedical Sciences at RMIT University, contributed to this article.
Rose (Shiqi) Luo, Postdoctoral Research Fellow, School of Health and Biomedical Sciences, RMIT University; Catherine Itsiopoulos, Professor and Dean, School of Health and Biomedical Sciences, RMIT University; Kate Anderson, Vice Chancellor’s Senior Research Fellow, RMIT University; Magdalena Plebanski, Professor of Immunology, RMIT University, and Zhen Zheng, Associate Professor, STEM | Health and Biomedical Sciences, RMIT University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Oven-Roasted Ratatouille
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This is a supremely low-effort, high-yield dish. It’s a nutritional tour-de-force, and very pleasing to the tastebuds too. We use flageolet beans in this recipe; they are small immature kidney beans. If they’re not available, using kidney beans or really any other legume is fine.
You will need
- 2 large zucchini, sliced
- 2 red peppers, sliced
- 1 large eggplant, sliced and cut into semicircles
- 1 red onion, thinly sliced
- 2 cans chopped tomatoes
- 2 cans flageolet beans, drained and rinsed (or 2 cups same, cooked, drained, and rinsed)
- ½ bulb garlic, crushed
- 2 tbsp extra virgin olive oil
- 1 tbsp balsamic vinegar
- 1 tbsp black pepper, coarse ground
- 1 tbsp nutritional yeast
- 1 tbsp red chili pepper flakes (omit or adjust per your heat preferences)
- ½ tsp MSG or 1 tsp low-sodium salt
- Mixed herbs, per your preference. It’s hard to go wrong with this one, but we suggest leaning towards either basil and oregano or rosemary and thyme. We also suggest having some finely chopped to go into the dish, and some held back to go on the dish as a garnish.
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 350℉ / 180℃.
2) Mix all the ingredients (except the tomatoes and herbs) in a big mixing bowl, ensuring even distribution.
2) Add the tomatoes. The reason we didn’t add these before is because it would interfere with the oil being distributed evenly across the vegetables.
3) Transfer to a deep-walled oven tray or an ovenproof dish, and roast for 30 minutes.
4) Stir, add the chopped herbs, stir again, and return to the oven for another 30 minutes.
5) Serve (hot or cold), adding any herb garnish you wish to use.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- Capsaicin For Weight Loss And Against Inflammation
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
Take care!
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Caffeine: Cognitive Enhancer Or Brain-Wrecker?
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The Two Sides Of Caffeine
We asked you for your health-related opinions on caffeine itself, not necessarily the coffee, tea, energy drinks, etc that might contain it.
We have, by the way previously written about the health effects of coffee and tea specifically:
As for our question about caffeine itself, though, we got the above-depicted, below-described, set of results:
- About 59% said “caffeine is a safe stimulant and cognitive enhancer”
- About 31% said “caffeine is a moderately safe recreational drug”
- About 8% said “caffeine’s addictive properties make it de facto bad”
- One (1) person said “caffeine will leave you a trembling exhausted wreck”
But what does the science say?
Caffeine is addictive: True or False?
True, though one will find occasional academics quibbling the definition. Most of the studies into the mechanisms of caffeine addiction have been conducted on rats, but human studies exist too and caffeine is generally considered addictive for humans, for example:
See also:
Notwithstanding its addictive status, caffeine is otherwise safe: True or False?
True-ish, for most people. Some people with heart conditions or a hypersensitivity to caffeine may find it is not safe for them at all, and for the rest of us, the dose makes the poison. For example:
❝Can too much caffeine kill you? Although quite rare, caffeine can be fatal in cases of overdose; such circumstances are generally not applicable to healthy individuals who typically consume caffeine via beverages such as tea or coffee.❞
this paper, by the way, also includes a good example of academics quibbling the definition of addiction!
Caffeine is a cognitive enhancer: True or False?
True, but only in the case of occasional use. If you are using it all the time, your physiology will normalize it and you will require caffeine in order to function at your normal level. To attain higher than that, once addicted to caffeine, would now require something else.
Read more: Caffeine: benefits and drawbacks for technical performance
Caffeine will leave you a trembling exhausted wreck: True or False?
True or False depending on usage:
- The famously moderate 3–5 cups per day will not, for most people, cause any such problems.
- Using/abusing it to make up for lost sleep (or some other source of fatigue, such as physical exhaustion from exertion), however, is much more likely to run into problems.
In the latter case, caffeine really is the “payday loan” of energy! It’ll give you an adrenal boost now (in return, you must suffer the adrenal dumping later, along with lost energy expended in the adrenaline surge), and also, the tiredness that you thought was gone, was just caffeine’s adenosine-blocking activities temporarily preventing you from being able to perceive the tiredness. So you’ll have to pay that back later, with interest, because of the extra time/exertion too.
Want to make caffeine a little more gentle on your system?
Taking l-theanine alongside caffeine can ameliorate some of caffeine’s less wonderful effects—and as a bonus, l-theanine has some nifty benefits of its own, too:
Enjoy!
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With all this bird flu around, how safe are eggs, chicken or milk?
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Enzo Palombo, Swinburne University of Technology
Recent outbreaks of bird flu – in US dairy herds, poultry farms in Australia and elsewhere, and isolated cases in humans – have raised the issue of food safety.
So can the virus transfer from infected farm animals to contaminate milk, meat or eggs? How likely is this?
And what do we need to think about to minimise our risk when shopping for or preparing food?
AS Foodstudio/Shutterstock How safe is milk?
Bird flu (or avian influenza) is a bird disease caused by specific types of influenza virus. But the virus can also infect cows. In the US, for instance, to date more than 80 dairy herds in at least nine states have been infected with the H5N1 version of the virus.
Investigations are under way to confirm how this happened. But we do know infected birds can shed the virus in their saliva, nasal secretions and faeces. So bird flu can potentially contaminate animal-derived food products during processing and manufacturing.
Indeed, fragments of bird flu genetic material (RNA) were found in cow’s milk from the dairy herds associated with infected US farmers.
However, the spread of bird flu among cattle, and possibly to humans, is likely to have been caused through contact with contaminated milking equipment, not the milk itself.
The test used to detect the virus in milk – which uses similar PCR technology to lab-based COVID tests – is also highly sensitive. This means it can detect very low levels of the bird flu RNA. But the test does not distinguish between live or inactivated virus, just that the RNA is present. So from this test alone, we cannot tell if the virus found in milk is infectious (and capable of infecting humans).
It’s best to stick with pasteurised milk. Amnixia/Shutterstock Does that mean milk is safe to drink and won’t transmit bird flu? Yes and no.
In Australia, where bird flu has not been reported in dairy cattle, the answer is yes. It is safe to drink milk and milk products made from Australian milk.
In the US, the answer depends on whether the milk is pasteurised. We know pasteurisation is a common and reliable method of destroying concerning microbes, including influenza virus. Like most viruses, influenza virus (including bird flu virus) is inactivated by heat.
Although there is little direct research on whether pasteurisation inactivates H5N1 in milk, we can extrapolate from what we know about heat inactivation of H5N1 in chicken and eggs.
So we can be confident there is no risk of bird flu transmission via pasteurised milk or milk products.
However, it’s another matter for unpasteurised or “raw” US milk or milk products. A recent study showed mice fed raw milk contaminated with bird flu developed signs of illness. So to be on the safe side, it would be advisable to avoid raw milk products.
How about chicken?
Bird flu has caused sporadic outbreaks in wild birds and domestic poultry worldwide, including in Australia. In recent weeks, there have been three reported outbreaks in Victorian poultry farms (two with H7N3 bird flu, one with H7N9). There has been one reported outbreak in Western Australia (H9N2).
The strains of bird flu identified in the Victorian and Western Australia outbreaks can cause human infection, although these are rare and typically result from close contact with infected live birds or contaminated environments.
Therefore, the chance of bird flu transmission in chicken meat is remote.
Nonetheless, it is timely to remind people to handle chicken meat with caution as many dangerous pathogens, such as Salmonella and Campylobacter, can be found on chicken carcasses.
Always handle chicken meat carefully when shopping, transporting it home and storing it in the kitchen. For instance, make sure no meat juices cross-contaminate other items, consider using a cool bag when transporting meat, and refrigerate or freeze the meat within two hours.
Avoid washing your chicken before cooking to prevent the spread of disease-causing microbes around the kitchen.
Finally, cook chicken thoroughly as viruses (including bird flu) cannot survive cooking temperatures.
Are eggs safe?
The recent Australian outbreaks have occurred in egg-laying or mixed poultry flocks, so concerns have been raised about bird flu transmission via contaminated chicken eggs.
Can flu viruses contaminate chicken eggs and potentially spread bird flu? It appears so. A report from 2007 said it was feasible for influenza viruses to enter through the eggshell. This is because influenza virus particles are smaller (100 nanometres) than the pores in eggshells (at least 200 nm).
So viruses could enter eggs and be protected from cleaning procedures designed to remove microbes from the egg surface.
Therefore, like the advice about milk and meat, cooking eggs is best.
The US Food and Drug Administration recommends cooking poultry, eggs and other animal products to the proper temperature and preventing cross-contamination between raw and cooked food.
In a nutshell
If you consume pasteurised milk products and thoroughly cook your chicken and eggs, there is nothing to worry about as bird flu is inactivated by heat.
The real fear is that the virus will evolve into highly pathogenic versions that can be transmitted from human to human.
That scenario is much more frightening than any potential spread though food.
Enzo Palombo, Professor of Microbiology, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Bamboo Shoots vs Asparagus – Which is Healthier?
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Our Verdict
When comparing bamboo shoots to asparagus, we picked the asparagus.
Why?
Both are great! But asparagus does distinguish itself on nutritional density.
In terms of macros, bamboo starts strong with more protein and fiber, but it’s not a huge amount more; the margins of difference are quite small.
In the category of vitamins, asparagus wins easily with more of vitamins A, B2, B3, B5, B9, C, E, K, and choline. In contrast, bamboo boasts only more vitamin B6. A clear win for asparagus.
The minerals line-up is closer; asparagus has more calcium, iron, magnesium, and selenium, while bamboo shoots have more manganese, phosphorus, potassium, and zinc. That’s a 4:4 tie, but asparagus’s margins of difference are larger, and if we need a further tiebreaker, bamboo also contains more sodium, which most people in the industrialized world could do with less of rather than more. So, a small win for asparagus.
In short, adding up the sections… Bamboo shoots, but asparagus scores, and wins the day. Enjoy both, of course, but if making a pick, then asparagus has more bang-for-buck.
Want to learn more?
You might like to read:
Asparagus vs Eggplant – Which is Healthier?
Take care!
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How long does back pain last? And how can learning about pain increase the chance of recovery?
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Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will have it this year.
Chronic pain, of which back pain is the most common, is the world’s most disabling health problem. Its economic impact dwarfs other health conditions.
If you get back pain, how long will it take to go away? We scoured the scientific literature to find out. We found data on almost 20,000 people, from 95 different studies and split them into three groups:
- acute – those with back pain that started less than six weeks ago
- subacute – where it started between six and 12 weeks ago
- chronic – where it started between three months and one year ago.
We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain.
Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access.
More pain doesn’t mean a more serious injury
Most acute back pain episodes are not caused by serious injury or disease.
There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine.
Your doctor or physio can rule out serious damage.
DG fotostock/ShutterstockEven very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system.
The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement.
The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain.
Reduce your chance of lasting pain
Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain:
- understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain
- reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal.
How to reduce your pain sensitivity and learn about pain
Learning about “how pain works” provides the most sustainable improvements in chronic back pain. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want.
Some programs combine education with gradual increases in movement.
Halfpoint/ShutterstockThese programs have been in development for years, but high-quality clinical trials are now emerging and it’s good news: they show most people with chronic back pain improve and many completely recover.
But most clinicians aren’t equipped to deliver these effective programs – good pain education is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure.
When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just been told it’s all in their head.
Community-driven not-for-profit organisations such as Pain Revolution are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than 80 local pain educators and supported them to bring greater understanding and improved care to their colleagues and community.
But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.
Sarah Wallwork, Post-doctoral Researcher, University of South Australia and Lorimer Moseley, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Want to sleep longer? Adding mini-bursts of exercise to your evening routine can help – new study
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Exercising before bed has long been discouraged as the body doesn’t have time to wind down before the lights go out.
But new research has found breaking up a quiet, sedentary evening of watching television with short bursts of resistance exercise can lead to longer periods of sleep.
Adults spend almost one third of the 24-hour day sleeping. But the quality and length of sleep can affect long-term health. Sleeping too little or waking often in the night is associated with an increased risk of heart disease and diabetes.
Physical activity during the day can help improve sleep. However, current recommendations discourage intense exercise before going to bed as it can increase a person’s heart rate and core temperature, which can ultimately disrupt sleep.
Nighttime habits
For many, the longest period of uninterrupted sitting happens at home in the evening. People also usually consume their largest meal during this time (or snack throughout the evening).
Insulin (the hormone that helps to remove sugar from the blood stream) tends to be at a lower level in the evening than in the morning.
Together these factors promote elevated blood sugar levels, which over the long term can be bad for a person’s health.
Our previous research found interrupting evening sitting every 30 minutes with three minutes of resistance exercise reduces the amount of sugar in the bloodstream after eating a meal.
But because sleep guidelines currently discourage exercising in the hours before going to sleep, we wanted to know if frequently performing these short bursts of light activity in the evening would affect sleep.
Activity breaks for better sleep
In our latest research, we asked 30 adults to complete two sessions based in a laboratory.
During one session the adults sat continuously for a four-hour period while watching streaming services. During the other session, they interrupted sitting by performing three minutes of body-weight resistance exercises (squats, calf raises and hip extensions) every 30 minutes.
After these sessions, participants went home to their normal life routines. Their sleep that evening was measured using a wrist monitor.
Our research found the quality of sleep (measured by how many times they woke in the night and the length of these awakenings) was the same after the two sessions. But the night after the participants did the exercise “activity breaks” they slept for almost 30 minutes longer.
Identifying the biological reasons for the extended sleep in our study requires further research.
But regardless of the reason, if activity breaks can extend sleep duration, then getting up and moving at regular intervals in the evening is likely to have clear health benefits.
Time to revisit guidelines
These results add to earlier work suggesting current sleep guidelines, which discourage evening exercise before bed, may need to be reviewed.
As the activity breaks were performed in a highly controlled laboratory environment, future research should explore how activity breaks performed in real life affect peoples sleep.
We selected simple, body-weight exercises to use in this study as they don’t require people to interrupt the show they may be watching, and don’t require a large space or equipment.
If people wanted to incorporate activity breaks in their own evening routines, they could probably get the same benefit from other types of exercise. For example, marching on the spot, walking up and down stairs, or even dancing in the living room.
The key is to frequently interrupt evening sitting time, with a little bit of whole-body movement at regular intervals.
In the long run, performing activity breaks may improve health by improving sleep and post-meal blood sugar levels. The most important thing is to get up frequently and move the body, in a way the works best for a person’s individual household.
Jennifer Gale, PhD candidate, Department of Human Nutrition, University of Otago and Meredith Peddie, Senior Lecturer, Department of Human Nutrition, University of Otago
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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