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Does anti-viral treatment in acute COVID infection decrease the risk of developing the Long-COVID Syndrome?, QJM: An International Journal of Medicine, Volume 114, Issue 12, December 2021, Pages 841–842, https://doi.org/10.1093/qjmed/hcab319
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A question that has often been asked is do vaccines prevent Long-COVID Syndrome? And, additionally, does anti-viral treatment of acute coronavirus disease-19 (COVID-19) infections reduce the risk of developing subsequently the Long-COVID Syndrome. We have some early epidemiological evidence that vaccines potentially do reduce the risk of the Long-COVID Syndrome but little evidence to date that specific anti-virals have the potential to also reduce the subsequent risk.
In a community population of 1.25 million individuals who downloaded a COVID symptom App, those who had dual vaccinations and experienced breakthrough COVID-19 infection—had significantly reduced disabling symptoms beyond ×28 days compared to unvaccinated individuals.1 In the unvaccinated population, 11% of individuals had persistent symptoms vs. 5% in the vaccinated population.
The QJM has recently published original clinical trials and meta-analyses of treatments for acute COVID-19 infections.2–5 In the current issue, we publish work from Dr Boglione and colleagues from the University of Eastern Piedmont on their analysis of risk factors for the Long-COVID Syndrome. This is a single-centre prospective study of discharged hospital patients followed up for 6 months. They found 16% of this patient population has significant limitations in everyday life at this time-point. Not surprisingly, the authors found that the incidence of the Long-COVID Syndrome was proportional to the severity of the acute illness in hospital, What was surprising was the finding of a highly significant effect of Remdesivir treatment and a significantly less risk of developing this syndrome. While this is a single-centre study with a modest number of recruited patients—it does raise the tantalizing possibility that treatment with Remdesivir and potentially other anti-viral therapies in the acute stages might have a potential role in reducing the risk of subsequently developing this disabling syndrome.
The value of Chinese Traditional Medicine (TCM) in asthma
Traditional Chinese Medicine (TCM) has a long and valued history. The earliest known written record of traditional Chinese medicine is the Huangdi neijing (The Yellow Emperor’s Inner Classic) from the third century BC. This work laid the foundation pillars that form the basis for clinical practice today. Critics of TCM in the Western world cite that the concepts and treatments have not been validated by appropriate clinical trials. The QJM has over recent years been publishing epidemiological observational studies on the outcomes of TCM-treated patients with a variety of disorders including stroke and cancer.6,7 In the current issue of the Journal, we publish a retrospective analysis by Dr Liao and colleagues from Chung Shan Medical University in Taiwan of a substantive number of asthmatic patients in which they compare healthcare utilization of asthmatic patients treated with TCM (n = 5235) to a control non-TCM-treated group (n = 5235). TCM-treated asthmatics were significantly less likely to present to the Accident and Emergency Department and less likely to be admitted (odds ratio: 0.63). While acknowledging this to be a retrospective study—it does suggest that using Traditional Chinese Medicine in Asthma is equally efficacious to western medicine.
