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1) This new paper in the Lancet suggests that the risk of Long Covid has substantially decreased compared to the pandemic period. The excess prevalence of severe symptoms self-attributed to SARS-CoV-2 was only 0.3% after 180 days. A brief breakdown...

2) This study was part of VASCO, a prospective cohort in the Netherlands to estimate COVID-19 vaccine effectiveness. Participants were included between September 2023 and January 2024, corresponding to the autumn Omicron JN.1 wave.

3) Infection status was largely based on a self-reported SARS-CoV-2 test. The researchers were able to compare ca 5000 people who reported a positive test to matched controls who did not. The study recorded symptom data before and after the infection.

4) Symptoms were assessed in multiple ways. They asked about 23 symptoms whose severity was rated on a 5-point scale. The severity of the symptom had to be lower than 3 pre-infection, and it had to increase to 3 points or higher post-infection.

5) In other words symptoms didn't had to be new to be included as Long Covid symptoms, an increase in severity also counted. There was also a direct question: “Are you currently experiencing long-term symptoms that you believe are partly or entirely caused by the coronavirus.”

6) Patients could indicate "none, mild, or severe" symptoms. The results showed an excess prevalence of 3.2% for mild and 0.3% for severe symptoms after 180 days but afterwards the difference between groups was no longer significantly different.

7) A previous Dutch study on the Lifelines cohort reported a Long Covid prevalence of 12.7% after 90-150 for the Alpha or Delta variants between 2020 and 2021. So it looks like the risk has decreased substantially due to vaccination, previous infections, milder variants, etc.

8 A caveat is that the study only recorded how patients feel for a year, it didn't measure a potentially increase risk for other negative health outcomes. Severe LC patients might have been too ill to participate and the VASCO cohort isn't fully representative of the population.

9) The clarify: the study doesn't show that the risk of Long Covid is gone, but that the risk likely has decreased substantially since the pandemic.

Who paid for it? The Dutch government - who has been spectacularly almost Tegnell-like in their downplaying of LongCovid and masks. Cohort issues for both infected and uninflected identification was terrible. Age of patients wasn’t representative at all and on and on. I’d say take this down.

Uninfected had negative serology and results were similar for those aged 18-59. Lots of limitations in this study but I think the main conclusion that LC risk has declined substantially since the pandemic, holds.