"[long term] risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection."
Though it does seem to make a distinction in grade ("these risks increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care)"), it doesn't seem to support the idea that the impacts are limited to the hospitalized.
They're just very small. If you look at the data, the risk ratios are in the range of 1.0x-2.0x, on outcomes which in healthy individuals are extremely rare to begin with. Same with the excess figures.
The logical conclusion given the rest of the data is that these outcomes would be concentrated in those who were very ill but below the threshold of hospitalization.
The study itself doesn't bin the groups far enough to show the implication for the asymptomatic or those with very minor symptoms, but there's a clear exponential trend that associates acute severity with long-term severity supra-linearly.
And 100% of the people I know who had it (measured in the tens; including myself) have had no lingering symptoms at all.
Anecdotes are not science. It is not "moving the goalposts" to note that lingering symptoms correlate with severity. The authors of the paper have already shown this, but didn't break it down enough.
That's for the entire cohort of non-hospitalized individuals, it's an average.
If you assume that they're uniformly distributed (e.g. if you assume that the relative risk of future myocarditis is identical for someone who has no symptoms, and for someone who's bedridden for a week with breathing difficulties but non-hospitalized), the figures show that if you're not hospitalized your risk of myocarditis and other heart issues is multiplied by about 2.
If the study were binned more finely I think you'd see a 5x multiplier if you have mild illness (mild in the clinical sense which simply means non-hospitalized but exhibiting symptoms) or no discernable effect if asymptomatic. I agree that there is no specific data for this, I'm extrapolating the curve.
> About half the people I know who got covid (and knew about it) had, or are currently having, a very unpleasant time.
We're not debating this point, this is a paper showing the correlation between the short term and long term effects of the disease.
Again, speaking from both personal anecdata and the wider scientific consensus - if you have symptomatic covid, it takes you a long time to feel "normal" again.
> if you have symptomatic covid, it takes you a long time to feel "normal" again.
The non-hospitalized group in this study includes both symptomatic and asymptomatic.
This comment thread is a bit weird, you seem to be attacking me on an emotional basis. I'm interested because I think this data shows a good correlation between severity of disease and severity of long term prognosis, that's all.
I have an interest in knowing this, as we all do, because like basically everyone else, I've had coronavirus, and if the data shows that this now means I have an elevated risk of heart issues I should be careful with things like heavy exercise. I don't think it does based on the correlation shown (I didn't have severe coronavirus), so it's actionable information.
If you disagree with my assessment that a 2x multiplier on a rare event is not worrisome, that's fine - that's just like, my opinion, man. :)
Your original comment reads as a much stronger statement:
> The meat of this seems to be in confirming that if you're not hospitalized the long-term effects are minimal. Not _zero_, but very small.
I think also 'the long-term effects are minimal' reads too broad since this study only covers a narrow set of long-term effects while your original comment can read as applying to all long-term effects.
> If you disagree with my assessment that a 2x multiplier on a rare event is not worrisome, that's fine - that's just like, my opinion, man. :)
I would want to look at the number of people effected a year before and after the change in order decide if it was worrisome or not.
Doubling of a very small number is not a "large statistical anomaly". Figure 5 shows that the difference is skewed strongly toward the hospitalized, and that the largest difference observed for the non-hospitalized cohort is measured at maybe 10 per 1,000 (1%) and most well-below that (single-digit difference per 1,000).
https://www.nature.com/articles/s41591-022-01689-3/figures/5
The abstract states that "These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection", but I'd urge attention to the data as this implies only that there is a detectable change, it's not a judgement on the size of the risk.
The worst cases are in intubated patients that basically lost proper oxygen flow for extended periods of time.