Long COVID cause(s)?

Preprint paper linked and early days yet, but opinions, docs?

Interesting article. It will be interesting how it plays out. The title is somewhat inaccurate as from the article it is proposed that the cause is actually a lingering infection, and the spike protein is just the marker of that infection or perhaps the mechanism of action, I expect the anti-vax people will jump on such misconceptions that the title suggests. One wonders if the title was purposefully chosen for that reason.
We know other viruses can survive inside the body for years or decades, so this may well be the mechanism
One of the problems with study of these sorts of problems is the overlap between “long Covid” and many other illnesses, particularly depression and conversion type illnesses. There is a long history of similar symptoms being labeled chronic fatigue, multiple environmental allergy, chronic EBV, chronic Lyme, fibromyalgia, It may well be that all of these syndromes have a physiologic basis, but they too have the problem of sifting out which people have that specific problem vs. all the other overlapping problems with similar symptoms.
Ultimately, it makes research difficult and results confusing. One interesting thought is that if persistent spike protein due to chronic infection is the cause, then preventing infection through immunization is even more important. Unfortunately, with current variants, prevention is looking less and less likely in the long run,.

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