‘Highly biased’ paper shifts myocarditis blame from vaccines to ‘long COVID’

A new study published by Nature Medicine on the “Long-term cardiovascular outcomes of COVID-19“ purports to show that the recent sharp uptick in inflammatory heart disease (pericarditis and myocarditis) is due to post-COVID-19 syndrome, also referred to as "long COVID-19." 

Mainstream media celebrates

The study’s authors claim, “the increased risk of myocarditis and pericarditis reported in this study is significant in people who were not vaccinated and is evident regardless of vaccination status.” 

While not claiming to account for the entire spike in post-vaccination heart inflammation cases, the claim that something other than the vaccine causes heart inflammation is “getting widespread publicity.” The wording of the claim may even lead readers to believe that COVID-19 is responsible for all the excess myocarditis cases, shifting the blame from the vaccines to the virus.

Ignore the big picture?

Before addressing the methodology of the paper, it is worth noting the year in which an overall rise in myocarditis and pericarditis cases was seen. That would be 2021, the year of the mRNA vaccinations, not 2020, the year of COVID-19 without a vaccine. 

So what changed in 2021? COVID-19, as the name states, dates from 2019 and over 20 million Americans tested positive for COVID-19 in 2020. The mass mRNA vaccination program is the only relevant change in 2021, the year of the myocarditis spike, as seen in this chart based on data from the Vaccine Adverse Event Reporting System (VAERS), a vaccine safety program, co-managed by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration.

While the above data are limited to recently vaccinated individuals, spikes are also seen in the charts below.  These charts were created by attorney Tom Renz from Department of Defense (DOD) data, provided by whistleblowers he represents. They represent data for all military personnel, vaccinated and unvaccinated. While 2021 cases are still expected to rise, the data already show that cases of acute myocarditis and pericarditis rose 175% and 62%, respectively, compared to the previous 5-year averages.

Correction or Coverup?

Following the whistleblower’s testimony at a congressional roundtable, the  DOD “corrected” previous years’ case numbers. AFLDS has noted that the original (pre-correction) DOD numbers, including the 175% increase in myocarditis following the vaccinations, appear more reliable for several reasons. For example, Vaccine Safety Research Foundation Executive Director Steve Kirsch points out, in correcting supposedly “corrupt” data from previous years, that “only the event counts related to adverse events caused by the vaccines (as determined in VAERS) were affected by this ‘corruption'. That is, huge increases observed prior to the correction were only on symptoms that were vaccine related, not on other symptoms … How could a glitch in the computer only affect symptoms associated with the COVID vaccine?”

In any case, even the DOD’s later “correction” to previous years’ cases still shows an 85% increase in Myocarditis in 2021 over the previous 5-year average, as seen in this chart:

How long is long?

The DOD statistics include all US military employees, both vaccinated and unvaccinated, and still show no uptick in 2020 heart inflammation cases despite more than 6% of the population testing positive for COVID-19 that year. In fact, 2020 saw less myocarditis and pericarditis cases than the 5-year averages.

Thus, to “blame” COVID-19, as opposed to the COVID-19 vaccines, for the spike in myocarditis, “long COVID” would have to be more than one year long, and, at the same time, would have to only begin a year after testing positive.

The Mayo Clinic, however, defines post-COVID-19 syndrome (long COVID-19) as health issues, “generally considered to be effects of COVID-19 that persist for more than four weeks after you've been diagnosed with the COVID-19 virus.”

That is, they are already present within four weeks of testing positive for COVID-19 and they then “persist". The statistics from the DOD do not support any claim that myocarditis was prevalent within 4 weeks of the millions of positive tests of Americans in 2020. To the contrary, as mentioned above, they show a decrease  in 2020 myocarditis cases in the military.

Flawed methodology

Professor Vinay Prasad, MD, MPH, a supporter of COVID-19 mRNA vaccines who was “courageous enough to call out the latest CDC mask study” as “irredeemably flawed” just last week, has put his analytical skills to work on this new study attempting to blame COVID-19 for the uptick in heart inflammation. Dr. Prasad finds the study methodology to be severely lacking on several fronts.

Exclusion of healthier COVID positive people

Prasad takes the researchers to task for limiting their analysis to the sickest subjects.  “The authors do not use a sero-prevalance denominator, so they are only showing outcomes from people sick enough to seek medical care (either for covid or other reason) and then get tested for COVID … 

“… people who had covid are vulnerable in ways not captured in the record. That is both why they got COVID, and why they went on to have bad CV [cardiovascular] things happen to them in greater numbers.”

Overtesting the subjects

This exclusion of healthier subjects causes a huge bias in the results, as summarized by Prasad. "… the study cannot separate the effect of COVID from the effect of getting ensnared by the medical system. There is an old saying in medicine, ‘show me a healthy person, and I will show you someone who has not had enough tests.’ The more you test the people who come to the hospital, the more diagnoses you will find. The control patients did not get the full force of American testing exceptionalism.”

Early cutoff date

Though this paper was just released in February 2022, the authors do not explain why they limited their study cohort to, “participants who had a positive COVID-19 test between 1 March 2020 and 15 January 2021.” Using a cutoff date of more than one year before publication means that, “likely nearly no one in the dataset had been vaccinated prior to getting COVID… These data apply to what COVID does to an unvaccinated person who presents to medical care at a Veterans Hospital prior to vaccine, and no other group. It does not apply to Omicron. It does not apply to breakthrough infections.”

Exclusion of most COVID-19 positive people

The researchers reported that they, “used national healthcare databases from the US Department of Veterans Affairs (VA).” Dr. Prasad points out that they thereby excluded not only all Americans who are not treated at VA health care facilities, but even veterans themselves if they were not tested there.  “The study does not include people who had COVID-19 and never sought testing (—this would need seroprevalence to establish the cohort) or got tested elsewhere and recovered.”

So this research has no applicability to people who “had COVID and either didn’t get tested, got home tested, or got tested outside their primary health care network.”

Failure to compare COVID to Flu

Prasad is left bewildered by another omission of the investigators. “We know the authors have access to influenza data. I know that because they used it before in a BMJ paper. So what am I to think that they don’t use that here? I want to know if COVID is WORSE for cardiovascular risk than influenza in years prior. It is highly curious that they do not provide this data.”

Death of real medicine

Prasad presents a sobering conclusion to his review. “Investigators are highly biased as post COVID is a gold mine for research funding. The more you fund something, the more you will find it as well. It would be wonderful if medicine returned to scientific principles, ran careful studies, and had appropriate skepticism, but that medicine is dead. COVID killed it. It was patient zero.”