Is #LongCovid a "real thing," #MedTwitter? I'll let you decide.
Here's my own case: I'm a cardiologist(40s) with no prior medical Hx & have run tons of marathons & several 1/2 Ironman Tris.
In March '20, I fell ill and became quickly hypoxic and confused. It was COVID-19. 1/
I was hospitalized 2x for hypoxia within 2 months, but had "clear" CXR and chest CTs. My PaO2 was 78 on an ABG, but my PFTs were normal. I had left arm & leg numbness and apnea during sleep, which wasn’t worked up. I was sent home from hospital 2x with a Dx of "anxiety." 2/
My workup was delayed, because my colleagues thought I "looked fine” despite fact that I was hypoxic, confused, couldn't walk to the bathroom without dyspnea, and couldn’t work.
Over 2.5 years I was diagnosed w:
-COVID encephalopathy
-Anoxic brain injury w ischemic lesions 3/
-Microvascular angina
-Appendicitis(s/p appy)
-Acalculous cholecystitis (s/p chole)
-Stage 3 Chronic Kidney Dx
-Ischemic Colitis
-Leukopenia
-Sleep apnea
-POTS
...& More!
I NEVER had elevated d dimer, CRP, ESR, or troponin-I.
But did have evidence of vascular inflammation 4/
...But ONLY when more sophisticated vascular inflammatory markers were checked. Check out this new study, which showed 14 more "nontraditional" vascular transformation biomarkers were elevated in #LongCovid compared to controls.
molmed.biomedcentral.com/articles/10.11… 5/
Two of the vascular biomarkers, ANG-1 and P-SEL, provided 96% classification accuracy for LC. Finally...great biomarker candidates!
SARS-CoV-2 is causing an endothelial (blood vessel lining) inflammation and damage in at least some people with #LongCovid. Why is this an issue?6/
Damaged blood vessels can lead to blood clots and damaged organs. In #LongCovid, there is evidence of MICROvascular damage, sometimes ONLY seen with special testing. Here's a study where they used Xenon MRIs to look at lungs in people with LC: 7/
pubs.rsna.org/doi/10.1148/ra…
Hopefully you can see where I'm going here- #LongCovid is a "stealth" disease, which requires "outside the box" thinking.
While mine was a more severe initial case with some abnormal testing(eventually)...A person can have "normal" traditional testing, and still be quite ill. 8/
Many people with #LongCovid had/have very mild initial cases, but are suffering greatly & need to be taken seriously.
What's the point of this thread? Not for pity, vaccine debates, or treatment suggestions.
It's to convince YOU, dear colleagues, that #LongCovid is real.
/end
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