Thread by @drclairetaylor

If you do one thing today, listen to cardiologist Dr Rae Duncan on #COVID19 #LongCovid &what Covid could be doing to our children.
It is heartfelt and genuine from someone who has seen the devastating effects of long Covid.
Excerpts below.
via @YouTube

She details that prior to the pandemic the average age of referrals to her cardiology clinic was aged 55-80yrs.
Now it is 16-40yrs
Now at least 50% are long Covid with cardiovascular symptoms.

What she says about these patients is utterly heartbreaking.
It mirrors what I see.
Some cannot stand up due to severe #POTS
Some are in wheelchairs
Some are in bed 23 hours a day with only 15 minutes where they can speak
#LongCovid

She has a virtual clinic like me- we see the sickest people who can’t get to clinic
‘ they have become progressively disabled with each subsequent infection’

‘This virus is running rampant’

‘The narrative that Covid is over is wrong&provides a breeding ground for new variants

‘I don’t see how this is sustainable in the long term’

‘I am seeing the devastating impact of this virus on young lives that have been damaged on a massive scale.
It makes me sad, it makes me upset, it makes me angry, because some of these could be prevented, I think’

‘ there is a need to reduce the reinfection rates from this virus.

We already know from published data that reinfection cumulatively increases your risk of long Covid&cardiovascular complications.

I think there needs to be a plan for the level of care needed going forwards’

‘We know now that Covid is causing endothelial damage. (Inflammation in the inner lining of the blood vessels).
This is a precursor to
- long Covid
- blood clots
- development of atherosclerosis

‘There are papers from multiple continents in millions of patients,all showing the same thing- that there is a significant increased risk of cardiovascular complications-not just in those with long Covid, but anyone infected with Covid’

Evidence that there was an extra 7200 heart attacks/strokes and extra 3500 DVTs 12 months after Covid out of 1.4 million infections.
Evidence for increased cardiovascular deaths up to 18 months after Covid.
These were massive UK studies.

Study showing that risk of cardiovascular events with Covid are higher in the unvaccinated.

We know from studies in adults that the more times you get infected with Covid, the higher those risks become.

Reinfection increases
-long Covid
-cardiovascular complications
-gastrointestinal complications
-neurological complications
-hospitalisation
-death

CHILDREN
Therefore- naturally- she shares my concern about what the potential impact could be on children.
We don’t have much research as it was originally believed Covid didn’t really impact children…..

At first it was believed that

-children don’t get Covid
now we know they do.

-children don’t transmit Covid
now we know they do&school is a major source of transmission

-children don’t get sick-
PIMS-TS/long Covid

-mild infection&recover
‘But do they, do we know that?’

What evidence do we have?
1. In lungs
Mild Covid recovered children and children with long Covid
Specialised scanning found subclinical damage in both groups…

2. Diabetes
There has been some data suggesting an increased incidence epidemiologically in children infected with SARS-CoV-2 with type 1 diabetes’

‘Correlation doesn’t prove causation but that obviously needs to be looked at’

Type 1 diabetes is life changing and life long.

3. Children’s hearts
- study used strain imaging to look at the hearts of children who had mild Covid and recovered.
- Dr Duncan is a strain imaging expert
- it looks at the contractility of the heart..

Strain imaging has been used in studies in adults
‘It can give us very early insight into subclinical heart muscle damage that is not visible to the naked eye.
It can show over time these may be individuals who could be at risk of heart failure (in adults)’

Results:
Took a group of children who had mild Covid& recovered and compared to a group without Covid infection
-subclinical reduction in contractility in the hearts of the children infected with Covid for several months after
-small study so she doesnt want to over egg it

Contd
The children did not have symptoms
She is not suggesting they have heart failure
It’s an observation from a small study
We don’t know if these findings on imaging will improve, normalise, get worse
But these were the results

Her concern about this is:

IF we are beginning to see a signal that Covid MAY be causing subclinical contractile abnormalities in the hearts of kids and we do nothing to reduce the reinfection rate, and ‘learning to live’ with Covid means 2 infections a year, her worry is..

‘What is that going to do to the organs of our children cumulatively over time?

‘Because this isn’t a cold virus it’s a SARS2 virus.’

‘My concern is how many infections can a child’s body take repeatedly before they go on to become disabled adults?’ Cont

‘Now I don’t know the answer to that, I don’t think anybody knows the answer to that, I don’t know if that will happen or not, but I don’t think we should be sitting back and playing roulette, and waiting to find out’

‘We need to have a think about how to reduce the reinfection rates, how we protect our children&citizens.

How we invest in clear air.
How we reduce the risk of catching this.

At the moment we do not have a cure.
We need investment in studies.
We need studies fast tracked.

‘I strongly feel that the precautionary principle has to be applied’

Dr Rae Duncan @Sunny_Rae1
Consultant cardiologist
Logical, evidence based plea for a rethink of the let it rip policy, especially with regards to our children.
#COVID19 #LongCovidKids #CleanAirClassrooms

@WHO @LongCovidKids