WesElyMD Profile picture
Husband & Dad. ICU Doc. Vanderbilt. @CIBScenter studies Covid & Long Covid, ICU Survivorship, PICS, Dementia, Delirium. Tweets my own. Still learning.

May 30, 2023, 12 tweets

1/🧵 Long COVID’s “Disability Roulette”

🔺No longer a mass Death event…
🔺COVID-19 is an ongoing mass #Disability event
🔺You & I might get #LongCOVID
🔺But society is yawning

This thread unpacks science, policy & hope.

No Paywall Boston Globe link:
bit.ly/3OGfSb1

Friends, I have an entire 20 tweet thread 🧵 uploading here (links, PDF images, etc etc -

but it’s stuck in twitter world.

I apologize for the glitch here. Oy!

2/ The heartbreak we see has scientists working to discover answers💔

Drs. @VirusesImmunity & @PutrinoLab explore hypotheses

📍viral persistence
📍vital reactivation
📍autoimmunity
📍inflammation

Testing antivirals, immune modulators, blood thinners. bit.ly/45E1F4v

3/ Data from 223 unvaxxed Mild/Mod COVID survivors

✔️ Show abnormal MRI 🧠 white matter inflammation at 9 mo vs matched controls
✔️Prolonged cellular changes occur & we don’t yet know the significance
✔️Clinical outcomes vary strikingly across studies

bit.ly/43f0vL2

4/ Brain inflammation in other types of #Dementia

🔸Is often present YEARS before memory & executive dysfunction deficits appear
🔸Don’t be complacent or assume #LongCOVID is safe for peoples’ brains
🔸It’s precarious!
🔸 I covered this haunting brain science in 🧵👇

5/ Dr. @EricTopol tackles important new COVID-19 brain data beautifully

Topol warns us…⛔️
“Recall post-polio syndrome appears 15-30 YEARS after polio - a leading theory is viral persistence.

H/T fig @SutherlandPhD

Read his new substack here: bit.ly/3OMOzfi

6/ COVID survivors who died of non-covid causes (N=20)

📌 In autopsies, 60% had “enormous amounts of Spike Protein” in skull, meninges & brain - ✍🏻 author @erturklab
📌Not seen in controls
📌Similar findings in skull & brain of mice
📌 Vaxx not studied

bit.ly/3MZDINI

7/ It is highly curious how these problems occurred in “neck-up” skull-meninges-brain structures 🤔

📎 Think again of long-term implications of this virus
📎 When >200 symptoms/signs occur in #LongCOVID after even mild infection
📎 Direct + indirect viral causes are at play

8/ We are sorting out risk factors for Long COVID

✔️ Eg: Obesity dampens the initial immune response to COVID
✔️ Pts w high BMI have less expression of IFN & TNF
✔️ “Leptin Resistance”👇
✔️ Could this allow ongoing viral replication & worse #LongCOVID?

bit.ly/43vvZfB

9/ More direction come from >200k Medicare pts

🔹Using narrow and broad definitions of Long COVID
🔹Risk factors found = hypertension, chronic lung disease, obesity, diabetes & depression
🔹Time between initial COVID & LC was ~8 mos

bit.ly/3MCrvgt

10/ How “Long” is Long COVID?

☑️ Swedish study found 85% of people w LC at 4 mos still had cognitive, muscle & fatigue problems at 2 yrs😔
☑️ Of those unable to work at 4 mo due to LC, ~50% unable to work at 2 yrs
☑️ Massive implications if plays out 🌎

bit.ly/3WG6Cp5

11/ A new “Scorecard for PASC” @JAMA_current

✏️ This is meant #Research
✏️ Not validated for clinical diagnostic use
✏️ N=9,764 pts

Notable:
10% pts had PASC at 6 mo
⬆️ COVID Reinfections ⬆️LC risk!

bit.ly/45ztWsQ

TY @tthaweethai @LisaAMcCorkell @leorahorwitzmd

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