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, 19 tweets

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

12/ Each week ~25,000 people join >10M in US (>65M 🌎)

Suffering memory loss, heart problems, dizziness, extreme fatigue, sexual dysfunction+

Consistent data show ~10-12% of people develop LC after acute COVID

⬆️es w repeat infxns & unvaxxed

bit.ly/43azA2N

13/ How bad is Long COVID⁉️

⚠️ Study of N=536 Long COVID Wave 1 or 2 pts (87% never hospitalized)
⚠️ Found single & multiple organ impairment at 6 mo in 69% & 23% ⚠️ At 1-year it was basically the same w 59% & 27%

Crazy stuff not to be taken lightly

bit.ly/3qiOh5x

14/ Long COVID is a public health disaster hiding in plain sight

People are losing hope Some of @POTUS’s $5B successor to Warp Speed, Project NextGen, should be earmarked to develop treatments for #longCOVID

bit.ly/3WEAxOu

15/ NIH-sponsored study of 825 pts in 44 centers
@JAMA_current

📍Found 56% of previously hospitalized COVID survivors struggled
📍To pay bills at 6 mos due to ongoing health problems
📍Even bathing & preparing meals was hard
📍Quality of Life deficits👇

bit.ly/3YGOM5k

16/ Ongoing Brain problems are a plague in Pts with Long COVID

▪️Brain🔬reveals loss of supportive cells called glial cells & death of neurons
▪️Early dementia-like signs in too many #LongCOVID pts
▪️Even those who had mild symptoms during initial COVID

bit.ly/3ItiANv

17/ Society just doesn’t seem to care about Long COVID

🚫 The $1B earmarked for LC research has yielded precious little
🚫 Mental & bureaucratic wranglings have stalled study teams
🚫 LC communities are beyond frustrated by delays

H/T @rachelcohrs

bit.ly/3ql4N5a

18/ Science doesn’t validate injury

People do that, or they don’t

A recent @NEJM piece on “Facing the New COVID-19 Reality” did not even mention Long COVID 🤯

Government & policy makers operationalize actual relief…or they don’t 👎

bit.ly/3K1mIW4

19/ Vaccines - a few words please…

✔️ Importantly, there is an entity of vaccine-injury that looks very much like Long COVID
✔️ It’s real. It’s very rare compared to COVID-induced viral injury
✔️ And it’s heartbreaking
✔️ Still, the 20% in US who have a full series of shots… twitter.com/i/web/status/1…

🎥 20/fin - My Hopes

🚩 Pts living w LC are the experts – LISTEN to them
🚩 Let’s find answers through hard-core science
🚩 New AHRQ network👇 is a start to make it easier for pts to get treatment, disability services, support groups
H/T @pamelarbishop

bit.ly/429RbXr

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