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@JohnsHopkinsSPH measured the prevalence of serious psychological distress in 1468 adults aged 18 years or older in Apr 2020 & compared it with an identical measure from the 2018 National Health Interview Survey (NHIS). Thread (1/6)

jamanetwork.com/journals/jama/…
In April 2020, 13.6% of US adults reported symptoms of serious psychological distress, relative to 3.9% in 2018. That’s a 3.5-fold increase. (2/6)
Age: symptoms of psychological distress were highest among young adults aged 18 to 29 years. Distress decreased with increasing age in 2020. Previously, no effect of age on distress. (3/6)
Ethnicity: Hispanic adults were most strongly affected. Previously not much influence of ethnicity on distress. (4/6)
Household income: also strongly associated with psychological distress. Also in 2018 but more so today. (5/6)
PUZZLING: #covid19 seems to have augmented psychological distress evenly among most strata (e.g. income) but seems to have affected the young in a disproportionate way. Something we should be watching closely. (6/6)
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Franz Wiesbauer, MD MPH
@medmastery
Short THREAD on chloroquine:

Mar 17: French doctor Didier Raoult et al publish a paper suggesting that hydroxychloroquine and antibiotic azithromycin could be effective against the disease. (1/6)

medrxiv.org/content/10.110… Image
Several public figures like @elonmusk jumped on the bandwagon promoting the drug based on results from basic research (not randomized trials, not even observational studies). (2/6) Image
And, obviously, the President also chimed in...(3/6) Image
Read 7 tweets
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Franz Wiesbauer, MD MPH
@medmastery
Great review of neuropathogenesis and neurologic manifestations of #covid19 published in JAMA Neurology on May 29 by @SpudichLabYale (THREAD, 1/10)
How does #sarscov2 get into the CNS? ACE2 receptors are expressed in multiple regions & on multiple cels of the human brain. (2/10)
Viral invasion of the CNS could happen in one of three ways. Nr 1: via the olfactory nerve (i.e., the transcribrial route). Olfactory nerve infection could also explain the common findings of loss of smell (anosmia) and loss of taste (ageusia). (3/10)
Read 11 tweets
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Franz Wiesbauer, MD MPH
@medmastery
THREAD: (1) A thought-provoking study by @Baric_Lab using reverse genetics and autopsy specimens demonstrates nasal ACE2 binding greater than in respiratory tract.

cell.com/cell/fulltext/…

#covid19 #coronavirus
(2) The nose contained highest percentage of ACE2 expressing cells. ACE2 levels waned in more distal bronchiolar & alveolar regions.
(3) ACE2 expression patterns were paralleled by high SARS-CoV-2 infectivity of nasal epithelium with marked reduction in distal lung (bronchioles & alveoli).
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