NEW—Long term chronic persistent #COVID19 illness finally makes it into NIH guidelines! #LongCovid has long been discussed, but thus formalizes the problems as part of COVID recovery. Thread 🧵. covid19treatmentguidelines.nih.gov/overview/clini…
2) “Persistent Symptoms or Illnesses After Recovery from Acute COVID-19:

There have been an increasing number of reports of patients who experience persistent symptoms after recovering from acute COVID-19.
3) “At this time, there is limited info on the prevalence, duration, underlying causes, and effective management strategies for these lingering signs and symptoms. Some of the symptoms overlap w/ post-intensive care syndrome that has been described in patients without COVID-19
4) “but prolonged symptoms and disabilities after COVID-19 have also been reported in patients w/ milder illness.
Some persistent symptoms that have been reported include fatigue, joint pain, chest pain, palpitations, shortness of breath, & worsened quality of life.
5) “One study from China found that pulmonary function was still impaired 1 month after hospital discharge.17 A study from the United Kingdom reported that among 100 hospitalized patients (32 received care in the ICU and 68 received care in hospital wards only)...
6) “72% of the ICU patients and 60% of the ward patients experienced fatigue and breathlessness at 4 to 8 weeks after hospital discharge. The authors of the study suggest that post-hospital rehabilitation may be necessary for some of these patients.
7) “Neurologic and psychiatric symptoms have also been reported among patients who have recovered from acute COVID-19. High rates of anxiety and depression have been reported in some patients using self-report scales for psychiatric distress...
8) “Younger patients have been reported to experience more psychiatric symptoms than patients aged >60 years. ⚠️
9) “Patients may continue to experience headaches, vision changes, hearing loss, loss of taste or smell, impaired mobility, numbness in extremities, tremors, myalgia, memory loss, cognitive impairment, and mood changes for up to 📌 *3 months* 📌after diagnosis of #COVID19.
10) “More research is needed to better understand the pathophysiology and clinical course of these post-infection sequelae and to identify management strategies for patients.

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More from @DrEricDing

16 Oct
BREAKING—Trump WH had installed 2 political operatives at CDC to control #COVID19 information, sometimes at odds with scientific evidence. The 2 appointees, w/ no public health background, tasked w/ “keeping eye” on Dr Redfield & scientists. Dystopian. 🧵
apnews.com/article/electi… Image
2) Reminds me of the old song about Soviet commissars—or political officers who watched over all activities to assure political purity.

If anyone remember “The Hunt for Red October”, they were the infiltrators to quash disloyal activities.
3) “The appointments were part of a push to get more “politicals” into the CDC to help control messaging after a handful of leaks were “upsetting the apple cart,” said an administration official.
Read 7 tweets
16 Oct
⚠️BREAKING—huge SOLIDARITY randomized trial by @WHO shows that the drug Remdesivir had **no effect** on reducing #COVID19 mortality at 28 days. The widely touted & hyped drug taken by Trump, also did *NOT prevent initiation of ventilation*, *nor shorten hospital stay*. Nothing! Image
2) and they indeed checked subgroups. and did a meta analysis pooling. Still nothing burger 🍔 for remdesivir. medrxiv.org/content/10.110…

➡️ THIS IS WHY WE DO TRIALS FOLKS!!! Image
3) Also this wasn’t a tiny study. It was done in 405 hospitals worldwide 🌎 in 30 countries—11,266 adults were randomized, w/ 2750 allocated Remdesivir, 954 Hydroxychloroquine, 1411 Lopinavir, 651 Interferon plus Lopinavir, 1412 only Interferon, & 4088 no study drug.

EPIC size.
Read 4 tweets
15 Oct
📍TRUMP WH MUZZLED CDC—Trump wanted churches open. So, WH told the CDC to remove church “choir singing” from guidelines of risky #COVID19 activities. CDC refused to edit & published anyway. WH Pence office went ballistic—forced deletion from CDC website. 🧵propublica.org/article/inside… Image
2) “Senior CDC staff describe waging battles that are as much about protecting science from the White House as protecting the public from COVID-19. It is a war that they have, more often than not, lost.
3) “Employees spoke openly about their “hill to die on” — the political interference that would prompt them to leave. Yet again and again, they surrendered and did as they were told. It wasn’t just worries over paying mortgages or forfeiting the prestige of the job.
Read 6 tweets
15 Oct
📍NEW: CDC reports an outbreak at an indoor recreational ice hockey near Tampa Bay, Florida. 15 players & staff fell in soon after, 13 confirmed #COVID19 positive. Both teams infected—and not even everyone tested. Only 1 spectator (not tested). Worrying outbreak for any sport. 🧵 Image
2) “Teams A and B, each consisting of 11 players (typically six on the ice and five on the bench at any given time), included men aged 19–53 years. During the 5 days after the game, 15 persons (14 of the 22 players and a rink staff) experienced symptoms: 13 of 15 lab confirmed.
3) “On June 19, 2020, the Florida Department of Health was notified of a team A player (the index patient) who experienced fever, cough, sore throat, and a headache beginning on June 17, the day after he had participated in an evening game; 2 days later, test positive.
Read 8 tweets
15 Oct
📍Trump’s “immunity” is likely artificial & temporary says experts. His synthetic antibodies could actually prevent his body from making own. Regeneron antibodies have a half life of 21–25 days—thus, by Oct 23, half gone by then. #COVID19 #TrumpCovid 🧵 nytimes.com/2020/10/14/hea…
2) “Without replenishment, this decline may leave Mr. Trump even more susceptible to the virus than most patients who have recovered from Covid-19, several experts warned.”

nytimes.com/2020/10/14/hea…
3) “Moreover, the steroid treatment the president received early in the course of his illness suppresses the body’s natural immune response, including its propensity to make antibodies of its own.”

nytimes.com/2020/10/14/hea…
Read 5 tweets
15 Oct
WORRISOME OUTBREAK—this one Canadian gym did almost everything right—6 feet apart, symptom screenings, cleaning, 50% capacity, masks before and after class. But no air ventilation improvement. Now an outbreak of 61 primary and secondary #COVID19 cases. 🧵
cnn.com/2020/10/13/wor…
2) the gym also tracked all those in attendance at each class, masking before and after classes, laundering towels and cleaning the rooms within 30 minutes of a complete class, said Dr. Elizabeth Richardson, Hamilton's medical officer of health.
But it still wasn't enough.
3) “Public health officials are very concerned about the number of cases and the size of the outbreak, especially because the city is not currently a hotspot and the facility was not ignoring health protocols, they said in a statement to CNN.
Read 7 tweets

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