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3 Apr, 10 tweets, 3 min read
A thread on possible clotting risks, elevated D-Dimer and Long Covid.
Disclaimer - this is not medical advice. In health matters speak to a doc. You do have a right to ask your doc though on things you read about, it is your health after all
D-dimer Wiki

In addition, it is used in the diagnosis of the blood disorder disseminated intravascular coagulation.[1] A four-fold increase in the protein is a strong predictor of mortality in those suffering from COVID-19.
D-dimer test is prescribed nowadays in acute phase to be sure that there is no clotting risk. I do not hear of it as much for most patients post-Covid (after few months).
I have heard of at least a few cases of sudden strokes/pulmonary embolism events 2-3 mths after recovery
Some research paper data excerpts:

1. Prolonged elevation of D-dimer levels in convalescent COVID‐19 patients is independent of the acute phase response…
Participants were assessed at a median of 80.5 (range 44–155) days after initial diagnosis.
For reference values, in lab reports I have seen <0.6 microgram/ml as the reference level for normal. Here in chart, it is in nanogram/ml (divide it by 1000). They have marked an upper boundary at 0.5 microgram/ml.
5/n Image
See number of observations above the normal level even after 2-3 months.

One more:

‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19…
Chart from supplemental material link given inside the paper…
8/n Image
Similarly see - a fraction of the people have elevated levels after even 2 months.
Those who have had Covid may want to show this to your docs.

Wish everyone good health.

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More from @CapOrbit

4 May
I read a transcript of a podcast where Graham Duncan, co-founder of East Rock Capital, a multi-family office investment firm that manages $2 billion for a small number of families was interviewed
Some good excerpts in the thread below:…

On not being rigid in investment management. Not being hung up on labels and identity but rather focusing on the goal and adapting to markets which are dynamic.

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On the topic of win rates...

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Read 4 tweets
1 May
Thread on long Covid and health risks.

Recovery from Covid is understood by most to be when acute phase symptoms, including fever, cough, fatigue, headaches, go away.

Are there hidden risks beyond the acute phase? Are some of them even fatal? Could some be prevented?
1/n Image
There is ample evidence that the body does not come back to pre-Covid equilibrium for some people, partly due to permanent damage to cells in different organs (as varied as pancreas, brain, lungs) for some and/or heightened inflammatory state in the body.

In light of this, it is important to recognize that there is need for caution even later. The impact of some of these long-covid conditions can be non-fatal but chronic. More worrying is the potential risk of death even months later.
Read 25 tweets
2 May 20
Thread - A book topic that I had read some time ago on the factual vs. the myriad counterfactual cases got me interested in this way of looking at events/actions.

On Covid (factual)
Deaths caused to date - 1218.
The lockdown has reduced what might have been a larger number
Tuberculosis in India - data for 2020 and 2019. Notified patients have decreased by 2.5 lakh. Big drivers of the decrease would be lack of transport/healthcare diverted to Covid/migration, primarily due to the lockdown.

2/n ImageImage
Source of above data:…

Number of patients in India - 26.9 lakh. Notified patients - 19.9 lakh…

Number of patients dying of TB in India - 4.2 lakh…

Read 11 tweets
10 Feb 20
Thoughts on impact of nCov on chemicals sector in India.

1. One cannot use a broad brush approach. Many companies have diversified revenue streams. They sell many different chemicals.

2. To make a chemical here you need the RM, which could be imported from China. Does the listco in India have access to alternate sources? At what cost?

3. A Chinese plant may be shut down because of restrictions. World-level supply comes down for that chemical. In this case, the Indian company can benefit it it did not have RM dependency on China (a good chance of that happening in chemicals, not in the pharma sector though)
Read 6 tweets
28 Nov 19
A thread on Mudra loans. They are in the news again after the RBI flagged off the fear of NPAs in Mudra loans.

Most people do not know (including the press and the sell-side) that the word "Mudra" has 2 meanings.

1. Mudra loans (as spoken of in press)
2. MUDRA, the company
Mudra loans - basically optics/marketing exercise. Quoting from the Mudra website - "All loans sanctioned on or after April 08, 2015 up to a loan size of 10 lakh for non-farm income generating activities will be branded as PMMY loans."
Imp. point - Such loans are not new
From the Mudra FY18 AR:

Imp. to note - Rs. 5.44 lakh crore disbursed by other institutions including banks, NBFCs, MFIs, not lending by the government specifically
Read 17 tweets
14 Oct 19
...the SIP closure ratio, which is the number of discontinued SIPs as a % of new SIPs registered, rose to 66% in Aug and Sep.

This meant that for every 3 SIP accounts opened, 2 were discontinued over the last 2 months.…
on SIP equity flows :
Aug-19 saw around Rs. 82 bn of SIP and Rs. 7 bn of lumpsum inflows.
Sep-19 saw around Rs. 89 bn of SIP inflows, Rs. 20 bn of lumpsum outflows.

Until when will expensive names be held up? Let's see over the next few months.
Large Cap SIP returns (sorted on 2yr) from Moneycontrol:
Read 5 tweets

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