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Krutika Kuppalli, MD FIDSA Profile picture
@KrutikaKuppalli
Apr 14, 2021 • 8 tweets • 3 min read • Read on X
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1/
Information regarding the six patients who have developed CVST after the #JohnsonandJohnson #CovidVaccine
- All were white females
- Only one was on oral contraceptives
2/ Clinical features of the patients
3/ Location of CVST
4/ All patients were #COVID19 Negative
5/ All patients had thrombocytopenic and 5/6 had a PF4 HIT Ab positive
6/ At this time, 1 has died, 3 remain hospitalized, 2 discharged home
7/
8/
Take Home Messages
- CVST is a rare event
- All patients had thrombocytopenia and positive PF4 Ab
- All patients were COVID-19 Negative
- Does not appear to be any patterns or risk factors
- If concern that patient has CVST should check PF4 Ab and consult with hematology

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More from @KrutikaKuppalli

Krutika Kuppalli, MD FIDSA Profile picture
Jul 6, 2022
✨@WHO published its first situation report for the multi-country #Monkeypox outbreak with data till 4 July 2022 there has been

👉6027 cases and 3 deaths in 59 countries in 5 WHO regions
👉2614 new cases (77% ⬆️) & 2 new deaths since last DON

Full🧵👇

who.int/publications/m…
✨Demographics
Sex is available for 73% (4406/6027) of cases
👉Of these, 99.5% (4385/4406) are males (median age 37 yrs)
👉Males 18-44 years of age account for 79% of cases
👉0.1% (6/5584) of cases with age data are aged 0-17 years of age.
✨Demographics
Among cases with reported sexual orientation
👉60% (1214/2025) identified as gay, bisexual and other men who have sex with men
👉41% (335/827) of cases with known #HIV status were positive for #HIV
Read 12 tweets
Krutika Kuppalli, MD FIDSA Profile picture
May 16, 2022
✨Update from @UKHSA on #monkeypox cases

- 4 additional cases have been detected (3 in #London and 1 linked case in NE #England)
- These cases have NO connection to those announced on 14 May and the imported case from 7 May

Full details and more info👇
gov.uk/government/new…
- The four new cases all appear to have been infected in #London and are gay, bisexual, or MSM
- Common contacts have been identified for 2/4 cases
-No link to travel to a country where #monkeypox is endemic
-All have West African clade of virus
-Further investigation is ongoing
- #monkeypox is spread by close contact
- Typical symptoms are fever, headache, muscle aches, backache, swollen lymph nodes
-Rash can develop and spread to other parts of the body including the genitals - it may look like #syphilis #herpes #chickenpox
Read 4 tweets
Krutika Kuppalli, MD FIDSA Profile picture
Jan 31, 2022
New data out today from #Denmark demonstrating that #Omicron #BA2 is more transmissible than #BA1 and has immune evasive properties reducing protective effect of #vaccination

Full 🧵👇
1/ medrxiv.org/content/10.110…
- Of 8,541 primary household cases with #Omicron, 2,122 were #BA2
- There were 5,702 secondary infections among 17,945 potential secondary cases
- In households with #Omicron, secondary attack rate was
29% - #BA1
39% - #BA2
2/ Image
- compared to #BA1, #BA2 associated with ⬆️ susceptibility of infection in
#unvaccinated (OR 2.19)
fully #vaccinated (OR 2.45)
#boosted (OR 2.99)
- ⬆️ transmissibility from #unvaccinated cases in #BA2 houses compared to #BA1 (OR 2.62) (Not seen in vaxd or boosted)
3/ Image
Read 4 tweets
Krutika Kuppalli, MD FIDSA Profile picture
Jan 10, 2022
Latest @WHO #TechnicalBrief on #Omicron
Overall risk remains very high & threat depends on

1⃣Transmissibility of #variant
2⃣How protective vaccines & prior infection are
3⃣Virulence of variant
4⃣Understanding of dynamics & uptake PHSM

Full 🧵👇 (1/)
who.int/publications/m…
Epidemiology (1)
-#Omicron has large growth advantage over #Delta - grows significantly more than Delta in countries with community transmission
- Evidence that immune evasion contributes to rapid spread
-Wk 52, global weekly #COVID19 incidence ⬆️ 71% compared to prior wk
(2/)
Epidemiology (2)
-Study from HK found #Omicron infects human bronchus tissue faster and better than #Delta
-#UK study found Omicron outcompetes Delta in experiments using cells derived from human nose, but not seen in lung derived cells
-Growth advantage in upper resp tract
(3/)
Read 17 tweets
Krutika Kuppalli, MD FIDSA Profile picture
Jan 1, 2022
This narrative is exactly what I was worried about👇

We still don’t know #Omicron causes less severe disease but has become so politicized leaders say it only causes a “sore throat” without thinking of the immediate & long term (post #COVID19 condition #LongCovid) effects
#COVID19 and #Omicron most certainly does not only cause a “sore throat” we are seeing ⬆️⬆️ numbers of ICU admits and hospitalizations.
Yes some may have mild disease (thank you #vaccines) but these people can still transmit and put others (ie immunecompromised) at high risk.
The strain this is putting on healthcare systems and workers is tremendous.

Procedures that are non-emergent like cardiac catheterizations, biopsies, & other important surgeries are being postponed. This may lead to delays in diagnosis of things like cancer & adverse outcomes.
Read 5 tweets
Krutika Kuppalli, MD FIDSA Profile picture
Dec 30, 2021
💯agree with @jabarocas - in the past 24 hours 5 healthcare worker friends in different parts of the #US have been diagnosed with #COVID19.
At this rate as hospitalizations ⬆️ there will be an ⬆️ shortage of HCW's- who will care for patients & what will it look like a🧵
1/
✅The provider: patient ratio ⬆️⬆️⬆️
✅Patients wait longer for things like water, ice, food, & meds as nurses are stretched caring for more patients
✅The lab is stretched thin so bloodwork takes longer to return
✅Radiology is busier so it takes longer for an X-ray
2/
✅Physicians have less time to spend with patients and families because they have more individuals to see
✅There is less time to critically think about patients as HCW's are in triage mode trying to meet patients needs (I understand this is concerning, but is reality)
3/
Read 5 tweets

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