Proud to have been a Subject Matter Expert to the POTUS Health Equity Task Force!

They're presenting today on what they learned about #LongCOVID (hhs.gov/live) & their presentation is so full of good recommendations that I can't even keep up.

1/
I'm thrilled at their takeaways, including 1) lab confirmation of COVID can't be required for care, 2) creating a federal advisory committee including LC patients, ME experts, & disability advocates, 3) help patients navigate the disability system & expediting claims, & others 2/
Excellent public comments from Michael Sieverts on how biases in PCR and antibody testing will trickle their way into research. Super important as research plans for #LongCOVID are currently being decided....

3/
Some examples of bias:

1) PCR: positive results are related to how early you get tested (false negative rates increase every day from day 3 of symptoms) so PCR-negative patients are less likely to have good access to healthcare

2) Antibody tests:


4/

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More from @ahandvanish

15 Jun
On those who participated in the survey on the clinical case definition - Patient AND Researcher is a new category (requested by @Dr2NisreenAlwan and yours truly) :)

2/
The parts of the clinical case definition that have reached consensus:

3/
Read 23 tweets
15 Jun
The CDC guidelines for #LongCOVID are out!!!

@itsbodypolitic and @patientled worked together to give feedback on these and it's really emotional to see our research, including the first report we did back in April 2020, cited here. 1/

cdc.gov/coronavirus/20…
It's going to take a while to go through & see what ended up in here, but a few things stand out to me that we pushed hard for:

A) The inclusion of a comprehensive symptom list, including PEM (and a definition for PEM!) and lesser-discussed but common symptoms. 2/
B) Instructions not to use lab confirmation: "Objective laboratory/imaging findings shouldn't be used as the only assessment of a patient’s well-being; lack of laboratory/imaging abnormalities does not invalidate the existence, severity, or importance of a patient’s symptoms." 3/
Read 6 tweets
1 Jun
This is very true. The best way to do research for #LongCOVID is to learn from people who have been working in post-viral illness for literal decades.

Here is a list of these researchers to get you started:
docs.google.com/document/d/17q… 1/
These areas of research are less known, including metabolic profiling, antiviral response phenotypes, neuroimmunology, cerebral blood flow, mitochondrial fragmentation, viral persistence, hypermobility, craniocervical issues, altered T&B cells, metabolomics & proteomics, etc. 2/
These researchers have made astounding post-viral findings in the above areas. Everyone interested in #LongCOVID should stop treating this as an illness unlike any other and instead dive into the massive amount of research that has already been done. 3/
Read 4 tweets
31 May
In a study of (mostly male) #LongCOVID patients in the military, those with lab-confirmed COVID diagnoses were 69% less likely to have anxiety/mood symptoms!

This supports the idea that LC patients w' false negatives have more anxiety bc they can't access the care they need.
1/
The study also found that a lack of lab-confirmed diagnosis led to a huge delay in #LongCOVID care: 8.5 weeks for those w' confirmation, 16 weeks (4 months!!) without.

Those without lab confirmation were also 63% more likely to have pain, likely because of lack of care. 2/
Read 8 tweets
27 May
A thread on models for patient involvement in research! #LongCOVID

First up:

This paper on design strategies in citizen science highlights a scale of 5 levels of participation. From lowest to highest involvement (through a patient lens):

osf.io/preprints/soca… 1/ Image
A) Contractual: members from the public (patients) ask scientists to conduct study; no direct involvement in the research process, apart from defining the problems & setting research priorities. 2/
B) Contributory: the lowest level of direct involvement consists of contributory projects, where patients assist academic scientists in data collection or processing according to neatly defined protocols (i.e. crowdsourcing).

3/
Read 11 tweets
21 May
There are a lot of #LongCOVID gems in this webinar from HCA Healthcare UK. I'm going to try to tweet them succinctly:

1. Non-hospitalized COVID patients had a slower recovery than hospitalized patients.

2. At 12 months out, the majority of non-hospitalized #LongCOVID patients are still not back to work full time.
Next speaker is a cardiologist.

3. Cardiac MRIs are helpful. Even when they look normal from a functioning standpoint, supepicardial late gadolinium enhancement can be identified, showing post-viral myocarditis. (Screenshotted case was in a patient 200+ days out from onset).
Read 47 tweets

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