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Dr Elisa Perego Profile picture
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4 Sep, 8 tweets, 6 min read
I agree 100% with @emilyesfraser. Minimizing #LongCovid is a huge failure in public health. One of the biggest in the pandemic.
People have been misled since the beginning about the gravity of covid. The long-term effects are often devastating, even, potentially, in children
The gravity and pandemic potential of SARS-CoV-2 infection were already evident since the first reports from Wuhan

@TheLancet 24 January 2020

#LongCovid

thelancet.com/journals/lance…
The earliest, severe patients treated and hospitalized in China were often *not* old

The median age in this early 2020 sample was 49 years

@TheLancet

#LongCovid

thelancet.com/journals/lance…
A Guardian article from 8 January 2020: the WHO is linking the Wuhan outbreak to a virus similar to SARS CoV and MERS Cov

We knew already SARS and MERS had high mortality and long term health effects

#LongCovid

theguardian.com/science/2020/j…
On 21 February 2020, a study in @JAMA_current noted asymptomatic transmission from a 20 year old woman to 5 family members

They weren't old, being in their 40s and 50s. They developed covid pneumonia --moderate to severe-- and needed hospital treatment

jamanetwork.com/journals/jama/…
A pediatric patient with ground glass opacities, visible on lung CT scan, was reported in January *2020* from China

The child was apparently asymptomatic. Only 10 year

Covid has never been the disease of "the old and sick"

@LongCovidKids #LongCovid

thelancet.com/journals/lance…
The 10 year old with apparently asymptomatic covid pneumonia, from January 2020, was part of a family cluster. Some family members developed severe covid.

Once again, they weren't in the elderly category. Their age ranged from their 30s to 60s.

#LongCovid
One year in, many of those early Wuhan patients are still ill

In a recent study, 49% were still symptomatic at 12 month

A minimum of 38 people from the original sample had died since hospital discharge.

@TheLancet

August 2021

#LongCovid

thelancet.com/journals/lance…

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More from @elisaperego78

Dr Elisa Perego Profile picture
7 Sep
Yes. Many are definitely underestimating the dangers of #LongCovid and #LongCovidKids

Patients have been reporting and publishing on the gravity of the condition for over 1 year. Policy makers are still hesitant to fully acknowledge it

Thread and data collection down here 🔽
I add in my own🧵 some scientific papers and other key contributions to knowledge by patient researchers. Not exhaustive!

@fi_lowenstein @itsbodypolitic
and @ahandvanish @patientled in the NYT: the pandemic is a mass disabling event

#LongCovid

nytimes.com/2021/03/17/opi…
Davis et al (2021) characterize #LongCovid in a large cohort of patients at 7 months from symptom onset. Patients come from support groups in many different countries.

@patientled

@EClinicalMed

thelancet.com/journals/eclin…
Read 44 tweets
Dr Elisa Perego Profile picture
5 Sep
Long-term damage to the kidney is a severe effect of SARS-CoV-2 infection. It's not that rare

It often starts with little symptoms or no symptoms at all. You can end up with permanent issues

A new study is out. But kidney injury in acute and #LongCovid has been known for long
John Hopkins Medicine, for example, was discussing acute and long-lasting kidney injury after SARS-CoV-2 infection in a featured article from May 2020

#LongCovid

hopkinsmedicine.org/health/conditi…
In an article from April 2021, Zhang et al follow the recovery trajectory of 143 hospitalized covid patients with new-onset kidney disease

9% still had kidney injury four months after hospital discharge (mostly elderly category)

#LongCovid

bmcinfectdis.biomedcentral.com/articles/10.11…
Read 11 tweets
Dr Elisa Perego Profile picture
5 Sep
I disagree. It wasn't clear at all since "the beginning" that SARS-CoV-2 would have to become endemic

Making a virus as dangerous as SARS-CoV-2 "endemic" is a failure. Very poor policy making.

The countries that went for elimination, achieved elimination.

#LongCovid
Countries that managed to eliminate or strictly contain SARS-CoV-2, like New Zealand, have been put at continuous risk by poor policy making from the rest of the world.

This includes poor political and public health choices in the EU, the UK and the US.

#LongCovid
Quite a few other countries, like Italy in the first wave, came close to elimination, too

Lombardy, one of the worst hit areas in the world in 2020, managed to crush the curve despite many mistakes in active pandemic management. Yes, I was there. I speak of reality, not models
Read 4 tweets
Dr Elisa Perego Profile picture
27 Aug
#LongCovid in China 🇨🇳 🧵

👉 49% sampled patients remained symptomatic after 1 year
👉 1276 survivors from Wuhan hospital
👉 one of the longest follow up in the world, with data at 12 month and comparison with data at 6 month from the same cohort

thelancet.com/journals/lance…
Key data points and take aways
👉 30% with dyspnea at 12 month, up from 26% at 6 month
👉 26% with symptoms described as "anxiety" or "depression" at 12 month, up from 23% at 6 month
👉 12% of patients who were employed before covid couldn't go back to work

#LongCovid
👉 12% had abnormal results at six minute walking distance test, down from 14% at 6 month
👉 3 patients diagnosed with ischemic stroke, 1 stable angina
👉 Lung diffusion impairment found in 23--54% patients at 12 month (three groups of severity). No improvement from 6 month mark
Read 11 tweets
Dr Elisa Perego Profile picture
25 Aug
#LongCovidKids in France 🇫🇷

PET scans reveal neurological damage in a sample of children following SARS-CoV-2 infection. Comparable issues were previously found by the same research group in #LongCovid adults.

Thanks to our friends of @apresj20 for sharing this important news.
Evidence for neurological impairment including from brain damage in #LongCovid is sadly growing

See for example another study here from the US

These are studies with some limitations like sample size. But match well the symptoms millions are reporting

news.harvard.edu/gazette/story/…
A severe burden of neurological long term effects from SARS-CoV-2 infection has already been reported in a vast sample published in a @TheLancet venue.

Data at 6 months after onset in thousands of patients.

thelancet.com/journals/lanps…
Read 5 tweets
Dr Elisa Perego Profile picture
19 Aug
New on #LongCovidKids 🧵🔥

👉 121 children aged 0--18 years
👉 37.2% had symptoms for at least 1 month
👉 symptoms included coughing, fatigue, SOB, chest and back pain, dizziness, headache, palpitations
👉 clear evidence of cardiovascular involvement

pubmed.ncbi.nlm.nih.gov/34407902/
👉 clinical signs on cardiovascular evaluation included changes and abnormalities in systolic blood pressure, left ventricular ejection fraction, relative wall thickness, and tricuspid annular plane systolic excursion
👉 evaluation included echocardiogram

#LongCovid
👉 a control group of 95 healthy children included
👉 the covid plus and control groups were comparable in age, weight, body mass index
👉 yet, statistically significant cardiovascular involvement was in the covid group 🔥
👉 #LongCovidKids is real, with clinical signs 🔥
Read 4 tweets

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