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Dr Elisa Perego Profile picture
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5 Sep, 11 tweets, 7 min read
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…
Legrand et al (2021) note that kidney injury is a common feature of COVID-19

They discuss the potential causes of kidney damage, such as direct viral attack, inflammation, micro-clotting and endothelial dysfunction

#LongCovid

nature.com/articles/s4158…
Tarragon et al (2021) discuss acute kidney injury (AKI) in a sample of hospitalized patients in Spain (n=41)

Acute renal injury is not rare in severe covid patients. It appears to be linked to worse outcomes and even death.

#LongCovid

revistanefrologia.com/en-acute-kidne…
A Yale study found that covid-induced kidney injury (COVID-AKI) is often more severe than AKI from other conditions

At 6 months from onset, covid patients had loss of kidney function *12* greater than non-covid patients!

#LongCovid

news.yale.edu/2021/03/22/cov…
Raina et al (2021) did a review of medical data from 42.612 covid patients

Almost 20% had acute kidney injury (AKI). Of these, 54% died

Covid-AKI, thus, was found to be common (although, I note, the sample leans towards more senior patients)

#LongCovid
karger.com/Article/FullTe…
Already in 2020, Fabrizi et al noted that acute kidney injury (AKI) is common in hospitalized covid patients

Renal damage following SARS-CoV-2 infection, thus, shouldn't come as a surprise to policy makers!

#LongCovid

pubmed.ncbi.nlm.nih.gov/33334023/
Are kids affected by acute kidney injury (AKI) in covid? Sadly, yes

Kari et al (2021) found that 21% of hospitalized children in their sample had AKI. 30% of kids in PICU

Residual kidney injury could persist

#LongCovidKids @LongCovidKids
@TigressEllie

bmcnephrol.biomedcentral.com/articles/10.11…
@Antonio_Caramia puo' essere di interesse per la discussione: purtroppo, danni ai reni comuni nei bimbi ospedalizzati

@MartaEsperti @docdrugztore
I start again this thread on the risk of covid-related kidney injury with a review, just out in the @bmj_latest

SARS-CoV-2 infection increases the risk of kidney damage even in mild covid cases

#LongCovid

bmj.com/content/374/bm…

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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
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
4 Sep
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…
Read 8 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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