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Dr Elisa Perego Profile picture
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15 Oct, 5 tweets, 3 min read
Important summary of covid pathology in the lung from newly published tissue biopsies.
Note the truly astounding devastation from SARS-CoV-2 in fatal disease, including clotting.
I add a few points on how paper can be relevant to #LongCovid and non-critical patients 🧵
👉 covid pneumonia can be asymptomatic/ pauci-symptomatic e.g. paper attached 🔽
🔥 phenomena as those found in critical patients, but on a lesser scale, can thus affect non-hospitalized/ "mild" patients . Long term lung damage can be there

#LongCovid

pubmed.ncbi.nlm.nih.gov/32216718/
👉 imaging techniques like the SPECT scan *do* reveal long term lung damage in #LongCovid 🔽
🔥 in view of potential, significant lung damage even in "mild" patients, it's key to stop discussing symptoms like breathing difficulty as "anxiety" and the like
pubmed.ncbi.nlm.nih.gov/34339624/
👉 note disease progression in the lung in time (3 to 47 days). As these are samples from deceased patients, we can't appreciate the full extent of lung pathology across months/ years
🔥 yet, we *must* address long term, potentially progressive lung impairment in #LongCovid
👉 also note the different disease pathways note in lung pathology (early disease up to 47 days)
🔥 what does this mean in practice for those who survive covid pneumonia? Different long term problems/ symptoms in different patients?
🔥 No surprise #LongCovid is multidimensional!

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More from @elisaperego78

Dr Elisa Perego Profile picture
13 Oct
In the wake of increasing recognition of failed pandemic responses worldwide, like in the UK

Let's always remember that many early covid patients from Wuhan weren't "old and sick"

This was already clear from January 2020 data in @TheLancet

#LongCovid

thelancet.com/journals/lance…
This evidence of early known clinical evidence from Wuhan is especially damning for ideologies like the Great Barrington Declaration, which posited, erroneously, that SARS-CoV-2 infection is not that dangerous in the young. This was already patently not the case in January 2020
#LongCovid and #LongCovidKids are the nail in the coffin of public health "measures" and ideologies that encouraged to let SARS-CoV-2 rip through the population.
SARS-CoV-2 is virus with high mortality, but an even more egregious morbidity rate i.e. long term damage
Read 4 tweets
Dr Elisa Perego Profile picture
13 Oct
In our review of #LongCovid rise, @felicitycallard and I noted how forms like "so called" LC were being dropped in mid-2020.
This was because of recognition of the obvious nature of SARS-CoV-2 sequelae
Using "so called" again now, is a political choice to minimize the disease
The re-introduction of forms like "so called" #LongCovid or "Long Covid" is, interestingly, linked to a specific historical phase in the pandemic: the moment in which there is a huge push for "endemic covid" by most policy makers, with no appropriate reasoning about mitigation
The only way the public will swallow the reality of being infected multiple times with a virus likely to give many a disability or increased risk for, for example, cardiovascular disease, is to lie, or muddle the water, about the gravity of SARS-CoV-2 infection
#LongCovid
Read 5 tweets
Dr Elisa Perego Profile picture
12 Oct
Excellent points by @ahandvanish @ClaireHastie1 et al. in 🧵
I see public health experts talking nonchalantly about SARS-CoV-2 infection. Some talking about reinfection as an "immune booster".
No.
We don't have any data to make safe predictions.
"Endemic covid" is a bad gamble.
The dangers of reinfection, or symptomatic infection after vaccination, are a special danger to those with #LongCovid and those from marginalised communities, who might not have access to optimal care. But *everyone* can be in danger. Covid is Russian roulette
We literally have no evidence to say multiple SARS-CoV-2 infections across a life will be a minor issue, or a positive, for most! On the contrary, emerging data e.g. from the #LongCovid community, are concerning and warrant extreme caution
SARS-CoV-2 is a very dangerous virus
Read 4 tweets
Dr Elisa Perego Profile picture
7 Oct
As an umbrella, #LongCovid refers to the long-term symptoms and sequelae of SARS-CoV-2 infection🧵
You can have delayed pulmonary embolism for sure! We perfectly know cardiovascular and clotting sequelae are key factors in Long Covid, often protracted from the acute phase
It's *crucial*, in my opinion, not to confuse the clinical definition of post-covid condition by the @WHO, or the name PASC, or other non-patient made term with #LongCovid. They aren't synonyms. Long Covid focuses on the long-term disease process from infection onwards
#LongCovid is a sophisticated patient made term. It came into being collectively, via the shared experiences of thousands of people, many of whom are scientists and healthcare professionals. It accounts for both disease development across time and sequelae from acute organ damage
Read 7 tweets
Dr Elisa Perego Profile picture
5 Oct
A massive, 1 year follow-up of 150,000 covid patients and the ❤

🔥 substantial risk of cardiovascular sequelae including myocarditis, embolism: confirmed
🔥 evident risk in non-hospitalized patients, too: confirmed

Those with #LongCovid have been right since the beginning
👉 a wide range of cardiovascular disorders noted
👉 mechanisms can be multiple
👉 disease burden is vast: the authors expressly recommend policy makers to prepare for potential huge increase in patients
👉 huge control group (from existing medical records)

#LongCovid
This study (coupled with similar large-scale follow ups, for example of long-term kidney injury) provides further, overwhelming evidence that
👉SARS-CoV-2 is far from being a benign virus
👉 those with #LongCovid who've been reporting cardiovascular symptoms were totally correct
Read 7 tweets
Dr Elisa Perego Profile picture
5 Oct
I'm truly sad to hear there are plans for covid care to be rationed in Australia.
This is what's been happening throughout the pandemic.
We need honesty from public health.
An unleashed or poorly controlled SARS-CoV-2 spread *will* bring *any* healthcare system to its knees 🧵
We saw in early 2020 Wuhan and Lombardy already how SARS-CoV-2 can literally wipe healthcare out. People were left to die at home with no care. We've seen the Italian Army bringing the coffins of covid victims out of Bergamo because the local crematorium couldn't cope.
We know SARS-CoV-2 can led to long-term symptoms and sequelae in a large percentage of those infected i.e. #LongCovid. Many of people with Long Covid aren't receiving any medical care because healthcare systems remain stretched all over the world. Some have died.
Read 5 tweets

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