66 ys old man | renal transplant recipient | first infection: March 2020 | analysis of viral genetic strains from 2 infections shows distinct lineages, but without apparent immune escape capacity | immune response by patient potentially below threshold to prevent reinfection
Development of poorly neutralizing antibodies maybe linked to abnormalities in naive CD4 T-cell pools | seroconversion alone may not protect from reinfection in immunocompromised patients ❗| specific immune features seen here possibly linked to this person's status
Cytokine + other immunological analysis from first infection, too, showed immunological dysfunction and inflammation | this persisted even after covid symptoms improved
#LongCovidKids in France 🇫🇷 @apresj20 | 201 pediatric patients | PCR + | most had mild disease at onset, often identified because of a cluster in their family | ~16% developed #LongCovid > symptoms lasting beyond 4 weeks from onset or appearing down disease course
Median age: 9 ys | Acute phase ❗younger kids most likely to be hospitalized | two cases of viral pneumonia in a 4 and a 8 year-old + seven cases of bronchial issues > among only 6.5% were checked via x ray | 1 year-old had encephalitis for one month but recovered
Most common #LongCovid symptoms noted: asthenia (significant fatigue), learning difficulties, headache | data obtained for 68% of original sample at 10--13 month follow up | no cases of MIS-C and myocarditis reported | symptomatic in acute phase more likely to have #LongCovidKids
A new report shared by our friends of @apresj20#LongCovid in France | the Hospital of Marseilles followed 201 pediatric covid patients from the first wave | 20% had prolonged symptoms #LongCovidKids | PET scan on a smaller sample proved neurological impairment | 🧵 🔽
🧵 with various contributions on whether those infected with SARS-CoV-2 always seroconvert (i.e. make antibodies). Papers cited by @ahandvanish shows not everyone does
We have known this for a while, and discussed it especially for #LongCovid
Timing and quality of serology tests also matter in my opinion, as shown by a growing body of literature. Covid and #LongCovid can be diagnosed on symptoms alone in many cases, especially for patients in high prevalence areas or who had CoV + contacts!
If we want to discuss protection from previous infection, especially in the context of vaccination (only 1 dose for the previously infected vs 2):
even those who seroconvert might be at risk of reinfection in case of immune dysfunction
Many complex experiences, some very good points in 🧵 🔽
But also clear evidence of the potentially massive impact of SARS-CoV-2 infection on the workforce. Many will be unable to work again or will need long-term sick leave
Trieste, northeast Italy, is now the province with one of the highest covid incidences in Italy.
The region of Friuli Venezia Giulia there has a lower vaccination rate than other regions in Italy. Unsafe vax demonstrations are driving SARS-CoV-2 spread
I'm disappointed by this statement from a number of medical associations in the UK in response to the @NICEComms publication of the new #MECFS guidelines
I've concerns, in particular, about the view of chronic diseases reflected in the statement 🧵
A first concern regards the full scope of clinical guidelines for a severe (post) infection disease like #MECFS: growing research on viral/other onset diseases reveals a multi-system, complex pathophysiology
You can't cure this with exercise or psychological therapy (CBT)
We really need the full extent of biomedical research on viral-onset and related diseases to be taken into consideration. Patients need appropriate treatment and support, not poor quality intervention that don't address a complex pathophysiology with severe symptoms