Covid reinfection | #LongCovid

Long-term immune profiling of renal transplant patient | infected with SARS-CoV-2 a second time and hospitalized ~233 days after first infection

Neutralizing antibodies and humoral memory response level insufficient

🧵

academic.oup.com/jid/advance-ar…
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
The study was carried out by @VirusesImmunity et al

I add here 🔽 a link to Prof Iwasaki 🧵 on the case study, with more information

Prof Iwasaki provided deeper insights into the case study and the immunological processes of SARS-CoV-2 re infection in this 🧵🔽

when the paper was published first as a pre-print

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More from @elisaperego78

2 Nov
#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

#apresJ20 🧵
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

#LongCovidKids
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
Read 7 tweets
1 Nov
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 | 🧵 🔽
Data on PET scan on which some of the analysis presented is based, can be find attached below 🔽

#LongCovidKids

link.springer.com/article/10.100…
Full data set on the cohort of pediatric #LongCovid patients from France can be found here 🔽

#apresJ20

onlinelibrary.wiley.com/doi/10.1111/ap…
Read 4 tweets
1 Nov
🧵 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

(many 🧵 by Hannah on this!)
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

Klein et al 2021

Read 4 tweets
30 Oct
Working or job loss with #LongCovid

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

#LongCovidWork
I add to this @patientled @itsbodypolitic research survey in a tweet by @ahandvanish

The majority of #LongCovid patients in their survey were unable to work ~7 months in. We've increasing evidence many don't recover beyond

Paper now in @EClinicalMed

Unable to work at all or maintain a full schedule to be more precise: 68%
Read 4 tweets
30 Oct
Healthcare in the city of Trieste, northeast Italy, is under great strain. No vax demonstrations last week drove a SARS-CoV-2 spread

People with covid pneumonia are waiting at the emergency in a key city hospital: no beds available anymore

corriere.it/cronache/21_ot…
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

amp24.ilsole24ore.com/pagina/AEZGITt
The Maggiore Hospital in Trieste has now opened a new covid ward to host patients with moderate covid.

Patients are already flowing in from strained emergency departments in Trieste and other cities in the Friul region, like Gorizia

rainews.it/tgr/fvg/artico…
Read 4 tweets
29 Oct
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 🧵

rcplondon.ac.uk/news/medical-l…
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

#MECFS
Read 7 tweets

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