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Dr Elisa Perego Profile picture
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9 Nov, 5 tweets, 2 min read
🔥 Discussion of❗silent hypoxia in acute covid= low oxygen levels, but not associated with feeling out of breath | many don't realise they're in a life-death situation
A note: hypoxemia | O2 drops may persist in #LongCovid even after pneumonia resolution 🧵
A pulse oximeter is a key tool to monitor your oxygen saturation | silent hypoxia comes with non-specific symptoms, such as dizziness, feeling uncomfortable or unwell etc. | many people in acute covid are, or have been, unaware of their hypoxic state exactly because of this!
People with #LongCovid have been long reporting about dropping oxygen levels and low saturation | this may come after exertion or in a relapsing-remitting pattern | drops in O2 in Long Covid have also been proven in a clinical setting, for example via a walking test
It is key, thus, that both clinicians and covid + #LongCovid patients are aware of the clinical manifestations of silent hypoxia | they must be provided with the right tools to assess and address it | people have died at home, or risked to, unaware of such key feature of covid!
A case series of 4 patients with severe hypoxia in acute covid -- but no evidence of respiratory distress --- can be found, for example, in this clinical review of silent hypoxia | all patients presented with O2 below 82% =life threatening! | one died

hindawi.com/journals/cricc…

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More from @elisaperego78

Dr Elisa Perego Profile picture
9 Nov
I just did another short thread on the deeply flawed @JAMAInternalMed study on #LongCovid | as I should have expected, I bumped into a medical doctor account using the study to minimize Long Covid... and retweeting material from the Great Barrington Declaration, too!
The fact that the @JAMAInternalMed study is being picked up and retweeted with positive feedback by accounts that look at the Great Barrington Declaration sympathetically puts the nail in the coffin into any residual credibility the research migh have imo!
This is the positive tweet about the study by the account I was talking about

Read 5 tweets
Dr Elisa Perego Profile picture
9 Nov
This is the @JAMAInternalMed #LongCovid study, which is drawing huge criticism by top experts because of severe flaws in study design, data collection, and interpretation

I provide 🔽 some comments based on key scientific evidence available on Long Covid

🧵

#apresJ20
First, we must address conflict of interest. The study's main author is a psychiatrist, as many other authors. Notably, the paper doesn't address key biomedical evidence on #LongCovid
It focuses on illness "beliefs" and suggests cognitive and behavioral intervention as therapy!
We perfectly know that #LongCovid has been proven to be a severe, disabling, and sometimes fatal disease by a significant number of top-notch research papers, including in key scientific journals like @Nature 🔽

It is also formally recognized by the WHO

nature.com/articles/s4158…
Read 13 tweets
Dr Elisa Perego Profile picture
9 Nov
Thanks @LongCOVIDPhysio for sharing my 🧵 on silent hypoxia | O2 drops in #LongCovid, especially in the context of exertion
I agree 💯 that people with Long Covid as well as other (post) viral conditions should *always* be accurately screened before being prescribed exercise!
Exertional desaturation (= O2 dropping after exercise) is only one of the many challenges #LongCovid patients may encounter: cardiovascular damage, myocarditis, exacerbation of symptoms after physical and other forms of exertion, are all critical issues to assess appropriately
Symptoms exacerbation as PEM/PESE is widely reported in viral onset and other (post) infection diseases like #MECFS
But there are many contexts, such as indeed some forms of cardiovascular disease, where exercise must be practiced with caution or avoided (as appropriate)
Read 4 tweets
Dr Elisa Perego Profile picture
7 Nov
#LongCovidKids in Iran 🇮🇷

Cohort of 58 pediatric patients referred to hospital in the Farsi province | February--November 2020 | confirmed covid diagnosis | ❗44% with reported #LongCovid three months after hospital discharge

🧵 with main study finds

link.springer.com/article/10.100…
26 children out of 58 reported #LongCovid symptoms | 55% female | age assessed 6--17 years | data collected via phone three months after hospital discharge | main symptoms noted include fatigue, shortness of breath, exercise intolerance, walking intolerance

#LongCovidKids
other reported #LongCovid symptoms: sleep disruption, joint and muscle pain, cough, headache, excess sputum, chest pain, palpitations, dizziness, loss of smell (and others) | symptom severity as reported ranged from "mild" to disabling |

#LongCovidKids
Read 9 tweets
Dr Elisa Perego Profile picture
5 Nov
Interesting to look at graphic 🔽 from @Join_ZOE on vaccine protection against covid for naive (=never infected) people vs those with vaccination + previous infection
A key issue to explore imo > does previous infection followed by #LongCovid change dynamics of protection?
🧵
This is a topic we have been discussing a lot in the #LongCovid community in view of reports of potential or proven immune dysfunction in Long Covid
I think immunity following vaccination in Long Covid is an area of research that need to be addressed urgently
Thanks @Know_HG for drawing my attention to the graphic
Read 4 tweets
Dr Elisa Perego Profile picture
5 Nov
Pediatric Covid-19 in Spain 🇪🇸
| analysis of the clinical spectrum of Covid in children seen at the emergency in 76 hospitals | cohort of n=1200 children under 18 | n=666 or 55% children hospitalized | n=123 or 18% required intensive care i.e. PICU 🧵

link.springer.com/article/10.100…
Median age: 4.7 years | 55% male | different levels of severity noted | from gastrointestinal symptoms to pulmonary involvement | MIS-C or multi-inflammatory syndrome diagnosed in 10% patients | over 20 pneumonia cases reported | most patients i.e. ~75% had no commorbities
8.5% had bacterial co-infection | 30% hospitalized patients ended up with severe complications | these included cardiac involvement in 11% ❗for example n=48 had myocardial involvement | and shock in 8% | 4 children needed ECMO i.e. mechanical blood oxygenation outside the body
Read 6 tweets

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