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Dr Elisa Perego Profile picture
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11 Nov, 6 tweets, 4 min read
Ok, we've been wondering *how* that flawed @JAMAInternalMed study on #LongCovid got published

A possible clue

JAMA hosts a series called "Less is More" where the piece is highlighted

This series focuses on reducing healthcare use in various ways

🧵

jamanetwork.com/journals/jamai…
JAMA's "Less is More" explores "the ways that overuse of medical care fails to improve outcomes, harms patients, and wastes resources"

Honestly, I find this troubling in a time of austerity and increasing cutting to healthcare resources

#LongCovid

jamanetwork.com/collections/44…
I also find this concept of "Less is More" troubling in view of viral-onset disease's history, where #pwME and other patients with complex, chronic diseases have been left with no care and appropriate research on their severe condition

#MECFS #LongCovid
I also find the concept of "Less is More" worrying in view of what we know about #LongCovid

Long Covid is a severe, complex, multi-system disease, which can be fatal. Patients have been left with no care even in life-threatening conditions

We need More, not Less
@apresj20 @reverseyourmind especially of interest
Just to add + be more clear: one possibility is that a piece supporting (among other things) cognitive behavioral therapy for "long covid symptoms" --instead of in depth analysis etc. for the disease --- could find a fertile terrain to get accepted, in a journal w that mindset

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More from @elisaperego78

Dr Elisa Perego Profile picture
12 Nov
It's now proven by a very significant number of publications: sadly, SARS-CoV-2 infection causes prolonged symptoms and damage in multiple organs and body systems 🧵

My gratitude to @apresj20 for their constant effort to promote top-notch science | advocacy on #LongCovid
Multidimensional analysis of SARS-CoV-2 infection long term effects in multiple organs

Increased risk of death even in non severe or critical patients

#LongCovid

@Nature

nature.com/articles/s4158…
Increased risk and proven evidence of kidney injury and chronic kidney disease in #LongCovid

Covid is hard on the kidneys. The numbers estimated by top experts like Dr Al-Aly are sadly enormous

jasn.asnjournals.org/content/32/11/…
Read 34 tweets
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 6 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
9 Nov
🔥 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
Read 5 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

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