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Dr Elisa Perego Profile picture
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12 Nov, 34 tweets, 24 min read
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/…
Severe risks of cardiovascular disease and other long-term effects, such as pulmonary embolism, proven in a significant number of Covid patients one year after acute disease

Huge study

Covid | #LongCovid are heavy on the heart | cardiovascular system

researchsquare.com/article/rs-940…
Organ impairment in #LongCovid is proven even in a significant percentage of (apparently) long risk, young patients

@bmj_latest

pubmed.ncbi.nlm.nih.gov/33785495/
Covid is associated with a prolonged state of abnormal coagulation, extending unfortunately well beyond the acute phase of the disease

#LongCovid

@TheLancet

thelancet.com/journals/lanha…
Persistent micro-clotting is associated with #LongCovid

Coagulopathy i.e. abnormalities in coagulation are a proven issue after SARS-CoV-2 infection

Further research by lead author R. Pretorious is currently ongoing

cardiab.biomedcentral.com/articles/10.11…
About half of the early patients hospitalized in Wuhan, China, were still ill at a one-year follow up

Many weren't old

Dozens had died after hospital discharge and never made it to their 12-month appointment

#LongCovid #apresJ20

qz.com/2052244/a-chin…
Late onset myocarditis i.e. inflammation of heart muscle is a know complication of SARS-CoV-2 infection

#LongCovid

Some adult patients with myocarditis have very severe multi system symptoms that are similar to children's MIS-C ⏩ MIS-A

@TheLancet

thelancet.com/journals/lanre…
#LongCovid is heavy on the heart and the cardiovascular system, we have noticed many times

Here another review of mounting evidence about ❤ sequelae after SARS-CoV-2 infection

#apresJ20

academic.oup.com/eurheartjsupp/…
Lung perfusion defects, persistent inflammation, microvascular injury to the lung, and possibly micro-clotting, in a pediatric case study using the SPECT scan technique

Similar results have been reported by the #LongCovid adult grassroots @MartaEsperti @JasmineHayer
Here the paper in the @LancetChildAdol

ncbi.nlm.nih.gov/pmc/articles/P…
An op ed by key expert Dr Al-Aly in @medpagetoday

#LongCovid is a devastating health crisis in the making, which needs to be addressed as far and as fast as possible

We can't drop the ball on it

medpagetoday.com/infectiousdise…
Covid patients have an increased risk of death at 6 months

Dr Al-Aly reports on his @Nature study (see above) based on analysis of medical records of 87.000 covid patients and 5 million people as controls

A big control group for control groups fans!

news-medical.net/news/20210423/…
A @CDCgov report shows around 30% of patients have persistent symptoms weeks or months after acute covid

Many young people are affected, not only the elderly!

#LongCovid

fox10phoenix.com/news/cdc-repor…
A vast percentage of covid patients report persistent symptoms ~7 months after infection | PCR + or diagnosis based on symptoms

Many unable to work

A @patientled study by #LongCovid experts @ahandvanish @AthenaAkrami et al

@EClinicalMed

thelancet.com/journals/eclin…
A 🧵 I've been compiling since a few weeks ago, with a big number of scientific papers on #LongCovidKids

#apresJ20

Evidence of #LongCovid in children is growing fast both from the patient community and biomedical research

I am still adding papers!

#LongCovid and respiratory injury

Growing research from countries such as the UK shows covid survivors many have damage and impairment to the lung for months, potentially years

Report on long term study from @imperialcollege 🔽

imperial.ac.uk/news/218933/ne…
Persistence damage and injury to the endothelium contributes to #LongCovid symptoms

The endothelium i.e. the lining of blood vessels, is proven to be heavily affected by SARS-CoV-2 infection ❗

onlinelibrary.wiley.com/doi/10.1111/jt…
50% of hospitalized patients who survived covid in hard hit Bergamo, Lombardy, had persistent symptoms and sequelae months after hospital discharge

These include coagulopathy, delayed pulmonary embolism, and exertional dyspnea

#LongCovid

pubmed.ncbi.nlm.nih.gov/33461632/
#LongCovid patients are prone to persistent damage to the endothelium i.e. lining of the blood vessels and ongoing inflammation

More evidence | see Fogarty et al 2021 above | in another publication 🔽

elifesciences.org/articles/64909
#LongCovid lungs

A special scan uses the gas xenon as contrast | indicates microvascular injury to the lung at the capillary level | damage not visible with a normal CT lung scan | 3 months after covid pneumonia | patients reported persistent respiratory symptoms
This is the link to the study 🔽❗

#LongCovid #apresJ20 lung damage

itnonline.com/article/xenon-…
Another study looks at micro-scale damage to the ❗ lung ❗| a specialised MRI scan | damaged lung gas exchange revealed | respiratory and other symptoms in #LongCovid may be due to organ damage not visible with conventional imaging 🔥

science.org/doi/10.1126/sc…
Can covid pneumonia cause permanent lung damage, especially in patients with pre existing lung disease?

A case study and detailed discussion from 🇯🇵

Persistent ground glass opacities and reduced quality of life months from onset ❗

#LongCovid

onlinelibrary.wiley.com/doi/10.1111/17…
A 12-month follow up on over 1000 covid patients in the UK 🇬🇧

Significant disease burden and protracted health effects from SARS-CoV-2 infection | high need for health care use in the long term

#LongCovid is a disaster in the making ❗

bmjopenrespres.bmj.com/content/8/1/e0…

#apresJ20
#LongCovid and diabetes

Growing research shows that SARS-CoV-2 infection can trigger diabetes | it appears also to damage directly the pancreas' cells, with unforeseen, worrying consequences for the future. Even cancer?

#apresJ20

api.nationalgeographic.com/distribution/p…
Diabetes and #LongCovid

A discussion of SARS-CoV-2 infection long-term effects on the pancreas

#apresJ20

onlinelibrary.wiley.com/doi/10.1111/17…
#LongCovid and the liver

SARS-CoV-2 infection and covid can have a severe impact on the liver | appropriate imaging + analysis of relevant blood markers is key | a sample of 54 covid patients + healthy control group | liver injury noted in covid ❗

onlinelibrary.wiley.com/doi/full/10.10…
An interview with Dr Banerjee of @PerspectumGroup | the project tracking organ damage in #LongCovid in 🇬🇧

Already in December 2020, he mentioned organ damage such as in the liver

And the case of a 26 yr old with an heart attack after covid ❗

#apresJ20

nsmedicaldevices.com/analysis/long-…
A discussion of @PerspectumGroup research on multi organ damage even in young, low risk patients in #LongCovid

@bmj_latest already out in November 2020!

We have had extensive evidence of Long Covid for over one year!

@apresj20

#apresJ20

bmj.com/content/371/bm…
#LongCovid and the thyroid

An easy-to-read report of Italian study on thyroid damage in covid | inflammation may persist for over 3 months | thyroiditis in covid present atypical features vs other viral triggers

#apresJ20

usnews.com/news/health-ne…

usnews.com/news/health-ne…
#LongCovid | thyroid

An interview with endocrinologist Dr W. Briggs (Texas)

Main ⏩ thyroiditis ~ thyroid disease are covid sequelae | great ⬆️ from 5--6 patients a year to 5--6 a month for Dr Briggs ❗ | symptoms may appear months after infection

newschannel10.com/2021/09/07/ama…
Huge mortality and morbidity in a group of ICU patients from Australia (med. age: 61 years)

⏩ ~20% died

At 6 months #LongCovid

⏩ ~71% of survivors had persistent symptoms
⏩ ~39% had a new disability
⏩ ~11% was unable to work

#apresJ20

ccforum.biomedcentral.com/articles/10.11…

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More from @elisaperego78

Dr Elisa Perego Profile picture
13 Nov
#LongCovid is severe, multi-system, potentially disabling and even fatal

It's proven, scientifically, beyond any doubt, that SARS-CoV-2 infection leads to prolonged covid symptoms and sequelae

SARS-CoV, the virus of SARS, caused vast health damage, too

#apresJ20 #covidlong
I and many others like @apresj20 have been fighting misinformation on #LongCovid severity, promoted even by verified accounts on this very same platform

I'll continue to support top-notch biomedical research and advocacy work to ensure care and recognition to patients worldwide
It is a pity to see some scientists, journalists and medical professionals contributing to minimizing the true extent and nature of SARS-CoV-2 infection
This is a great disservice to covid | #LongCovid patients and society in general
We are paying for this misinformation dearly
Read 7 tweets
Dr Elisa Perego Profile picture
11 Nov
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
Read 6 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

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