Exciting paper on endothelial dysfunction (ED) in #LongCovid! (Endothelium is a membrane that lines blood vessels).

"Long COVID-19 symptoms, specifically non-respiratory symptoms, are due to persistent endothelial dysfunction."

frontiersin.org/articles/10.33…

Some key points:

1/ Image
-Endothelial dysfunction (ED) is associated with high cholesterol!
-3 symptoms were associated with ED: fatigue, cognitive dysfunction, & shortness of breath. Others, including loss of sense of smell & cough, were not!

#LongCovid

2/ Image
-Reduced Left Ventricle GLS (Global Longitudinal Strain) was associated with #LongCovid (which I believe validates findings from @PutrinoLab et al?)
-There's a note that beta blockers were associated with reduced Long Covid symptoms

3/
tagging @doctorasadkhan @SimonNicholasS1 @pausedME re cholesterol
@EricTopol you may be interested in this paper
@PutrinoLab I've just been told this team has a follow up paper coming out soon looking at the effects of sulodexide as a treatment in these patients. #LongCovid

4/

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More from @ahandvanish

29 Nov
It might not be obvious to those without kids or those who aren't following COVID data closely, but schools are creating & normalizing some of the worst COVID policies. My friend is a teacher who was exposed to 2 students (both positive) during close in-person tutoring...

1/
But the school doesn't count it as an exposure because they were all masked & she doesn't have symptoms (yet - they take 5-6 days to appear).

They have a substitute teacher shortage (obviously) so she isn't even allowed to self-quarantine; they made her come back to work.

2/
Another school I know of started out saying a class only has to quarantine if 2 kids are positive; that moved up to 4 kids, then half. So if half minus one students in the class test positive, the class doesn't quarantine 🤯

3/
Read 5 tweets
19 Nov
I mentioned treatments on this panel today - #LongCovid providers need to learn what is available from existing post-viral illness & myalgic encephalomyelitis experts.

This list of treatments is from the ME/CFS Clinician Coalition & is super useful:

drive.google.com/file/d/1T6psBJ…
The ME/CFS Clinician Coalition is a wealth of resources. Here are a list of courses with Continuing Medical Education (CME) credits for new #LongCovid providers: mecfscliniciancoalition.org/medical-educat…

2/
Here is a recommended list of tests to do for #LongCovid patients if you're a new provider:

drive.google.com/file/d/1Yu79EY…

cc @WesElyMD @kavitapmd

3/
Read 4 tweets
3 Nov
It's been a rough week of learning that the Covid info in the general public is way worse than I understood.

I didn't understand that doctors are *still* telling people they're 100% safe from transmission/transmitting if they're vaccinated, even if they're 8 months out from vax.
I didn't understand that people are sending their kids to school despite someone in the house having Covid.

I didn't understand the cognitive games & justifications people were using to go out with friends even if their partner is ill.
I've reached a new level of hopelessness I didn't think was possible. The amount of information that needed to be communicated to the public like 4 months ago is just not happening, and people are taking advantage of that to be selfish.
Read 4 tweets
29 Oct
If there was one pandemic-related piece of info I wish people would learn, it's this:

For every 1 recorded COVID case, there are 3 unrecorded cases.

*Most* people who got COVID don't have a positive test because they didn't get any test.

cdc.gov/coronavirus/20… #LongCovid

1/
This is an average number which has improved over time. In the first wave, when tests were not available, the best case estimate is that there was 1 recorded case for every 33 unrecorded cases! #LongCovid

nature.com/articles/s4158…

2/
For 2020 overall (including both first and subsequent waves), estimates were 1 recorded case for every 7-8 unrecorded cases.



This has massive implications for care, research, immunity, etc. A few points:

3/
Read 10 tweets
27 Oct
New paper on 10,024 breakthrough infections shows that vaccination does not prevent #LongCovid.

medrxiv.org/content/10.110…

1/
Interestingly it does show a possible small reduction in the likelihood of getting certain #LongCovid symptoms, including fatigue and possible cognitive and neuropathy symptoms, & a possible small increase in other LC symptoms (headache, abdominal symptoms). More data needed!

2/
And it does show a substantial decrease in severe acute outcomes, like ICU admission, respiratory failure, death, psychotic disorders, and thromboembolisms, as well as a substantial decrease in loss of sense of smell.

3/
Read 5 tweets
12 Oct
I've started to hear cases of people who got COVID twice - who recovered the 1st time, but got #LongCovid the 2nd.

This is in line with everything we know about infectious-onset conditions. The body cannot sustain hit after hit to the immune system without consequences.

1/
We saw reinfections start happening last summer for the first wavers. The research below shows reinfections could happen as early as 4 months after infection. 2/

In endemic conditions, reinfection would likely happen after about 1.5 years.


3/
Read 5 tweets

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