This week marks the 1 year anniversary of @patientled's 2nd #LongCovid paper (now peer-reviewed & published: thelancet.com/journals/eclin…).

The good news: it got better information to many new researchers, including the accurate symptoms, neurological severity, & testing issues.
1/
It has over 200k views & several hundred citations, & informed policy in many countries & orgs, including the US, UK, Belgium, Spain, the WHO, CDC, & others.

The bad news:

2/
Most of this info is still not common knowledge to the general public & new patients. So many have no knowledge that cognitive dysfunction, memory issues, neurological issues, post-exertional malaise, dysautonomia (incl temperature & heart issues), & more are SO COMMON.

3/
#LongCovid patients have an average of 56 symptoms (not uncommon for a multi-systemic illness), not just 1-2 like is often talked about in the news or bad studies.

Some of these have names & can be at least partially treated (occipital neuralgia, POTS, MCAS, reactivations)

4/
It's been hard to watch, especially knowing that the earlier people get care, the more likely they are to recover.

So today in anticipation of the biggest wave of #LongCovid to date, I will be retweeting this thread of year-old tweets.

5/
If someone in your life has new heart issues/tachycardia, vertigo, cognitive dysfunction, memory loss, extreme exhaustion, exercise & alcohol intolerance, new allergies, reversed sleep schedule, migraines, nonstop fevers, tremors, etc after COVID, they're not alone. #LongCovid 6/
Please help them get help. A good first step is joining @itsbodypolitic, which has a massive number of resources & competent provider recommendations. wearebodypolitic.com/covid19

And share this info.

In the next 2 months, this is likely to affect at least some of you. #LongCovid
7/

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More from @ahandvanish

30 Nov
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/
Read 6 tweets
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

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