Hannah Davis Profile picture
Jan 5, 2022 10 tweets 4 min read Read on X
New, very strong, meta-analysis published on 81 studies estimating #LongCovid prevalence!

Key findings:

32% of patients have fatigue at 12 weeks, 31% at 6+ months
22% have cognitive impairment at 12 weeks, 21% at 6+ months

Lots of additional info:

1/
sciencedirect.com/science/articl…
It focuses on 2 most common & debilitating #LongCovid symptoms: fatigue & cognitive impairment. Unlike other studies which don't include cognition or only include 1 impairment (i.e. difficulty concentrating), this includes memory & more comprehensive cognitive symptoms.

2/
A really key finding is that fatigue and cognitive impairment were not statistically significantly different between hospitalized and non-hospitalized patients!

This is a major point as the public assumes that non-hospitalized cases are "mild".

#LongCovid

3/
Another key (but depressing) finding:

Though some symptoms (like anosmia) improve over time, cognitive impairment & fatigue don't seem to improve for most over time.

The rates of both symptoms were the same when looking at under 6 months & over 6 months.

#LongCovid

4/
Adults experienced both symptoms more frequently than children, though a substantial % of children also experienced both.

Fatigue: 34% of adults and 11% of kids
Cognitive impairment: 23% of adults and 9% of kids (though subgroup analysis was not significant).

#LongCovid

5/
Interestingly, objective measures of fatigue and cognitive impairment produced *higher* levels of these symptoms than subjective measures (49% vs 25% for fatigue; 36% vs 18% for cognitive impairment).

#LongCovid

6/
These symptoms were associated with inflammatory markers and "considerable functional impairment". All studies showed decrease in quality of life.

Many showed activity impairment (which includes difficulties with performing daily tasks, self-care, & mobility).

#LongCovid

7/
Between 29.0%-47.4% of those who had been employed pre-COVID weren't able to return to work!

An estimated 5%-90% were unable to reach their pre-COVID employment level.

cc @julierehmeyer @kathrynsbach
#LongCovid

8/
The 81 studies included Italy, Spain, US, China, UK, Denmark, France, Norway, Australia, Austria, Brazil, Canada, Egypt, Germany, Israel, Russia, Netherlands, Belgium, Czech Republic, England, Faroe Islands, Iran, Japan, Mexico, Pakistan, Singapore, Sweden, Switzerland, Turkey 9/
A lot of people are bad at understanding what a meta-analysis is, geez. 5-90% means there’s a diverse range across 81 studies on what “reach their previous employment level means.” Yes, that specific point is not very helpful.

10/

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More from @ahandvanish

Oct 12
Incredible visit Thursday to the opening of Mount Sinai’s Cohen Center for Recovery from Complex Chronic Illness, led by the renowned @PutrinoLab! #LongCovid 1/ Sign that says Cohen Center for Recovery from Complex Chronic illness
David Putrino in the center, masked, showing off tools used for metabolic and mitochondrial dysfunction
The Center is incredible and truly blew me away - designed on so many levels with patients in mind, with top notch care, using many of the most advanced tools available 2/
Some of the many tools patients are assessed with include:

-EndoPat (endothelial dysfunction)
-tilt table (dysautonomia)
-transcranial Doppler (cerebral blood flow)
-machine that identifies metabolic & mitochondrial dysfunction
-eeg & cognitive battery

3/
Read 8 tweets
Aug 28
Major paper! The team found that fibrinogen (which converts to fibrin):

-binds to spike
-forms clots + neuro issues
-acute stage fibrinogen = predictive biomarker of #LongCovid cog dysfunction!
-suppresses natural killer (NK) cells (which clear virus!)
1/nature.com/articles/s4158…
The fibrin also:
-promotes neuroinflammation & neuronal loss post infection
-promotes innate immune activation in the brain & lungs independent of active infection
-downregulated JAK-STAT pathway & targets of p38 MAP kinase, pathways that regulate NK cell activation #LongCovid 2/
They used a monoclonal antibody targeting the fibrin domain, and found it protected against microglial activation & neuronal injury, as well as from thromboinflammation in the lung after infection! #LongCovid 3/
Read 5 tweets
Jul 11
I've been doing #TheNicotineTest (via 7mg patches) for a month now & it has greatly improved my quality of life.

Major caveat: I'm on ivabradine. The nicotine increases heart rate, & I wouldn't recommend to anyone w POTS who isn't on beta-blockers or ivabradine. #LongCovid 1/
The biggest change is feeling like I have more *oxygen* circulating in my body - the weird altitude-sickness feeling is lessened.

Major improvements to cognition/awareness (esp executive functioning & processing), and improved physical capacity and overall baseline. 2/
The first tolerance break I felt more air hunger and worse baseline than pre-nicotine, but every other tolerance break has been equal or better than pre-nicotine.

It feels like an excellent symptom management tool, but *not* a cure. 3/
Read 7 tweets
May 1
From the Conference of Retroviruses & Opportunistic Infections: persistence of Covid in megakaryocytes in #LongCovid.

Over my head, but my understanding: megakaryocytes (type of bone marrow cell) being infected = continuous infection, very serious!

1/ croiconference.org/wp-content/upl…
graph showing levels of circulating Megakaryocytes; very low for healthy controls, high for severe Covid and Long Covid
This could cause additional impacts like deficits in platelet energy metabolism, or hormonal dysregulation (because platelets carry serotonin) #LongCovid

More about this here from the amazing @polybioRF!

2/polybio.org/projects/sars-…
The study found:

-circulating megakaryocytes harbored Spike, SARS-CoV-2 ssRNA, & dsRNA in #LongCovid patients

-these produced platelets containing Spike & SARS-CoV-2 ssRNA 3/
Read 5 tweets
Oct 30, 2023
Because this video has caused so much willful misinterpretation, I want to clarify: in the clip I’m countering the myth that #longcovid is lingering symptoms of acute COVID, since many people think it’s just a cough. I should‘ve said “acute COVID”; brain fogged & trying my best.
The interview was an hour long & they edited it to 5 min. I talked their ear off about all hypotheses & the science behind each & it didn’t make it in - the piece was for a general audience. I talked about all the other things COVID can cause, include diabetes & clots, at length.
Anyone who is suggesting I don’t think #longcovid is from COVID (????) or that I don’t think viral persistence is a high priority hypothesis (????) are *actively* ignoring 3.5 yrs of advocacy & that I’ve been highlighting viral persistence since 2020
Read 7 tweets
Sep 20, 2023
The most exciting hypotheses in #LongCovid and #pwME are ones that could have cures! This includes viral persistence and others, and also includes the itaconate shunt hypothesis. I'm going to tweet this video as I watch it to try to explain it more 1/
Dr. Ron Davis used to work on the Human Genome Project but switched to ME/CFS when his son got sick. He's the director at the Stanford Genome Center. He is focused on *a cure* for ME/CFS. "I believe it is a curable disease." 2/ slide that says "ME/CFS - A curable disease?"
He describes the common onsets of ME - usually viral, but can have other causes too, refers to a big parasite onset in Norway from a few years ago 3/ Image
Read 13 tweets

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