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 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
Sep 11, 2023
FDA Stakeholder meeting on #LongCovid today:

@TheCrankyQueer: highlight the need for trans inclusion in trials, including understanding how different labs may present; biomarker nuance

Oved Amitay: need to create a center of excellence to learn from trials in other diseases 1/
Oved: FDA needs to align on decisions across similar fields, needs cross-talk across similar groups

@Dysautonomia: Most even great researchers don't understand autonomic disorders, which happen in up to 2/3 of LC...is there an opportunity to offer autonomic training? 2/
@Dysautonomia: Also, need to make arms in these trials for pre-Covid POTS/MECFS - this helps learn about LC as well (ie does Paxlovid help pre-covid pts)

Me: There are over 50 drugs ready to be trialed: 3/docs.google.com/document/d/1JJ…
Read 24 tweets
Jul 27, 2023
A beautiful piece by @edyong209 that fully describes & communicates the complexity of fatigue & Post-Exertional Malaise in #LongCovid.

Ironically am crashy today so going to pull out amazing quotes:

"Now, at least, she can watch TV on the same day she takes a shower." 1/
"Fatigue turns the most mundane of tasks into an “agonizing cost-benefit analysis,” @turnoftheshrew said. If you do laundry, how long will you need to rest to later make a meal? If you drink water, will you be able to reach the toilet?"

2/
"Only a quarter of long-haulers have symptoms that severely limit their daily activities, but even those with “moderate” cases are profoundly limited. @julialmv still works, but washing her hair, she told me, leaves her as exhausted as the long-distance runs she used to do." 3/
Read 33 tweets
Jul 13, 2023
This is one of the most accurate papers on #LongCovid recovery I've seen. It's full of crucial points:

-Only 7.6% recovered.

-Recovery was *more* likely in people who were in the ICU. This was something we saw early, but why?

A few thoughts:

1/ https://t.co/kdPhkTVR5mpapers.ssrn.com/sol3/papers.cf…
Those hospitalized with COVID, esp in the early pandemic, seem more likely to have forms of #LongCovid that are *not* the neurological form.

The neuro form seems to last longer (& often overlaps with ME/CFS & dysautonomia, lifelong conditions).



2/
Other factors that correlated with INCREASED likelihood to recover from #LongCovid include:

-being male
-having cardiovascular comorbidities
-lost appetite in acute phase
-had smell/taste alterations (this is often its own subtype that can come with no other symptoms)

3/
Read 10 tweets
Jun 29, 2023
There is a National Academies conference today focused on *all* illnesses that start after infection & viruses, like multiple sclerosis & others.

Livestream:

(This is *not* the definition conference & *not* focused on #LongCovid, but LC is a part!)nationalacademies.org/event/06-29-20…
Tim Henrich from University of California shows the many, many viruses that have long-term sequelae. 2/
2 years after acute Ebola infection, patients have *higher* rates of markers of tissue damage, T Cell and B cell activation & exhaustion, markers of inflammation 3/
Read 11 tweets

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