Thread by @elisaperego78

#LongCovid in Italy

Official data for hospitalized patients in the Lombardy region

Lombardy was the world's first covid epicenter outside China

~50% patients has a degree of disability several months in 🔺️

🧵 with comments, caveats, implications

quotidianosanita.it/m/scienza-e-fa…

First, we have to consider these data in view of large hospitalization surges from covid worldwide: 145.000 people are hospitalized today in the US alone. We can't acritically apply data from one context to another. Yet, it's clear many hospitalized patients will suffer long term

It is absolutely evident ---also in view of innumerable studies on hospitalized and non-hospitalized patients--- that SARS-CoV-2 infection can lead to prolonged, potentially lifelong, disabling, and life-threatening symptoms and sequelae: #LongCovid

Covid is not mild

A pillar of the Lombardy study is assessment of lung function and impairment. This is because the study is based on hospitalized patients, many | most of which had covid pneumonia. Overtaken Lombardy was mostly hospitalizing those with severe respiratory symptoms and high fever |

The study -- which involved over 800 hospitalized patients who survived acute covid -- also assessed through some screening and questionnaires the persistence of multi-system #LongCovid -- with symptoms that ranged from cognitive impairment to cardiovascular issues

Among severe, hospitalized patients in the acute covid phase: 20% presented mild disability. Increasing levels of disability were seen in other patients. 6 to 12% had moderate disability and 4% presented *severe* disability

four classes of disability were scored

#LongCovid

We have to remember a few key points. These preliminary data from Lombardy aren't a random sample. First, patients assessed here are *those who survived*. They are severe, but *not* critically ill covid patients. In-hospital mortality in first-wave Lombardy was ~30%

#LongCovid

A second key point is: overtaken Lombardy was often leaving severe patients at home, simply because hospitals were too full to accommodate everyone. The patient cohort here, thus, just reflects those who made it to the hospital and were enrolled in a follow up study

Many others, including those with severe covid disease, had never been enrolled in any formal study, or never received any treatment |support. This is because of policy as well as healthcare disruption in Lombardy
"Mild" patients are also left beahind
#LongCovid

In view of the above, these data from Lombardy cannot be considered a random sample to assess #LongCovid in a wider cohort across different age and other groups
They do, however, confirm the severe long-term burden in terms of disability and lost life quality from covid

Thanks @FranceskoNew and @docdrugztore for sharing this piece with me in the first place and your ongoing support

I also want to add that these patients received treatment in the acute phase as well as support and assessment in the #LongCovid phase.

The 42% disabled percentage in hospitalized patients is not necessarily *good news* for the non-hospitalized who didn't receive any care.