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WesElyMD

@WesElyMD

Jan 20

@NEJM

1/🧵 @NEJM “Covid19 has rendered U.S. racial, ethnic & social health inequities too stark to ignore.”

In the face of staggering inequities in Covid morbidity & mortality, the scientific workforce must confront #StructuralRacism

TY @DrCHWilkins & authors
bit.ly/3fGHycT

2/ The 2020 U.S. Census estimated that 33% of people in the United States identify as members of racial or ethnic groups that are underrepresented in medicine but less than 6% of research faculty are members of such groups.

@FDA

3/ Only 4 to 5% of participants in trials of drugs submitted for approval by the @FDA between 1997 & 2014 were from groups historically underrepresented in medicine.

Read 5 tweets

WesElyMD

@WesElyMD

Jan 19

@Nature

1/🧵 BEWARE: Mild” COVID can cause #LongCOVID‼️

@Nature study of N=147 (31 w LongCOVID) found Covid infection exerts unique & prolonged effects on our innate & adaptive immune system over 8 months later.

This may drive Long Covid.

go.nature.com/3ntDOQk

2/ Obviously, Acute COVID-19, caused by infection w SARS-CoV-2 is characterized by wide ranging severity from asymptomatic to fatal. Our immune response (big or little) to the virus drives the pathology that can kill us.

3/ We know that the acute infection causes pronounced immune system problems w lowering lymph cells and rising inflammatory mediators that can cause organ damage.

This is why I have to put so many people on ventilators & dialysis.

Read 8 tweets

WesElyMD

@WesElyMD

Jan 17

1/🧵Racism & Medicine #MLK

Why was my patient w no brain function shackled?

“Racism is rarely used in medical literature. Most MDs are not explicitly racist & committed to treating patients equally. But they operate in an inherently racist system.”

bit.ly/3rqcwvw

2/ This man’s ankle was shackled despite that he was brain dead after being found down.

Two immediate problems faced us as a medical team that blocked upholding his dignity.

1. The shackles
2. That we were not allowed to communicate directly to his family.

3/ First battle – unshackle this man.

📍Repeated attempts by our team were met w refusal by the prison guards & wardens.
📍I realize that everyone’s safety must be prioritized, But…
📍This man was of absolutely NO risk to anyone.
📍We were a risk to him.

Read 10 tweets

WesElyMD

@WesElyMD

Jan 17

1/🧵Important = Brain Injury in #COVID💥

📍N=251 hospitalized COVID pts had biomarkers of neurodegeneration (dying brain cells).

📍Previously healthy COVID pts had ⬆️er levels than Alzheimer’s pts!

How do we understand this?
Hint: #Vaccinate yourself

bit.ly/3frTcbB

2/ These elevated brain biomarkers indicate disease to different types of brain cells (eg, astrocytes, glial cells, neurons) in COVID patients. These were early unvaccinated pandemic patients. Vaccinated people will be less prone. WHY?

3/ There isn’t a ton of brain invasion by COVID. We think most of the 🧠 injury is INDIRECT. Meaning downstream injury from 1. upstream inflammation 2. blood clotting & 3. heavy sedation causing #delirium, which we proved to be a #dementia risk factor!

bit.ly/3qCaOrQ

Read 7 tweets

WesElyMD

@WesElyMD

Jan 17

1/🧵 Somebody had to die to get me a bed…

Voice on to listen: 🎧

My patient, now a #LongCOVID survivor & mentor to young Black boys told me…

“I was getting so sick w #COVID, & there was not a bed. They called everywhere & suddenly that night they said the VA got a bed.

2/ So somebody had to die that day, you know, so I’m just saying, wow, you know. But I told my wife, when I left here, I’m in God’s hands, you know, and I don’t know why I said it, but there was nothing she could do for me. (Pics w perm)

3/ So many things fell into place, it’s just not a coincidence. I thank God every day. I’m a different kind of guy, you know. I had to change a lot of my life. I got involved w young men to try to change the trajectory of their lives. That changed me & became therapy for me.

Read 6 tweets

WesElyMD

@WesElyMD

Jan 14

https://twitter.com/weselymd/status/1390124955996667907

1/🧵 Sleep for Sick Patients & #LongCOVID

If sleep is so important, why do we wake you up (hourly) in hospital?

Do #LongCOVID pts need MORE rest than they think?

We’re studying this to see if “forcing” hospital quiet times helps people survive & get less #delirium.

Read on…

https://twitter.com/weselymd/status/1390124955996667907

2/ It makes sense to me that it’s unhealthy to keep waking up people who are trying to get rest & heal.

If the body needs 7 hours #sleep a night when NOT sick (see 🧵 in tweet above), is it anti-medicine to prevent us from even more sleep when so much repair is needed?

@fi_lowenstein

3/ @fi_lowenstein & @itsbodypolitic wrote a wonderful piece about how she “rested herself” to health when suffering #LongCOVID.

I tell my COVID survivors @CIBScenter, “However much sleep/rest you think you need, double it.”

bit.ly/34JSyEd

Read 9 tweets

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