WesElyMD Profile picture
Mar 3 13 tweets 9 min read
1/🧵 WAKE UP - #COVID is a Ball & Chain for heart disease & stroke.
This 154,000 pt study & others solidify COVID as a PREDICTOR of a variety of CardioVascular Dzs.
Translation: #LongCOVID pts suffer heart attacks, strokes & much more.
2/ SHOCKER: Amazing work scientifically. Every med student is taught to gauge Cardiovascular risk history: Smoking, Obesity, HTN, Cholesterol, Family History…

Add COVID to the list. Solid data from @NatureMedicine of US Veterans used >11M contemporary + historical controls!
3/ Main figure shows both hazard ratios & excess burden per 1,000 persons of highlighted types of problems like strokes, V Tach & #POTS, myocarditis, heart attacks, heart failure & blood clots in 154,000 people 30 days after COVID vs. 5,637,647 contemporary controls.
4/ These data on #SARSCoV2 infection provide a GRIM answer to the question: What are COVID19’s long-term cardiovascular outcomes? Considering millions already infected & still UnVaxxed, this solidifies #LongCOVID as a major #PublicHealth nightmare.
JAMA: bit.ly/3C9N9mD
5/ The 154k patients avg 61 yo, 89% males, 71% White. Because this vascular dz study was so large, it also included ~17,000 female patients; ~37,000 Black patients; and almost 8000 Latino, Asian, American Indian, Native Hawaiian & patients of other races with COVID- 19.
6/ Bottom line: Patients with COVID were at ⬆️ risk of a broad range of cardiovascular disorders including cerebrovascular disorders, electrical rhythm problems, ischemic and non–ischemic heart 💔 disease, pericarditis, myocarditis, heart failure, and blood clots.
7/ Myocarditis
Because some COVID #vaccines are associated w rare myocarditis, they designed analyses to remove the effect of vaccination. The ⬆️ risk of myocarditis & pericarditis remained in people not vaccinated and was evident regardless of vaccine status.
8/ Surprises
Risks were highest for heart failure & atrial fibrillation, but the breadth of cardiovascular disease involvement was eye popping even in patients w COVID that never required hospitalization.

#LongCOVID happens in MILD disease.

9/ This graph shows a variety of lower but still elevated heart stroke and clotting risks for people never hospitalized during acute COVID (green) who are the majority of people with COVID. The study did not analyze symptomatic vs asymptomatic infections.
10/🎥 Don’t forget that even young healthy people can get super sick, like this patient of mine who still has her 4 kids to raise after this devastating situation with her acute COVID.

Heartbreaking. I hope all will reconsider getting #Vaxxed.
11/ The authors warn: “Our data showed COVID-19 may be an equal opportunity #offender.”

Risks were evident in young & old people, Black & White people, males & females, smokers & nonsmokers, and in those with & w/out diabetes.
Getting COVID means you have a new risk factor for cardiovascular disease. If you had COVID or are high risk because you are immunocompromised or still unvaxxed, please #Mask & #Distance & watch for early signs or symptoms of heart disease

#LongCOVID bites.

By the way, vaccines were accounted for and remember that vaccination reduces risk of #LongCOVID:👇

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More from @WesElyMD

Feb 21
1/🧵 Paul Farmer has died.

It is so heartbreaking 💔. Let us collectively mourn his passing - one of the greatest #PublicHealth figures in the history of Medicine.

His @PIH is a tribute to a kinder gentler way to love each other.

2/ Dr. Farmer started his vocation of #SocialJustice by serving the beautiful people of Haiti, the world’s 1st Black republic. He looked in their eyes & saw their needs…HIV, malaria, Tb, hunger, poverty, neglect.

In response he took action…

(paintings below by my daughter)
3/ Paul Farmer is the central figure in Kidder’s 📚 “Mountains Beyond Mountains.” If you haven’t read it, order now.

Through his drive and insights we learned to say “Yes” to bringing modern medicine to the most remote settings of human life on Earth 🌍
Read 6 tweets
Feb 21
1/🧵 Why is COVID hospitalization like 2X sticks of dynamite 🧨?
A thread on the ICU portion… #PICS + #LongCOVID.
Prevent this w 3 steps:
📌Avoid #COVID by Vax & Mask
📌Avoid severe COVID by Paxlovid & Monoclonal Ab
📌👇 read here about PICS & how to reduce injury in the ICU
2/ Here’s what you must know if you get too sick & land in an ICU.

History Lesson 📝
In the past, too many decisions in #CriticalCare were guided by fear. We oversedated patients for too long out of worry they might self-extubate & pull off restraints.

That’s happening again 🤮
3/ We kept patients immobilized due to an overly conservative approach to fall prevention that precluded us from attempting to walk them early. We kept families away from patients, treating loved ones as visitors rather than members of the healing plan.

That’s happening again.
Read 10 tweets
Feb 15
1/🧵 Seeing Differently in #COVID ICU Care 👁

The world tells me “stuff” & “freedom ” bring happiness, yet neither suffice or satisfy.

If I reject chances to serve my suffering patients, I am left bereft.

Merciful care brings healing & provides joy all around.

What is #Mercy?
2/ My working definition of mercy is my willingness to dive into the chaos of another person’s life & provide lifting & healing.

Often as an ICU physician I do the former but not the latter.

That is, I dive into their #chaos without admitting I don’t know what’s right for them.
3/…but without performing actions that lead to lifting and healing of my patient’s spirit & mind, what I’m doing is dispensing false mercy.

eg, If in #COVID, I make the lungs 🫁 my whole goal, sedate & depersonalize someone for too long, I beget new diseases.

#PICS #LongCovid
Read 5 tweets
Feb 14
1/🧵 #WISDOM of Wine, Coffee & Chocolate. 🍷 🍫 ☕️
Millions love morning coffee or curling up w DARK chocolate & wine
What’s the #SCIENCE?

All 3 in moderation are safe…
This thread will focus on WINE! Let’s explore actual SCIENCE…
2/ This infographic shows the putative benefits – weight & BP control, diabetes & stroke prevention. But what do actual data say about this?
3/ Wine has antioxidants and flavonoids that might reduce cardiac disease.
Resveratrol from grapes inhibits initiation, promotion, and progression of cancer.
Read 14 tweets
Feb 10
1/🧵🎥 Politicians & Media are sending messages to take down #COVID protections.

In US it’s premature. Why?

📍>50% adults are NOT protected w #Booster
📍>75% of kids 5-11 are NOT fully #Vaccinated
📍Feb 8th >3,000 died
📍>17,000 dead in past week
📍>60,000 💀 January

2/ Last week I had moments where I thought, “It really is sad that society has to keep masking up & those poor kids in school haven’t seen people smile in so long.”

THEN…I thought about how dangerous it is for #CovidKids who get #longCovid to have to live that way.

3/ People continue to contract #Covid from children who skate through #Omicron initially while adults spend 3 weeks in ICU & die.

Denmark 🇩🇰 Israel 🇮🇱 South Africa 🇿🇦 will be safer faster.

US 🇺🇸 will lag behind by YEARS.

Messaging about an end to the pandemic is premature!
Read 6 tweets
Feb 8
1/🧵ICU Burn-Out Prevention in #COVID: a few thoughts
Early on as an ICU Doc, I carried a lot of shame because I realized that even though I sufficed as a technician and possessed the right knowledge, I was NOT doing a good job as a “person” with “people.”
#burnout #nurse Image
2/ Which is to say, I was only “good” doctor on paper. NOT in real life.

I kept myself at too much of a distance, and I thought my job was to do procedures well and provide the right medicines.

Now I know that was not enough, not by a LONG SHOT.
3/ 📚 I wrote: “That shot of adrenaline from saving a life dissipated once the ventilator was in place…as if we handed over care of our patients to machines while we went off & intubated, sedated & paralyzed the next person...

P.58 #EveryDeepDrawnBreath Image
Read 5 tweets

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