Not sure how it's possible public health officials "initially believed only a small minority of people would suffer from Long Covid". I wrote some of the first papers ever on #LongCovid myself. Co-authors and I wrote the costs were going to be "unfathomable" = huge | in 2020

🧵
"Research indicating sequelae even in asymptomatic/pauci-symptomatic cases, suggests screening and treatment may be needed for millions" | a note: we wrote this in summer 2020 | we're now at hundreds of millions, if not billions, of infected people at risk!
An early report by @patientled found a significant percentage of people in their sample had
prolonged symptoms for several weeks | a note: we're again in 2020, so the survey was based on an early timeframe | but prolonged disease in many was evident!

patientresearchcovid19.com/research/repor…
Again in summer 2020, Carfi et al published a research letter in @JAMA_current on "persistent symptoms in patients after acute covid 19"
Based on a sample of 143 hospitalized patients, they showed only 12% of survivors were symptoms free ~60 days from onset | mean age 56 years
Again in 2020, Putmann et al addressed cardiac involvement in 100 patients with covid onset ~71 days before | mostly non-hospitalized | 78% had myocardial involvement | 60% onoing myocardial inflammation | mean age 49 years | not old!

pubmed.ncbi.nlm.nih.gov/32730619/
These are some very early published pieces on prolonged symptoms and sequelae after SARS-CoV-2 infection | just a small list! | as we know, #LongCovid was being defined and recognized by those with the disease in late winter to spring 2020.
A lot of early knowledge on #LongCovid was created and shared via means which aren't those through which knowledge in medicine is usually built: tweets, posts in support groups, blogs, interviews to newspapers, videos.

sciencedirect.com/science/articl…
Many of those sharing their experiences on social and other media were not medical professionals (although some were!). Some were too ill to write scientific papers themselves, despite having a scientific background.
All this huge amount of knowledge shared by those with #LongCovid made clear already in early-to-mid 2020, that a significant percentage of those infected with SARS-CoV-2 was not recovering within the 2-6 week timeframe of official guidelines.
#LongCovid was formally recognized by the WHO in August 2020. Since the early studies in 2020, thousands of papers have been published on Long Covid. These studies show Long Covid isn't rare. I don't even mention the existent research on the SARS sequelae | #longSARS.
Sedicent "experts" saying #LongCovid was believed to be rare are clearly not expert, or they are not providing a clear description of both the disease and how knowledge on the disease evolved. Long Covid was never shown to be rare, or not a big problem. Quite the opposite.

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More from @elisaperego78

May 16
I'm a bit exhausted to repeat this. But #LongCovid | covid are among the best studied diseases in history. In addition to the sheer amount of studies, a lot of research has been done with some of the most advanced techniques in biomedical research. Let's have a look!

🧵
Brightest X-rays on Earth expose covid damage to the lung | the innovative imaging technique can pick up micrometre-scale of organs

@Nature | November 2021

nature.com/articles/d4158…
In @NatGeo | January 2022 | a long but accessible read on the implementation of cutting-edge technology and scanning techniques to explore the vascular nature of covid

nationalgeographic.com/science/articl…
Read 13 tweets
May 16
For those complaining we don't have a "clear definition" of #LongCovid just 2 years after the disease appeared: health bodies like @WHO are *still* working on the classification and definition of common, well-known diseases like diabetes | see e.g. 2019

who.int/publications/i…
The scientific endeavor is dynamic and ongoing. New biomedical research can drastically change our understanding of a disease or common biological phenomena. #LongCovid | covid are new diseases that appeared only over 2 years ago (although there is a lot of evidence from SARS)
Knowledge building on covid has been extremely fast despite the huge challenges of the pandemic. There are hundreds of thousands of publications on acute covid and thousands on #LongCovid. These are among the most studied diseases in history, especially given the short time frame
Read 4 tweets
May 13
I've been wondering about it too. Many with subtle symptoms and signs might not even understand they had covid
A note: many of the early advocates and patient researchers that identified, named and defined #LongCovid in early 2020 had severe, if not life-threatening covid

🧵
Many had been phone triaged and left at home with extremely dangerous issues, like coagulopathy, hypoxemia and pneumonia. This would have required immediate medical attention, if not for the "wartime" triage of 2020. Many have forgotten how *bad* was in early hotspots
Many of these issues, at the same time, could present themselves in a prolonged, and/or delayed manner. Peaks in severity took place beyond what the "acute" phase of covid would be. This is something the media, policy makers, and medical professionals fail to convey
Read 15 tweets
May 11
More evidence of microvascular |endothelial injury in #LongCovid. Among biomarkers, a loss of 3% or more in oxygen saturation on mild exercise. Not that the community hasn't been reporting hypoxemia for 2 years to be told the pulse oximeter "is broken"

ashpublications.org/bloodadvances/…
I add here as an example an interview I did (with many others) with Ed Yong, where I specifically mention oxygen saturation drops as something the patient community has been flagging since the beginning. But wasn't addressed in conventional research

theatlantic.com/science/archiv…
I did the interview in August 2021 and the piece was out on 1 September 2021. We are still here, with research finally out in 2022, but many living with #LongCovid still deprived of any appropriate support, including myself. And I'm one with even basic tests not "normal"
Read 5 tweets
May 11
A reason why patient-led research and involvement is key in biomedical research. And should be rewarded, and elevated to the normal. For #LongCovid and other diseases, too.
Medicine is often not equipped to deal with complex research challenges and out-of-the-box thinking
This is doesn't mean that patients must necessarily do research if they aren't interested to! But in many patient communities, people living with the disease are involved in research efforts. This is especially the case of #LongCovid and other viral onset diseases like ME
Their contributions, however, might be dismissed, diminished, marginalised, or even exploited by conventional (i.e. non patient) researchers. Ideas produced by patients beyond the conventional channels of medicine (e.g. on Twitter) might be taken with no consent or recognition
Read 5 tweets
May 11
A case study of acute liver failure associated with MIS-C in a 10 month neonate | fatal case | evidence of severe multi-organ involvement and prolonged disease | delayed onset in respect to SARS-CoV-2 exposure

#LongCovid

🧵
frontiersin.org/articles/10.33…
The boy presented with symptoms and signs of severe liver involvement 45 days after a known exposure from the mother. In addition to acute liver failure, he also met the diagnostic criteria for MIS-C = covid-related hyperinflammation syndrome with multi-organ involvement
The baby was positive for SARS-CoV-2 antibodies but negative to PCR test for covid. The lungs had evidence of some small clots. Disease presentation was so severe to require ICU admission and in the end proved to be fatal.
Read 7 tweets

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