Big #LongCovid paper out with a lot of new insights (n=78k)!
-76% of LC patients were not hospitalized (!!)
-82% of female patients non-hospitalized vs 68% males
-36-50 year olds were the highest risk age group
-59.8% of patients female; 46.2% male
-Heartbeat irregularities were more common in age 13-22 (possibly dysautonomia)
-Myopathies (diseases that affect the muscles that control voluntary movement) were 11.1x more common in #LongCovid compared to the same population pre-COVID!
2/
On average, patients with #LongCovid had higher
HHS-HCC risk scores after COVID-19 than before.
HHS-HCC risk scores identify which patients are likely to consume more healthcare resources & incur more healthcare-related costs in the long run.
3/
Of everyone diagnosed with a #LongCovid code, the most common age range was 36-50.
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As other studies have found, there is a gender difference, but it heavily depends on age group! For children under 12 and adults over 50, the chance of getting #LongCovid is almost equal between male and female patients.
5/
Obstructive sleep apnea was the most common sleeping diagnosis, which seems weird to me. Wonder if any of these are actually central apnea?
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A few diagnoses were highlighted as uncommon but potentially serious, with a large difference between pre- & post-COVID.
These included myopathies (11.1x more common), diseases affecting the interstitium (4.8x more), pulmonary embolism (2.6x), other brain disorders (2x).
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Breakdown of "other disorders of the brain", which seems to be ME/CFS-type manifestations, metabolic encephalopathy, and encephalopathy.
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44 countries have experienced a 10-fold increase in at least 13 infectious diseases compared to pre-pandemic rates, including RSV, cholera, measles, influenza, chickenpox, tuberculosis (TB), and others. 2/
While some (like TB) may be related to declining vaccination rates, COVID impacts the others.
"Immune mechanisms [like] a period of increased vulnerability to other infections following acute COVID infection" is a major contributor, esp irt respiratory infections in children 3/
Michael Peluso (@MichaelPelusoMD) introduces CHIIME, which adds an arm of ME/CFS patients to the LIINC study - will include PET imaging and tissue biopsy analysis, gut biopsies:
Phenotyping with patient-reported and objective clinical measures:
Incredible visit Thursday to the opening of Mount Sinai’s Cohen Center for Recovery from Complex Chronic Illness, led by the renowned @PutrinoLab! #LongCovid 1/
The Center is incredible and truly blew me away - designed on so many levels with patients in mind, with top notch care, using many of the most advanced tools available 2/
Some of the many tools patients are assessed with include:
The fibrin also:
-promotes neuroinflammation & neuronal loss post infection
-promotes innate immune activation in the brain & lungs independent of active infection
-downregulated JAK-STAT pathway & targets of p38 MAP kinase, pathways that regulate NK cell activation #LongCovid 2/
They used a monoclonal antibody targeting the fibrin domain, and found it protected against microglial activation & neuronal injury, as well as from thromboinflammation in the lung after infection! #LongCovid 3/
I've been doing #TheNicotineTest (via 7mg patches) for a month now & it has greatly improved my quality of life.
Major caveat: I'm on ivabradine. The nicotine increases heart rate, & I wouldn't recommend to anyone w POTS who isn't on beta-blockers or ivabradine. #LongCovid 1/
The biggest change is feeling like I have more *oxygen* circulating in my body - the weird altitude-sickness feeling is lessened.
Major improvements to cognition/awareness (esp executive functioning & processing), and improved physical capacity and overall baseline. 2/
The first tolerance break I felt more air hunger and worse baseline than pre-nicotine, but every other tolerance break has been equal or better than pre-nicotine.
It feels like an excellent symptom management tool, but *not* a cure. 3/
This could cause additional impacts like deficits in platelet energy metabolism, or hormonal dysregulation (because platelets carry serotonin) #LongCovid