"In the past month we found a 30-fold increased incidence of Kawasaki-like disease. A similar outbreak of [severe] Kawasaki-like disease is expected in countries involved in the SARS-CoV-2 epidemic"

—13 May 2020—data from Bergamo—Italy @TheLancet

#MISC

thelancet.com/journals/lance…
Some early pandemic history. This in the top @TheLancet journal from May 2020 is a first description of the severe, sometimes fatal multi-inflammatory syndrome seen in children weeks after SARS-CoV-2 infection — later known as MISC or PIMS.
"Children diagnosed after the SARS-CoV-2 epidemic began showed evidence of immune response to the virus, were older, had a higher rate of cardiac involvement, and features of MAS. The SARS-CoV-2 epidemic was associated with high incidence of a severe form of Kawasaki disease."
MISC was first identified in early pandemic epicenters, like, primarily, in the hard-hit Bergamo, in the Lombardy region, Italy. In view of its clinical features, MISC was initially compared to an already known clinical entity, namely Kawasaki disease (and called Kawasaki-like)
"In this study, the clinical and biochemical features of patients with Kawasaki disease diagnosed during the COVID-19 pandemic appeared to differ from our historical cohort of patients; therefore, we have classified these patients as Kawasaki-like disease."
Make no mistake. We knew a lot of things about SARS-CoV-2 already at the beginning of the pandemic. Some vital information was published in the most prestigious medical and scientific journals on the planet.
We knew this virus was very dangerous for at least some children in early 2020 already.
An article in Italian from 28 April 2020

"Kawasaki disease: a severe increase in Bergamo. According to pediatricians there is a link to covid"

"Italy and the UK are seeing an increase in Kawasaki disease. In Bergamo there's 30-fold increase"

quotidianosanita.it/m/scienza-e-fa…
Italy's news in spring and summer 2020 were reporting quite openly on the Kawasaki like disease seen in children after (other cases were being reported in additional early hotspots like the UK). A fast Google search will suffice.
"Kawasaki syndrome: it hits blood vessels in children (and could be linked to covid)" from Italy, 28 April 2020

"Dr Ciuffreda first diagnosed one case at the emergency in Bergamo in March 2020"

"Many cases from Genova to London, Bergamo, Lisbon"

corriere.it/salute/malatti…
"Kawasaki disease is an inflammation of the blood vessels, a vasculitis."

We have been discussing so many times even on this very platform the role of vascular disease (including covid-related vasculitis) in acute and #LongCovid
MISC wasn't fully meeting the clinical case criteria for pre covid Kawasaki disease, hence names like Kawasaki like, and then MISC and PIMS, but the strong cardiovascular component of the disease remains interesting especially in terms of pandemic history and understanding covid

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More from @elisaperego78

Nov 28
I will have to repeat this again. We knew covid and #LongCovid had a strong cardiovascular and endothelial component in 2020 and 2021 already. A lot of work on proving this, and raising the alert, was done by patients and advocates. It's published and recorded on many platforms.
Medical professionals and health bodies trying to gloss over this, and to suggest we've just discovered #LongCovid and covid have a severe cardiovascular impact: please do better. Letting SARS-CoV-2 rip was a severe error. Letting millions with no care was a severe error.
There was also emerging, very strong evidence published already in early 2020 about the pathophysiology of covid. This research clearly showed the devastating impact of the disease across the human body. Covid is not a "cold." Never was. Never been.
Read 4 tweets
Nov 26
"Covid is now coming back quite strong. We have, again, people who need ICU care and hospitalization. We've a covid ward again. And young, healthy people can get a harsh "flu-like presentation" Influenza is also here."

—healthcare personnel—Liguria—Italy
genova.repubblica.it/cronaca/2022/1…
Thanks @Miti_Vigliero for sharing first. This is a summary and translation from Italian by myself. In @Miti_Vigliero thread (Italian, below) you can find more from the interview. Bottom line: Italy's growing. The Liguria region in the north is hit by both covid and influenza
Read 6 tweets
Nov 26
"We are seeing many covid reinfections, some very close in time. Even in those who were vaccinated with multiple doses. Reinfections can be dangerous. Covid is growing again. It's not endemic."

—Prof. M. Andreoni—Italy

qds.it/covid-andreoni…
"Letting SARS-CoV-2 spread is dangerous, especially for elderly people who aren't boosted. We need them to get, at least, the booster, True, covid may appear less dangerous now, but the strong inflammation this disease still causes remains an issue"

—Prof. M. Andreoni—Italy
A summary and translation of an interview with Prof. M. Andreoni—Italy, Tor Vergata University (translation by myself). I draw attention again to growing awareness among professionals that covid can reinfect in a short time frame, and this can be quite dangerous.
Read 5 tweets
Nov 22
"Tonsils and adenoids are important sites of SARS-CoV-2 infection in asymptomatic children."

A study on dozens of children that underwent surgery like tonsillectomy (=removal of the tonsils) in the first two years of the pandemic.

h/t @Elodie_A_N
sciencedirect.com/science/articl…
"Positive immunostaining in adenotonsillar tissue samples suggests that lymphoid tissue can be a reservoir of SARS-CoV-2 and may play an important role in community dissemination."
"It remains unclear [according to the study I shared above] for how long the lymphoid tissue can sustain the SARS-CoV-2 in a persistent infection, and whether this persistence has any impact on virus transmission."

#LongCovid
Read 10 tweets
Nov 21
#LongCovid is not rare. This was especially the case in the pre-vaccine, pre-omicron era, and in early hotspots with collapsed healthcare systems.
Policy makers: you were told in good time. Time to act, accelerate research, and contain this pandemic.
We are in the timeline of a mass disabling event, with first wavers left with no medical care especially hit. People are still dying, being hospitalized, and developing Long Covid in great numbers. The pandemic isn't over. Many countries are growing again.
We can't live this way. I don't think we should be accepting this, when mitigations like mask use are available
Read 4 tweets
Nov 20
"I've started to walk again after 2 years. I'll have permanent "scars" from covid but I thank life"
— Maurizio Jack Giustolisi—a Sicilian former athlete. He went through a long ICU stay, coma, and a tortuous, difficult rehabilitation

#LongCovid

livesicilia.it/covid19-mauriz…
On rehabilitation in former athletes post covid — here a very serious case @OnTapPhysio
Read 8 tweets

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