Thread by @jeffgilchrist

Even #mild #COVID #infection increases risk of #blood #clots and #death

A study in the UK found that mild (non-hospitalized) infections led to a 2.7x higher risk of blood clots and 10.2x higher risk of death compared to controls ( heart.bmj.com/node/174901.fu… ). H/T: @LauraMiers 🧵1/

The study looked at 17,871 COVID-19 cases in the UK between March 2020 and March 2021. People hospitalized *for* COVID-19 were at even higher risk:
118.0x = All-cause Death
27.6 = Venous Thromboembolism (blood clots)
21.6x = Heart Failure
17.5x = Stroke

2/

14.9x = Atrial Fibrillation (AF)
13.6x = Pericarditis
9.9x = Myocardial Infarction (heart attack)

3/

The authors stated, "The associated risks were greatest in the first 30 days after infection but remained higher than controls even after this period." 4/

It is important to note that the majority of the study was conducted *before* the COVID-19 vaccines were approved and being given in the UK. 5/

@greg_travis took data from the CDC and plotted the deaths per months in males aged 25-54 from cardiovascular or respiratory disease and found a 39% increase in deaths/month since the start of the pandemic even in this younger age group (

https://twitter.com/greg_travis/status/1602337780125908995

). 6/

Dr. Rae Duncan (@Sunny_Rae1) discusses how COVID infection causes endothelial damage (inner lining of blood vessels) happening directly from the virus infection itself and also from the immune response that is generated (cytokines) (

https://twitter.com/jeffgilchrist/status/1586321257091698688

). 7/

Dr. Claire Taylor (@drclairetaylor) explains more about which tests are needed to detect these microclots as the more common D-Dimer and CTPA tests will frequently come back "normal" but can find them using a VQ scan (

https://twitter.com/jeffgilchrist/status/1586043185901760512

). 8/

Dr. Rae Duncan (@Sunny_Rae1) provides a real world example from the cardiovascular clinic she started where all the Long COVID patients they treated had microclots and platelet activation (

https://twitter.com/jeffgilchrist/status/1586043132134576128

). 9/

@PutrinoLab has found a way to image #microclots and activated #platelets which can be seen with your own eyes through a microscope (

https://twitter.com/VirusesImmunity/status/1589762087597019137

). 10/

@PutrinoLab explains how microclots and platelet hyperactivation can be used as a biomarker by taking blood, spin, stain, and look under a microscope and then process the image (

https://twitter.com/PutrinoLab/status/1601223290273398784

). 11/

The theory is that microclots may be blocking delicate blood vessels throughout the body, preventing oxygen from getting to where it needs to go resulting in shortness of breath, organ damage, cognitive dysfunction, and debilitating fatigue ( webmd.com/lung/news/2022… ). 12/

These images show microclots (green) circulating in the blood of people. You can see there is very little in image A from the controls without Long COVID and significantly more in images B, C, and D from those patients with Long COVID ( pubmed.ncbi.nlm.nih.gov/35195253/ ). 13/

Besides cardiovascular damage, mild COVID infections can also damage your lungs too (

https://twitter.com/jeffgilchrist/status/1604112214788640768

). 14/

For a one page web view/unrolled version of this thread on "Even mild COVID infection increases risk of blood clots and death" that is easier for people outside of Twitter to share you can use: pingthread.com/thread/1604832…

A study just published found that mild COVID-19 induces early quantifiable persistent troponin I elevations in men age 55+ ( frontiersin.org/articles/10.33… ). Troponin I proteins are released in the blood when the heart muscle has been damaged. H/T: @ringleader_ 15/

The study looked at 278 individuals in Switzerland from April 2020 to July 2021 (so the majority of the study took place before COVID vaccines were approved). 16/

Troponin I levels were significantly increased in male COVID-19 patients age 55+ compared to controls from baseline until week 9 after infection and still remained elevated for at least 14 months (when the study finished). There was no significant difference found in women. 17/

"This statistically significant change in troponin I concentration was not dependent on co-morbidities in this group. ALT, Creatinine, BNP, and D-Dimer values after convalescence did not differ in comparison to the control cohort." 18/

The study concludes, "This suggests the possibility of an ongoing, long-term, low-grade myocardial injury." 19/

The researchers believe this myocardial injury is likely the result of a combination of cytokine release, inflammation, microvascular damage, and a resulting supply/demand imbalance. 20/

Early data from their cohort revealed a gender difference in early immunological response after COVID-19 infection which may help explain why they are seeing a difference in troponin I levels between men and women post-infection. 21/