Believers that #LongCovid is "all in your mind" because there are on specific biomarkers or routine diagnostic tests are "normal" need to look at other autoimmune/inflammatory disorders. In #MultipleSclerosis, or example, it took decades to refine the diagnostic criteria. 1/🧵
First, before MRI/CT scans were invented, many #MS pts were misdiagnosed with psych disorders, including hysteria. Spinal taps in MS patients did not always reveal abnormalities. Many patients had various non-specific white matter lesions in MRI, but some had few or none. 2/🧵
Some #MS pts had optic neuritis, but many did not. Some had a lesion in the cervical cord, and many did not. How do you make sense of it all? It took many years and several revisions to come with the diagnostic criteria that we use today to diagnose MS and MS variants. 3/🧵
Rheumatoid #arthritis is another example: many are RF-positive, and some are RF-negative. #Sjogrens syndrome is another diagnostic dilemma, especially if anti-SSA and anti-SSB antibodies are negative. The point is: autoimmune/inflammatory disorders are COMPLEX! 4/🧵
#LongCovid has significant autoimmune/inflammatory basis, but needs to be defined better by subtypes (neurologic, cardiovascular, pulmonary, psychiatric, mixed, etc.) Specialized tests should be developed (serum cytokine panel? T-cell immunologic panel? Cardiac MRI?) 5/🧵
#LongCovid is not one disease and not one disease process, but should be viewed as an umbrella that, depending on the subtype, should lead to these subtypes' specific diagnostic tests. Treatment, which has to be developed, may have to be tailored to the subtypes as well. 6/🧵
Nobody should expect #LongCovid to be diagnosed or treated based on simple & cheap diagnostics or therapies. It's going to be complex, tedious & expensive - exactly what our #healthcare dislikes! It will take innovation, creation & thinking outside the box to yield results. 7/7
P.S. First post should read "Believers that #LongCovid is "all in your mind" because there are NO specific biomarkers..."
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