Thread by @elisaperego78

There are many infectious diseases where the early phase is "mild" or asymptomatic. But the prolonged pathology is not, and can be severe in the long-term. Examples are HIV/AIDS or EBV/multiple sclerosis. Don't necessarily trust SARS-CoV-2 if the early infection is uneventful 🧵

Pathogens have, obviously, their own specific features and mechanisms of actions. SARS-CoV-2 is not EBV/ Epstein Barr virus or HIV. What I'm saying here, is that the immediate clinical manifestations of an infection aren't necessarily indicative of overall severity

Since early 2020, we have known that SARS-CoV-2 can manifest with pauci-symptomatic/asymptomatic early pathology, which can kill or disable with time. Covid can manifest with an early mild flu-like illness (prodromal phase) which progresses to death

thelancet.com/article/S0140-…

We soon learnt, already in early 2020, that Covid can progress to prolonged disease and sequelae beyond the first weeks from infection (#LongCovid). Long Covid emerged initially thanks to advocacy from survivors. It was recognized by WHO in August 2020
sciencedirect.com/science/articl…

We have still to learn about the longest term sequelae of SARS-CoV-2 infection. Many pathogens in addition to HIV can cause severe or fatal disease years or decades from infection: e.g. poliovirus (post polio syndrome) or oncogenic viruses associated with cancer like EBV or HPV

A vast range of pathogens are firmly associated with prolonged disease and sequelae, including SARS-CoV, MERS CoV (both of which share similarities with SARS-CoV-2), Ebola virus (post Ebola syndrome), monkeypox virus, West Nile virus, Zika virus, and many others

Pertussis, commonly known as whooping cough, is another infectious disease which is associated with an insidious onset. It has a "prodromal phase" with milder, non-specific symptoms. The disease can soon progress to a "paroxysmal" phase with severe cough.

cdc.gov/pertussis/clin…

This is just a brief thread. The takeaway, however, is that we can't be complacent with a viral infection, SARS-CoV-2, which has already caused millions of deaths worldwide and is firmly associated with severe morbidity (ill health) already within three years (#LongCovid)

People also need to be fully aware that early, "mild" or asymptomatic disease in the first few days from SARS-CoV-2 infection, isn't necessarily the end of it. You can get worse and even suffer life-threatening events in time. This is scientifically proven. Be careful out there.

Bibliography as usual. On prolonged disease and sequelae from various viral and other infections (I see Long Ebola has entered the scientific literature, too, in addition to post Ebola syndrome)

frontiersin.org/articles/10.33…

ncbi.nlm.nih.gov/pmc/articles/P…

academic.oup.com/cid/article-ab…

On the ability of viruses such as HPV and others to trigger cancer far from infection

ncbi.nlm.nih.gov/pmc/articles/P…(

cancer.gov/about-cancer/c…

On the long-term effects of severe coronaviruses in humans like SARS CoV and MERS CoV (also look for e.g. #longSARS here on Twitter)

ncbi.nlm.nih.gov/pmc/articles/P…

globalnews.ca/news/404562/sa…

On EBV and the recent discovery of its link with multiple sclerosis
EBV is also linked to a range of other diseases from later onset cancer, to mononucleosis, to ME/CFS.

nih.gov/news-events/ni…

en.m.wikipedia.org/wiki/Epstein%E…

msdmanuals.com/home/infection…