A study from #Brazil finds 1 in 4 adults who had mild #COVID19 demonstrated cognitive deficits. The average age of study participants was 38. See what happened when they were asked to copy a diagram. We are not prepared for this. #MedTwitter#LongCovidbrainfacts.org/diseases-and-d…
Many people are replying “I wouldn’t have been able to copy that drawing accurately even before #COVID19.” This is true. On avg, 5-8% of population are unable to reproduce this. What concerned researchers was that in this study of ppl w/ mild COVID, 25% of them could not.
There are less complex drawings that can look for more obvious visuoconstructive deficits. We often ask patients to draw a clock showing a specific time when screening for dementia. Here’s a published example of those drawings (unrelated to COVID). sistershospitallers.org/clock-drawing-…
Multiple people have also commented that I didn’t include the actual study. The link to the article in the first tweet of the 🧵 in fact contains a hyperlink to the study publication, available w/ no paywall, but here it is again: nature.com/articles/s4138…. #LongCovid#MedTwitter
Author notes findings are worrisome because “groups’s mean age was 38 & mostly highly ed profs such as physicians & nurses, as recruitment took place during the initial stage of the #pandemic.”
And it wasn’t the #COVID19 vax— it didn’t exist yet.
And finally, if you are #MedTwitter or someone else who requires more details than in this 🧵, please go to the article or the orig publication of the study linked earlier. If you need more info on the study that isn’t in there, contact the study authors (I’m not one of them).
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#MedTwitter
There is a widespread outbreak of #norovirus, a GI virus that causes projectile vomiting & profuse diarrhea usually lasting 24-48 hrs. Wastewater levels nationwide are high. It’s miserable & incredibly contagious. So many friends are texting us SOS, so here’s a 🧵. /1
Norovirus spreads when as few as 10 viral particles get in the mouth. This happens via direct contact (eg, kissing), contaminated food/water, or touching contaminated surfaces (countertop, toy, soiled clothes) then mouth (eg, toddler toys in mouth, eating by hand, nailbiting). /2
#MedTwitter
Given how contagious #norovirus is & how it spreads, it is like a brushfire in close quarters and/or where common items are handled by many. Cruise ships are famous for outbreaks, but also daycares/schools, dorms, dining hall/salad bars, nursing homes, jails, etc. /3
🧵 #MedTwitter IMPORTANT
The case of this 🇨🇦 adolescent with #H5N1 #BirdFlu is terrifying. Her only medical history was mild asthma, & symptoms started w/ fever and conjunctivitis. On d5 from symptom onset, she was admitted in respiratory failure, kidney failure, in shock … /1
Despite 3 antivirals (oseltamivir, amantadine, & baloxavir) to which her virus appeared to be susceptible & plasma exchange (three times !!), she spent 2 wks on ECMO and almost 3 wks on a ventilator and was dialysis-dependent. She survived. Let her be a warning, #MedTwitter /2
In an H5N1 outbreak, if even a small % of people get so sick, hospitals are in trouble. If a #H5N1 virus gains ability to spread btwn humans & enters widespread circulation, humanity is in trouble. No amount of #publichealth effort or cost to prep for #BirdFlu is too great. /3
#MedTwitter
NEW Analysis of 641K hospital admissions in 3.5y finds ending universal masking & #COVID19 testing was assoc w/ a 25% ⬆️ in hospital-onset resp viral infections (w/ longer stay & ⬆️ mortality) & resumption of universal hospital masking with a 33% ⬇️. #WearAMask /1
#MedTwitter
The ⬇️ in respiratory viral infections w/ universal masking included #COVID19, #influenza, & #RSV: .
We need universal masking in hospitals, especially now when #SARSCoV2, #flu, & #RSV levels are high nationwide based on wastewater testing. /2 ja.ma/3Z5fdn7
#MedTwitter
The study didn’t assess #longCovid (LC) risk but given that preventing #COVID19 is the only reliable way to prevent LC, universal masking in hospital would likely also ⬇️ LC risk. In my opinion, lack of universal masking should be a hospital quality measure. /3
President Jimmy Carter died today at age 100, having lived w/ melanoma that had spread to his brain & liver for >9y. I grew up in GA admiring him, so as an oncologist, I’d like to honor his life by teaching you a bit. #melsm #MedTwitter
First, the ⚠️ signs (ABCDE 👇) & pics
/1
It’s important to know who’s at ⬆️ risk for #melanoma (see 📸 ).
UV exposure (☀️ or tanning bed) is the major risk.
Having 5 sunburns doubles your lifetime risk of melanoma. Age matters. Even ONE blistering sunburn as a kid/teen doubles lifetime risk!
🔑 AVOID BURNS! /2
People with dark skin can also get melanoma (though they are at much lower risk than people with fair skin).
And #melanoma can appear in unusual places including some you might not expect like your nails or even areas that get little or no sun exposure. /3
NEW 📣 Nat’l study in #Sweden: 86% of people on sick leave due to #COVID19 in wave 1 of #pandemic still had symptoms 18m later, esp fatigue, cognition, sleep, movement. Risks higher if hospitalized or female. Vax didn’t exist then.
#MedTwitter #LongCovid
The study also found nearly half of respondents also had problems w/ functioning in daily life 18 mos after they were infected w/ #COVID19. That is #LongCovid. This is a stunning number.
Sweden never had a full lockdown or mask mandate in wave 1. /2
#MedTwitter
With this approach, #COVID19 deaths were noticeably higher in #Sweden than in neighboring countries with more precautions. For example, see this graph from ABC based on a Johns Hopkins analysis of the region. The King said: “I think we have failed.” /3 au.news.yahoo.com/leaders-tragic…
NEW Longest prospective study of #LongCovidKids: 1.3K kids who tested pos for #COVID19 were followed up to 3y. Of note, 89% of cases were “mild” & 9% had no symptoms, & 80% had zero doses of vaccine. Mix of variants, but most were Omicron then Delta. /1 thelancet.com/action/showPdf…
Sadly, 23% of kids had #LongCovid at 3 mos. While #s fell over time, 13% at 6 mos, 8% at 1 yr, 6% at 18 mos, & 7% at 2 yrs still had #LongCovid. This is tragic, both because it means that 1 in 12 kids are still suffering a year later, & most of those remain ill longer term. /2
Adolescents/teens were at MUCH greater risk than age <12, as were those infected by earlier variants. Females & those w/ comorbidities were also at slightly increased risk. Infection w/ orig variant resulted in ⬆️ autoimmune disease. Vaccination reduced risk of #LongCovid. /3