Thread by @drclairetaylor

1/Covid is a vascular disease. Even in children. 🩸

Why are the Sun&the mirror today reporting a warning about children&Covid from a paper from December 2020??

@Sunny_Rae1 and I talked about thrombotic microangiopathy a YEAR ago on Twitter space

2/This is recording of that space. It was listened to by over 20k people

@TheSun says today-3 YEARS later
🔴VIRTUALLY all children infected with Covid suffer from serious blood vessel damage, scientists have warned.
US study found a "high proportion” of kids with the bug had elevated levels of a biomarker tied to this type of cardiovascular injury.

4/And this was even the case for those who only had mild symptoms.’

So we have known since December 2020 blood vessel inflammation occurs in mild infection.
Because that is the paper the Sun is referring to. Not a new paper. An old one.
We always knew.

5/ ‘In the brain, damage to vessels could lead to inflammation, while in the limbs, reduced blood flow could lead to ‘Covid toe’, it added’

I have just done a thread on neuroinflammation

https://x.com/drclairetaylor/status/1716021333845332176?s=46&t=x5zAnjMFOis7mfC5WZbcIA

https://twitter.com/drclairetaylor/status/1716021333845332176

6/ The researchers also found many children with the bug test positive of thrombotic microangiopathy (TMA) - a rare but serious medical disease.’

7/The actual study was published in December 2020

ashpublications.org/bloodadvances/…

8/Conclusions
🔴sC5b9 plasma levels are elevated in children with SARS-CoV-2 infection, even if they have minimal symptoms of COVID-19.
🔴A high proportion of children with SARS-CoV-2 infection met clinical criteria for TMA.

50 hospitalised paediatric patients
21 mild disease
11 severe disease
18 Misc-c ( huge inflammatory response)

They compared C5b9 (normal 247 ng/mL) levels with Covid patients&healthy controls.
🔴elevations found in patients with minimal disease (median, 392 ng/mL)
🔴severe disease (median, 646 ng/mL)
🔴MIS-C (median, 630 ng/mL)
🟢compared to 26 healthy control subjects (median, 57 ng/mL

11/The difference is stark.
Concerning some would say?

89% met criteria for TMA. A high proportion of tested children with SARS-CoV-2 infection had evidence of complement activation and met clinical and diagnostic criteria for TMA.

12/The median sC5b9 level in the healthy control subjects (57 ng/mL; interquartile range [IQR], 9-163 ng/mL) differed significantly from that in patients with minimal disease

13/Of note, all patients in the MIS-C group were previously healthy or had minimal comorbidities.
@PIMS_Hub

14/For those who were diagnosed with thrombotic microangiopathy this is the list of co-morbidities. Majority were healthy children ( this is for the ‘oh they have pre-existing condition minimisers)
NOT that it matters

15/‘Strikingly, sC5b9 levels were abnormal even in children with minimal disease or an INCIDENTAL finding of SARS-CoV-2 infection, suggesting that any exposure to SARS-CoV-2 may be sufficient to induce elevations in this biomarker’
Any EXPOSURE- kids are exposed daily to Covid.

16/ This line is super important

The presence of elevated sC5b9 levels in 🔴ALL SARS-CoV-2 groups compared with healthy control subjects suggests that complement activation and thrombotic microangiopathy are prevalent in pediatric patients with SARS-CoV-2 infections.

17What is thrombotic microangiopathy?

‘pattern of damage that can occur in the smallest blood vessels inside many of the body’s vital organs – most commonly the kidney&brain.
microangiopathy translates to “small blood vessel problem.”
Thrombotic means blood clots are involved’

18/It can be diagnosed by looking at the clinical presentation and various blood markers
Here is a general paper on it ncbi.nlm.nih.gov/pmc/articles/P…

19/What is MIS-C?
Multisystem inflammatory syndrome in children temporally related to SARS CoV-2 (PMIS or PIMS-TS)
🔴it is a serious disease that can cause inflammation in the blood vessels to the heart and other organs
There can be a delay in symptoms weeks after Covid.

20/So why is this warning being put out now by the sun&the mirror?
Timing is always everything.
We are on cusp of winter.
We have multiple variants circulating
Could it be something important is about to come out?
🔴ALL parents need to read this paper. Demand mitigations

21/We know from this study that Covid affects children’s blood vessels already. We know it is something to do with the way children fight off infection (complement activation). Basically, a big immune response often called the ‘host response’
I’ve always said: watch the kids.

22/Visuals from the paper:
🔴sC5b9 levels in healthy controls versus Covid infected children
🔴Higher levels in those with kidney damage

23/Overall message

24/What does the UK gov Green book say?

Pediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS)
estimated to affect around 1 in 3,000 children.

PIMS-TS risk in the UK declined during the Delta wave,falling further after the Omicron

They state:
majority of children recover completely after acute Covid&any persistent systems will improve with time.
Serious long-term complications after recovering from acute SARS-CoV-2 infection, too, are rare in children
🔴NO mention of TMA

Let’s hope to god they are right