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Noha Aboelata, MD Profile picture
@NohaAboelataMD
Dec 3 • 6 tweets • 2 min read Twitter logo Read on Twitter
Amazing but frustrating!
3 patients with "chronic, unrelenting fatigue and cognitive impairment" plus other severe disabling symptoms experienced complete and sustained remission within days of receiving monoclonal antibody treatment. Amazing!🧵 1/6
sciencedirect.com/science/articl…
Their covid infections were pre-Delta, so previous monoclonals (casirivimab/imdevimab) were effective. Each patient "rapidly returned to normal health and previous lifestyles/occupations with normalized exercise tolerance, still sustained to date over two years later." Amazing!
Frustration #1: Why isn't everyone with Long Covid, particularly with pre-Omicron infection, being offered this monoclonal Ab treatment? It's quite safe, what is the downside? These 3 people have been better for OVER TWO YEARS. So many are suffering now - and have been for years!
Frustration #2: So much Regeneron sat on shelves, unable to be accessed for treatment. It saved many lives but too many didn't receive it and suffered or died. Then covid mutated and we had to stop giving it (too early imo). So much of the stuff expired and had to be discarded.😪
Frustration #3: Where are new monoclonals? I know they're expensive, especially since they're relatively variant-specific, but such a good treatment option for those who can't take the others, and prophylaxis for those with immune compromise. It’s maddening not to have new ones.
I'm hopeful about these results, both because of the clues they offer to the mechanisms of long covid and because of the promise of treatment. I'd like to see monoclonals readily accessible on a large scale and new ones matched to subsequent variants - like yesterday! 6/6

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More from @NohaAboelataMD

Noha Aboelata, MD Profile picture
Oct 29
Just got off the phone with a family member and I'm just 🤬

Them: Just got vaccinated, now I have fever, cough and sore throat. Could it be the vaccine?
Me: Fever sure, but not cough or sore throat
Them: On call doctor is calling in an antibiotic
Me: Diagnosis?
Them: No idea
1/2
Me: Have you tested for anything?
Them: No, should I?

Reader, this is someone who is post solid organ transplant. If they have covid or flu, they need proper antivirals ASAP to dramatically reduce their risk of hospitalization or death.

Doctors, please stop doing this!! 🤬🤬🤬
UPDATE after home covid test, and I quote, "This sh** positive than a MFer!"

There you have it. If I know my family well (and I do), that on-call doc is about to learn a lesson they will not soon forget. DON'T be that doctor.
Read 4 tweets
Noha Aboelata, MD Profile picture
Oct 15
Reading propaganda like this sends a chill up my spine. Not just because people will believe it and cause harm, but because it signals that we're still in a precarious situation: the powers that be are promoting covid spread, ignoring post- & long-covid, and giving false hope.🧵
Most claims in the article are demonstrably false, or fall in the hopium/copium category. Not drinking the kool-aid? You must be suffering from "anxiety." This is not some altruistic effort to try to reassure the public - if it was, they wouldn't need to obfuscate and omit facts.
This misinformation is to further an agenda and leverages the fact that there are so many willing participants. Yes the truth is a bit unsettling, and practicing the precautionary principle isn't always easy. But we deserve honesty & transparency about what is and isn't known.
Read 4 tweets
Noha Aboelata, MD Profile picture
Aug 10
Recently overheard: "I think I got a summer flu."
Highly improbable! Here's Oakland wastewater, similar across the nation (flat lines at the bottom: flu A/B). It's not flu season & covid doesn't have a season. Reminder of the difference and why it's important to get it right.🧵 90 day graph showing SARS-COV-2, flu A and flu B in wastewater in Oakland, CA. flu A and B are flat lines and SARS-COV-2 is heading up from a low point in early June.
Unlike flu, with covid we can see:
- presymtomatic and asymptomatic transmission
- superspreaders/multiple chains of transmission
- post-infection blood clots, heart attacks, strokes
- multisystem inflammatory syndrome in adults and children
More differences:

-SARS-CoV-2 binds to ACE2 receptors on multiple organ systems (lungs, heart, kidneys, liver, brain, etc.). Flu binds only to cells of the respiratory tract.

- You may get flu every few years. With covid it can be frequent and there doesn't seem to be a limit.
Read 5 tweets
Noha Aboelata, MD Profile picture
Aug 3
Protect the children! As they had back to school, a reminder that covid is not benign, even in children.

Very incomplete data set (>1.13 people have died in US and this only accounts for 996,981), but still we see 2,292 deaths in children 17 and under.🧵
https://t.co/La829oQzencovid.cdc.gov/covid-data-tra…
Deaths by age. 2,292 deaths in 0-17 yo
Covid is now a leading cause of death in all age groups and the only infectious cause in most. Most children with severe outcomes have no underlying condition or common ones like asthma, obesity or being born premature. Of course, death isn't the only bad outcome we worry about.
It's worth noting that we have a much bigger blind spot when it comes to understanding the disease process and progress in children because most of the research has focused on adults. Children are not small adults! We still have a lot to learn.
covid19treatmentguidelines.nih.gov/management/cli…
Read 13 tweets
Noha Aboelata, MD Profile picture
Jul 22
Welcome to the phase of the pandemic where "we have the tools" but are removing *access* to the tools.

"At least 3,289,000 Medicaid enrollees have been disenrolled as of July 21, 2023," (35 states + DC)

Texas in the lead with a disenrolled rate of 82%. https://t.co/De4uco40Elkff.org/medicaid/issue…
There is wide variation in disenrollment rates across reporting states, ranging from 82% in Texas to 10% in Michigan
"Across all states with available data, 74% of all people disenrolled had their coverage terminated for procedural reasons."

So they're likely still eligible but kicked off due to red tape. Seems like a good argument to maintain continuous coverage and find a better "procedure." Overall, 74% of disenrollments are due to procedural reasons, among states reporting as of July 21, 2023 (range: 30-96%)
~225,0000 Californians lost coverage as of July 1 in the first round of the Medi-Cal renewal process (suspended early in the pandemic). This is ~21% of the >1 million people who were due to reapply. Under 3% of these people no longer qualify for Medi-Cal.

calmatters.org/health/2023/07…
Read 5 tweets
Noha Aboelata, MD Profile picture
Jul 21
Who should get a bivalent booster now? If you're 65+ or immunocompromised, a 2nd bivalent has been an option since April. Since then, we've learned that an updated booster will likely be here in September. We'll go back to a monovalent vaccine, now against one of the XBBs.🧵
Hopefully we're still dealing with all XBB in September! Either way, the monovalent will likely be much better coverage than the current bivalent, which consists of old & older strains. The bivalent will still provide protection, but it's presumably quite inferior. So what to do?
Unfortunately, we have no guidelines yet on the fall booster (who, how often, etc.). So those currently eligible for a 2nd bivalent are having to decide what to do without this important info. Less than ideal, but I hope walking through the considerations and caveats will help:
Read 13 tweets

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