Dr Elisa Perego Profile picture
May 20 19 tweets 5 min read Read on X
Five years ago today the term #LongCovid was first used as a Twitter hashtag. A single tweet by a patient linked together a growing, grassroots movement of people who weren't recovering from Covid. Across the world, we were fighting for recognition and studying our own disease Image
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I feel strange posting this again after five years of fighting, suffering, and a global, grassroot mobilization of Covid survivors, who changed how Covid was understood and communicated to the public
Far from being a short, respiratory illness in most, dangerous only for the "old and frail", as said in early guidelines, Covid was a prolonged, multi-system disease, which could be severe and even fatal also in the "young and healthy": #LongCovid

sciencedirect.com/science/articl…
In early to mid 2020, a grassroots, international, collaborative movement of Covid survivors brought into light the severity, variability and prolonged nature of symptoms and sequelae, many of which remained beyond the medical gaze at the time

#LongCovid

wellcomeopenresearch.org/articles/5-224
#LongCovid was first identified, named, defined by patients finding one other on social media like Twitter in early/mid 2020. By August 2020, Long Covid was openly recognised by WHO after intense advocacy-research which reached the highest echelons of policymaking
By mid 2020 to early 2021, #LongCovid was entering the biomedical literature. Guidelines were written. The mechanisms underlying the disease, the symptoms, the epidemiology were being described, studied, elucidated. Patients were at the forefront of advocacy and discovery
As of 2025, Covid and #LongCovid are among the most studied diseases in medical history, especially given the short timeframe. Thousands and thousands of scientific publications exist on LC, which show prolonged pathology and sequelae in basically all organs and body systems
But the Covid pandemic remains one of the deadliest pandemics in recorded history and a mass disabling event. 20 to 30 millions were estimated to have died from Covid as of 2023. Hundreds of millions are estimated to have experienced LongCovid

osf.io/preprints/soca…
I wrote again what I wrote 1 year ago today, the exact words: Too many have died. Too many remain with no access to medical care. Trials are lagging behind. There is no cure. People are losing their lives, livelihood, family, health and support networks.
We are still fighting for full recognition, for dignity, for treatments, for safety. The pandemic is not over, new variants are rising, people lack appropriate access to care. I am grateful for the massive wave of research, and fast recognition in 2020-1. Yet, so much suffering
I am grateful that a name created by a person living with the disease has become in so many contexts and publications the official name of the disease. A community carried us there. A collective movement of patients, a collective effort empowers a patient community #LongCovid Image
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On this day, I want to express my gratitude and respect to all patients, advocates, patient-researchers and allies who brought us here. I also want to remember the lives lost, the pain, the suffering, the lack of care, the fight. Thinking about all of you. Thanks

#LongCovid
@LongCovidSOS @long_covid @apresj20 @LongCovidItalia @LongCovidKids @covideuskal @winslow_la @CovidSolidarit1 @LongCovidAdvoc @longcovidaragon @LongCovidAP @LongCovidChile @MartaEsperti @lapsyrevoltee #apresJ20 @AcpeCovid @ClaireCozler @james__glen @ShaneyWright
@LongCovidSOS @long_covid @apresj20 @LongCovidItalia @LongCovidKids @covideuskal @winslow_la @CovidSolidarit1 @LongCovidAdvoc @longcovidaragon @LongCovidAP @LongCovidChile @MartaEsperti @lapsyrevoltee @AcpeCovid @ClaireCozler @james__glen @ShaneyWright @felicitycallard @covid_madrid @DebHolloway @0bj3ctivity @1goodtern @_CatintheHat @LongCLand @CounsellingSam @LongCovidScot @LongCovidWales @IchBin_RO #covidpersistente #countlongcovid @Dr2NisreenAlwan @alitwy @Saffiya_Khan1 @_Lucibee @MeetJess @acrossthemersey
@LongCovidSOS @long_covid @apresj20 @LongCovidItalia @LongCovidKids @covideuskal @winslow_la @CovidSolidarit1 @LongCovidAdvoc @longcovidaragon @LongCovidAP @LongCovidChile @MartaEsperti @lapsyrevoltee @AcpeCovid @ClaireCozler @james__glen @ShaneyWright @felicitycallard @covid_madrid @DebHolloway @0bj3ctivity @1goodtern @_CatintheHat @LongCLand @CounsellingSam @LongCovidScot @LongCovidWales @IchBin_RO @Dr2NisreenAlwan @alitwy @Saffiya_Khan1 @_Lucibee @MeetJess @acrossthemersey @Antonio_Caramia @AlisonGeorge10 @BenjaminMateus7 @EvanBlake17 (thanks for the most comprehensive interview I ever made on LC and disease eradication/elimination)
@LongCovidSOS @long_covid @apresj20 @LongCovidItalia @LongCovidKids @covideuskal @winslow_la @CovidSolidarit1 @LongCovidAdvoc @longcovidaragon @LongCovidAP @LongCovidChile @MartaEsperti @lapsyrevoltee @AcpeCovid @ClaireCozler @james__glen @ShaneyWright @felicitycallard @covid_madrid @DebHolloway @0bj3ctivity @1goodtern @_CatintheHat @LongCLand @CounsellingSam @LongCovidScot @LongCovidWales @IchBin_RO @Dr2NisreenAlwan @alitwy @Saffiya_Khan1 @_Lucibee @MeetJess @acrossthemersey @Antonio_Caramia @AlisonGeorge10 @BenjaminMateus7 @EvanBlake17 @AnciraBecky @calirunnerdoc @LongCovidHell @LongCovidFight
@LongCovidSOS @long_covid @apresj20 @LongCovidItalia @LongCovidKids @covideuskal @winslow_la @CovidSolidarit1 @LongCovidAdvoc @longcovidaragon @LongCovidAP @LongCovidChile @MartaEsperti @lapsyrevoltee @AcpeCovid @ClaireCozler @james__glen @ShaneyWright @felicitycallard @covid_madrid @DebHolloway @0bj3ctivity @1goodtern @_CatintheHat @LongCLand @CounsellingSam @LongCovidScot @LongCovidWales @IchBin_RO @Dr2NisreenAlwan @alitwy @Saffiya_Khan1 @_Lucibee @MeetJess @acrossthemersey @Antonio_Caramia @AlisonGeorge10 @BenjaminMateus7 @EvanBlake17 @AnciraBecky @calirunnerdoc @LongCovidHell @LongCovidFight I added some of you who might be interested in this thread or were there in those early days or have been allies. Sorry if I haven't tagged everyone! Too many, and quite a few seem to have left this platform or I can't see them. My apologies for missing someone. And thanks again
@kasza_leslie @LongCovidNL @LongCOVIDPhysio @longcovidspain @jlerollblues @TheExtraFiles #longcovidawarness
More bibliography on #LongCovid as a patient-named disease entity and a social movement

sciencedirect.com/science/articl…

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More from @elisaperego78

May 11
Biopsies of five patients with myocarditis in #LongCovid showed disruption of mitochondrial integrity in the heart. This research was replicated in mice and shed light on the profound cardiovascular impact of SARS-CoV-2 infection on cardiovascular health
sciencedirect.com/science/articl…
The team's "investigation provides histopathological and electron microscopic analyses from endomyocardial biopsies of five patients who experienced various post-COVID-19 cardiovascular outcomes." such as myocarditis (inflammation of the heart muscle)
"Electron microscopy revealed widespread mitochondrial disorder and the presence of myofilament degradation within the cardiomyocytes from the patients.

Similar mitochondria disorganization were found in SARS-CoV-2 infected mice."
Read 5 tweets
May 10
I appreciate WHO raising awareness about Long Covid. I, however, considered, and still consider, a great mistake to have declared the end of Covid "as a global emergency" two years ago. This contributed to minimize the ongoing risks of SARS-CoV-2 infection, including death and LC
We must also interrogate ourselves as to whether LC is (only) 6% of people who get Covid (as per WHO quote). I think further reflection is needed here, especially when taking into consideration sub-clinical pathology and those who are never diagnosed with LC.
(Not making any assumptions about prevalence and incidence of LC in this thread myself, as there are so many issues to consider, as I have already pointed out many times. I think, however, health bodies should be careful around this point, too.)
Read 4 tweets
May 7
New PET imaging data reveal the long-term impact of COVID on heart and lungs, showing changes to these organs which are not detectable by standard medical assessments. 

#LongCovid

healthimaging.com/topics/medical…
"We [study's authors] believe long COVID results in an inflammatory response that may predispose patients to premature coronary artery disease, pulmonary hypertension, and valvular damage such as stenosis or regurgitation."
Study on 100 patients who were treated for COVID in 🇺🇸 between December 2020 and July 2021. Nearly one year after their initial infection, each patient was struggling with lingering cardiopulmonary symptoms; 91 underwent hybrid 18F-fluorodeoxyglucose PET/MRI
Read 8 tweets
May 5
NVC test shows significant microvascular damage in #LongCovid patients vs matched healthy controls. Dilated capillaries, microhaemorrhages, abnormal shapes and reduced capillary density are still detectable in LC 12 months after acute SARS-CoV-2 infection
rmdopen.bmj.com/content/11/2/e…
Background to the study "SARS-CoV-2 induces endothelial and capillary damage, that is detectable by nailfold videocapillaroscopy (NVC)."
"NVC [had showed in prior research] significant capillary dilations, microhaemorrhages and abnormal shapes in the acute phase of COVID-19 and significant reduction of nailfold capillary density in the short-term recovery phase (3 months)."
Read 4 tweets
May 1
New study links a range of proteins identified in the blood of Covid survivors with cell death and lung damage in #LongCovid patients affected by severe respiratory symptoms (pre-vaccine cohort)
news.ki.se/long-covid-bio…
"The proteins were mainly found in patients with LC and severe respiratory problems. This is a biomarker pattern [known] to be linked to inflammatory signal pathways involved in cell death and lung damage..also..observed in other patient groups with severe pulmonary disorders”
Sample of 256 people, including Covid survivors who appear not to have developed Long Covid, and also seem to miss the protein biomarkers in their blood
Read 4 tweets
Apr 11
When you talk about Long Covid, please always be crystal clear that there is a wide range of tests and biomarkers which show, beyond any doubt, multi-system pathology, sometimes captured down to the cellular level. Long Covid isn't just a bunch of symptoms
Presenting Long Covid as a "mystery" illness, a disorder with "no tests", some fatigue, or a "syndrome" characterized by "brain fog" and "sleep problems" helped no one. For sure, symptoms such as fatigue are common in Long Covid (I have it myself).
Yet, the scientific evidence shows much more. From lung perfusion defects, to viral persistence, from abnormal coagulation markers to evidence of endothelial dysfunction, there is a wide palette of tests and biomarkers that show the pathology's exent and scope in Long Covid
Read 5 tweets

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