I'm working with a patient who has post-COVID periodontal issues. I'd like to share some of the resources and research I have and hear from those who have experienced this. Please share any treatments or trials you're aware of!
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1/ Examining the Possible Correlation between Periodontitis and COVID-19:

2/todaysrdh.com/examining-the-…

2024 Data from our Long Covid Center at Brigham and Women’s Hospital in Boston, MA.
Our total patient count since we opened in March 2021 is 5,100 🩵
Now I’ll get into the numbers from 2024
1/ 2024:
New referrals- 1,131
Average age- 49 years old
Gender Identity:
- Female 71%
- Male 28%
- NB or non-conforming 1%
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I spoke to one of our doctors/researchers in Pain Medicine about their findings using stellate ganglion nerve blocks for Long COVID. They are doing an observational study, the data should be fully analyzed within the next month
1/ They have a cohort of 200 patients who received SGBs. Of those, 50 patients returned the follow up surveys for the studies. The survey is a PROM of symptoms and ranked severity
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Let me tell you how knowledgeable people living with Long COVID are- EVERY time we have an expert come to speak to our group the level of complexity and insight of their questions is so high that the presenters are always taken aback. I warn them in advance but they still away saying WOW So the discussions get very in depth. It’s patients who are driving research and advocacy. I hate that it falls on you, but man, you’re knocking it out of the park

This study by Peter Novak and David Systrom from @BrighamWomens is really interesting and VALIDATING for people with autonomic dysfunction. Let’s dive in:

frontiersin.org/journals/neuro… POTS (Postural Tachycardia Syndrome) and HYCH (Hypocapnic Cerebral Hypoperfusion) are both conditions involving orthostatic intolerance, but POTS is marked by tachycardia and HYCH is distinguished by hyperventilation and low CO2. HYCH is less understood and less studied and as a result, often missed.
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On May 24th 2020, deaths from COVID19 in the U.S. reached 100,000. @nytimes posted the names & bio for every person who died. They weren’t a number, they were people with rich lives and family and friends who loved them.
1/ Since then, 1.2 million more in the US have died and millions and millions more are disabled from COVID.
We cannot forget them or leave them behind.
We need to stay loud and demand funding for research and services as the number of people affected continues to grow.
2/

🧵🧵🧵
LONG COVID CLINICS:
Let’s talk about them. They get a lot of criticism in the Long COVID community and that’s fair.
Clinics are understaffed, wait times are long, they may not offer concrete treatments and you can end up seeing providers who know less about Long COVID than you do.
1/ We are not perfect here at Brigham and Women’s, but we might be the largest and “oldest” Long COVID clinic in the country so I’d like to tell you what I have learned along the way and the 10 things that I think every Long COVID clinic needs.
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I met with the program managers of the 2 other Long COVID programs in Boston yesterday, Boston Medical Center and Beth Israel Deaconess. We are planning to pool our resources to help fill gaps in care for LC patients.
I’ll share some takeaways
1/ Long Covid programs are hard to find and poorly advertised, even in our area. There is a lot of confusion as to who has programs and what each program offers. This is due in large part to hospitals closing LC programs that existed in the earlier part of the pandemic.
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Listen to how WEIRD this is. We have a patient who has consistently tested positive for COVID for 90 days now.
In addition, they are symptomatic with fevers, headaches, brain fog and fatigue.
1/ Our wonderful doctors in Immunology and Infectious Disease are going to see this patient and requested some labs including a PCR test for Covid. These orders were placed for the patient.
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🧵🧵🧵 US federal initiatives to address Long Covid:
The Agency for Healthcare Research and Quality (AHRQ) is US Department of Health and Human Services (HHS) agency that works to improve the quality, safety and equity of healthcare for Americans.
1/ Learn more about them here:

2/ahrq.gov/cpi/about/inde…

Next up: RECOVER SLEEP. This protocol is not on their website. I don’t know why.
I want it to be because they are revising the whole thing, but I know that’s not it 🫤
1/ Here in Boston RECOVER SLEEP will be at Brigham and Women’s, Beth Israel Deaconess and I believe (don’t quote me) Boston Medical Center
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I’d like to share information about our Long COVID program at Brigham 💙
Brigham and Women’s Hospital is in Boston MA. Like New York City, we had a a surge of early cases of COVID. Multiple units were converted to ICUs. Brigham also has 14 ECMO machines
1/ Brigham (BWH) expected that patients who had been hospitalized would need significant aftercare and starting expanding ambulatory services for post-Covid care. But as 2020 went on, it was clear that people who were NOT hospitalized were also not recovering
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Actual note I just read from a neurologist who advised against autonomic testing:
“I suspect this is most likely a post viral/inflammatory type syndrome. I certainly think there is a very good chance she will improve over time. There is nothing from her history or exam to suggest a neurological disorder. It could be that at this point anxiety is playing a part in hindering her recovery”
1/
#longcovid #dysautonomia #medtwitter #serenitynow We sent her for autonomic testing. And it showed small fiber neuropathy and very clearly POTS. It wasn’t borderline at all.
SO, we referred her to an autonomic neurologist to review the results and manage her care
2/