Micro Clots & Endothelial Dysfunction in Long COVID:
Plus new Epidemiology in @JAMA_current some say proves #LongCOVID is a hoax⁉️
Truth is…endothelial dysfunction plus inflammation can lead to life-altering brain & body dz.
Micro-clots are being found in some LC pts. This can occur from ongoing endothelial dysfunction, which is linked with inflammation & can lead to problems with vascular reactivity.
Let’s explore some angles…
2/ Remember that none of these Vascular flow problems occur in isolation from inflammation. This new piece by Jamie Ducharme balances the discussion well and opens our mind to these micro-clots as real pathology…
It’s time for great studies, not immediate widespread treatment with blood thinners.
https://bit.ly/3He2FCj
4/ Recent epidemiology studies “inspire” us see the scope of our challenges ahead, but they do NOT undermine the realities of #LongCOVID.
Take the INSPIRE study in JAMAOPEN of 1,000 patients. What did we learn?
https://bit.ly/3H6Rdso
5/ 1,000 patients with infectious symptoms in the height of early COVID self-enrolled into an online cohort. (75% w COVID and 25% without).
They self-report problems they feel at baseline and 3 months later. Baseline systemic problems 87% covid pos vs. 55% covid neg.
https://bit.ly/3h3SDZR
6/ Overall, as the primary author says, “40% of the COVID-positive and 54% of the COVID-negative group reported moderate to severe residual symptoms 3 months after enrolling.”
https://bit.ly/3iAevwp
7/ Some who tend to “diss” Long COVID jumped on these data with the excitement of a puppy, saying, “See, I told you so, Long COVID isn’t real.”
Look into the eyes & lives of the disabled with LC, believe, and don’t be taken in by such rhetoric.
8/ The authors themselves pointed out well their take is that the pandemic’s negative impact on peoples’ SUBJECTIVE self-report was widespread across COVID and non-COVID illnesses like pneumonia, RSV, and pharyngitis. I agree.
@WesElyMD I'd suggest the cohorts in this study weren't well matched to begin with - "those in the COVID-19–negative group were older and more likely to be of non-White race (eg, Black or African American); be unmarried; have lower annual family income; have public insurance; be unemployed; receive COVID-19 testing in an ED; and have a higher prevalence of moderate or severe asthma, hypertension or high blood pressure, or diabetes" 1/3
@WesElyMD
Covid positive patients were much more likely to report symptoms during their initial infection and much more likely to be hospitalised. Yet their baseline Promis scores (for cognitive function, physical function and social participation) were similar to the non-covid group at baseline.
The covid positive group improved more in these areas after 3 months, but I'd suggests this might be beause the covid cohort were fitter to begin with. 2/3
And don't get me started on using subjective questionnaires when objective assessments such as activity tracking, heart rate monitoring or exercise testing are available. 3/3