I just crossed the 4 month mark of being sick w'
#COVID19
. I am young, & I was healthy. Dying is not the only thing to worry about. I still have a near-daily fever, loss of cognitive function, essential tremors, GI issues, severe headaches, heartrate of 150+, viral arthritis, 1/
There's a big reality gap right now between people who are actively staying on top of COVID research & those who just trust the current guidelines. There's no judgment here, but I'd like to try to communicate the worldview of the former based on what we know about COVID now:
1/
I think a lot of people assume
#LongCovid
is a continuation of the acute COVID symptoms, that just take a long time to get over.
In reality it is an often delayed onset of *new* neurological, immunological, cardiovascular, and systemic symptoms.
1/
Big news: I was lucky to get tested for micro blood clots, & I have a lot of them!
#LongCovid
Healthy control blood on the left. Mine on the right. The green is all microclots!
These clots are likely blocking oxygen from getting around my body & could explain many symptoms. 1/
New study shows white Americans who learn about Covid's racial disparities have:
1) reduced fear about Covid
2) reduced empathy for those vulnerable to Covid
3) reduced support for Covid protections
White supremacy directly increases Covid's harms.
For those of us who are up to date on COVID impacts, including breakthroughs & reinfections, it genuinely looks like we are going to kill or disable an enormous % of our population in the next 10 years, & our leaders have decided to intentionally keep people in the dark.
11/
heart palpitations, muscle aches, a feeling like my body has forgotten to breathe. Over the past 124 days I've lost all feeling in my arms & hands, had extreme back/kidney/rib pain, phantom smells (like someone BBQing bad meat), tinnitus, difficulty understanding text/reading, 2/
The CDC is starting to acknowledge us & the
#LongCovid
numbers are high: 35% of people are not back to normal after the suggested 'recovery' period.
Given the US's current cases of 4.2 million, that's 1,470,000 long haulers in the US alone.
8/
difficulty following conversations, sensitivity to noise & light, nonstop bruising. *Thinking* can cause headaches now. I'm not alone in the cognitive issues; it's as common a symptom as cough.
No one knows when
#longcovid
patients aren't contagious; many are alone for months.
I've debated for a long time about being public with this, bc it's heavy & I still haven't come to terms with it. But I have a rare pre-COVID datapoint so will do it, hoping it helps people:
Right before I got COVID, I did neuro testing to see if I had ADHD.
1/
#LongCovid
It is hard to overestimate the impact of processing speed deficits. Unfortunately, these seem to be the primary difficulties we see in our Covid-19 long-haulers who can't think on their feet, can't respond to questions or requests, and cannot 'keep up.'
@CIBScenter
The US has chosen to prioritize the economy despite strong, countless studies that COVID harms many people, even those without
#LongCovid
or hospitalization. COVID predominantly affects the *vascular* system (the blood vessels), causing harm to the blood cells & blood flow;
2/
People w'
#longcovid
weren't able to get testing until late. There are people on my same timeline who are only now learning they had strokes & encephalitis & heart attacks. MRIs/CT scans were only accessible in the ER. Drs were solely looking at the lungs for way too long. 4/
Our review of
#LongCovid
research is out!
This was a HUGE labor of love over 10 months from
@julialmv
@LisaAMcCorkell
@EricTopol
& me!
It includes 200+ references focusing on biomedical findings in Long Covid. I hope it educates & inspires new research!
But there is no public awareness that just having COVID in itself is a huge health risk for your future, even from a "mild" infection, even if you feel recovered.
10/
This isn't the flu where you can curl up with netflix and tea for a few weeks; this is an active, awful illness with neurological effects for most.
For now we're holding out hope for
#recognition
,
#research
&
#rehab
. And we're doing our own research: 11/
I had been isolating for 11 days on the day of my first symptoms and I probably got it on a trip to the grocery store. There is almost nothing that is worth losing 4+ months of your life in this way. No BBQ, no tech event, no haircut. 10/
The symptoms are bizarre. There are people with brand new
#allergies
to the point of anaphylaxis; others whose allergies have disappeared. Post-menopausal women who are having spotting and periods again. Medications spontaneously stop working, need to be adjusted higher/lower. 5/
In patients aged 18-34 with no pre-existing conditions, that number is 20%. I was in that unlucky camp & you could be too. This life is a weird parallel one where almost everything in your old world feels alien & unreal; I don't want it to happen to a single other person. 9/
Your first COVID infection can leave you with pre-existing conditions that will make you more vulnerable to subsequent infections.
#LongCovid
If COVID circulates forever, you will be more vulnerable with every year that goes by.
4/
this has a downstream impact on nerves, immune system, & multiple organs, including the brain. Vaccination prevents against death, but not against long term damage.
3/
It causes flareups of other viruses, past surgeries, other conditions. Old injuries are raw & feel new again. My left leg & foot, injured in a moped accident in 2017, feels crushed like it happened yesterday.
Intolerance to exercise, alcohol, caffeine, & stress are common. 6/
...we are going to be in trouble if we start getting lumped into a singular diagnosis or the dismissive "chronic fatigue syndrome"; everyone's
#LongCovid
struggles are different, not everyone has fatigue/exercise intolerance, advocacy for heterogeneous treatments is vital! 13/
Insomnia is common. The dreams are vivid & bizarre, often lucid dreams, often violent & nightmarish, many reports of dreaming about people who have passed away.
The symptoms wax & wane; you think you're getting better, only to be hit again. New symptoms appear constantly. 7/
Behind the scenes, all of this is acknowledged. Researchers, including at NIH, have acknowledged a likely wave of early onset dementia. The WHO & CDC meet with patients regularly & acknowledge the severity & future consequences.
9/
I want to add that people with myalgic encephalomyelitis (
#pwme
) have gone through this same thing without any of the attention
#LongCovid
is getting; we need to remember them & bring them along with whatever recognition & funding we receive. And IMPORTANTLY, like
#ME
... 12/
Even having *non-hospitalized* COVID increases the risk of 18 severe vascular conditions, including strokes, heart failure, clots, embolisms.
COVID can cause reactivated EBV, which is associated with lymphomas, multiple sclerosis, and other health issues.
6/
I know more people with
#LongCovid
from the Omicron wave than any other point.
Some hadn't known about Long Covid before getting sick, & are now confused and furious that they weren't warned this could happen.
COVID can cause severe cognitive issues and brain changes in people who had never been hospitalized. There is no evidence that this resolves; many have had this for 2 years. Past SARS resulted in the same.
These are just a few examples. There are thousands. Harm is not rare.
7/
There is no real evidence that COVID will evolve to become less dangerous over time, but there is evidence to suggest it will become more dangerous especially given the amount of spread and ability to create new variants.
8/
There is no permanent protection from this, neither from vaccination not infection. Having some immunity does not prevent damage on subsequent infections. COVID infections can impact fertility in all genders, making conceiving harder and causing more miscarriages.
5/
My dad passed away today from ocular melanoma. He was 55. He was a kind, generous person who valued always trying to grow & be the best person he could be. He was an amazing writer and cyclist and father to 6 kids, the youngest who is six. We love him so much & are heartbroken.
Major
#LongCovid
paper out today with 2 findings:
1) Mental health conditions after COVID returned to normal over time
2) Cognitive & neurological impacts did not. Risk of cognitive impairment, strokes, dementia, seizures persisted for at least 2 years
New data from the U.S. Bureau of Labor:
The number of people with a disability dramatically increased & hit a new record of 34 million in June 2023.
#LongCovid
is a mass disabling event.
As always, if you or a family member have health issues from COVID, I recommend joining the
@itsbodypolitic
support group, and
@patientled
for current research.
13/
Testing was seen as hurting Trump politically, so testing guidelines were intentionally made narrow for that reason. Direct quote: "Case identification is bad for the president’s re-election."
(This is absolutely still happening).
2/
Study looking at
#LongCovid
2 years after infection:
Despite exercise, respiratory & olfactory rehab, cognition/speech therapy & psychological support, the main symptoms (fatigue, neurocognition, muscle) did not resolve.
Only 9% of patients recovered. 1/
My tangible ask of people reading this: please continue to mask, or start again if you've stopped, & please implement ventilation protocols where you have power to do so (including your own homes), & please stay home when you're sick, even if you test negative for COVID.
8/
New CDC study finds that 36% of COVID patients *never seroconvert*, meaning they NEVER make antibodies!
#LongCovid
This is a huge finding which we need to amplify broadly! Please retweet & send to providers, patients, support groups,
#MedTwitter
, etc.
1/
We know a lot about
#LongCovid
by now. We know it has complex, multi-systemic, interlinking causes, including microclots, deformed blood cells, immune system dysfunction, dysfunction of mitochondria (which are responsible for energy production - dysfunction is a big deal!)
2/
My processing speed was in the 96th percentile (meaning it was higher than 96% of people who took the test).
After I got COVID and my brain issues started, I did the same testing with the same provider, and my processing speed had dropped to the 14th percentile.
#LongCovid
2/
We know enough about
#LongCovid
to know it's not a simple illness, & is causing major systems of the body to become dysfunctional in ways that medicine is not yet advanced enough to fix.
We know for many manifestations, incl dysautonomia, microclots, ME/CFS, there is no cure. 3/
Case report of a
#LongCovid
patient, sick for 7 months, whose symptoms completely resolved after taking Paxlovid.
Paxlovid is one of the most obvious drugs for a Long Covid clinical trial - why isn't it happening?
We continue to have data hidden from us, sowing confusion for political gain at the cost of our health and safety. The pandemic is not over and the risk is not either.
5/
A friend in the Bay Area (
@longestrecovery
) is having trouble getting her family tested for monkeypox despite them having all the symptoms. Her infectious disease and primary care doctors want her to get tested. The Department of Public Health has denied her a test because 1/
7 inaccurate narratives were pushed by a WH pandemic adviser, including that children were immune, football players couldn't get seriously ill from COVID, and that COVID was like the flu.
3/
Too tired to continue this thread atm but if you are someone who thought
#LongCovid
was just "not getting better from Covid symptoms", please update your models. 4/
Truly can’t believe there are people saying we should let Omicron spread to give everyone immunity. It’s like we’ve learned nothing from these two years of hell
The summary: vaccination definitely seems to reduce the risk of
#LongCovid
, often by 40-50%.
*But* solidly 9.5%-14% of breakthroughs still result in Long Covid.
These figures make sense to me, given the estimated rate of LC in unvaccinated people (~10-30%).
2/
Will also just add:
#LongCovid
is not having one or two random symptoms. In our
@patientled
data we found patients experienced an *average* of 56 symptoms. It's really hard to mistake.
5/
We looked at 205 symptoms over 10 organs systems (Neuropsychiatric, Pulmonary, Head Ears Eyes Nose Throat (HEENT), Gastrointestinal, Cardiovascular, Musculoskeletal, Immunologic, Dermatologic, Reproductive/Genitourinary/Endocrine).
On average, 9 in 10 of these were affected!
2/
The most important things for in-person events are mandatory masks (for everyone) & extremely good ventilation. Asking for vaccination/boosters is good but not sufficient - vaccinated people still spread COVID.
Planning events without both of these things is unethical.
“If everyone were really fully informed – I mean really fully informed – we wouldn't need mask rules. We wouldn’t need them because it would be just so incredibly clear what's at stake.” -
@FurnessColin
#LongCovid
Yay our
#LongCovid
paper is online!!!
While we had a few thousand more fill in the survey, this paper focuses on 3,762
#longhaulers
(sick >28 days) who got sick between Dec-May (to look at an average of ~6 months of data).
Some key findings:
1/
This is what
#LongCovid
looks like: a heart rate of 74 beats per minute (sitting down), jumping to 146 after standing.
(This is a form of dysautonomia called POTS, which is common after viruses and is a really common post-COVID diagnosis).
POTUS is wrongly reinforcing the idea that when you get COVID you’ll either be hospitalized/die or you’ll have a “mild” case.
#LongCovid
friends - what was your “mild” case like?
Having low processing speed affects everything. It impacts basic communication with people, like texting & talking. Not only how long it takes to actually communicate, but how much you ingest about what you are reading/hearing. Relationships become hard to maintain.
#LongCovid
3/
This tremendously exciting paper is now published:
Exercise in
#LongCovid
induces severe tissue damage & skeletal muscle necrosis, metabolic disturbances, myopathy, & tissue infiltration of amyloid-containing deposits.
Patient-Led Research Collaborative helped fund this study!
After a long wait, our longitudinal long COVID study is finally published in
@NatureComms
: . We find a skeletal muscle alterations in patients with
#longcovid
, which worsen with exercise. 1/n
A thread about how privilege shapes individual response to threats - with denial among the privileged impacting the less privileged. I think perhaps how you respond to threats around you has a lot to do with your life experience, sense of security & appetite for reality🧵
An increasing % of our society is becoming disabled from
#LongCovid
& no one in power is addressing this.
Lowest current estimate = 12 million Americans with Long Covid. 3.6% of the country, 1 in 27 people. The majority can’t work fulltime. Many need caretakers. What’s the plan?
It's hard to communicate that there is no restaurant, concert, event, conference - nothing - that is worth
#LongCovid
and the resulting illnesses (ME/CFS, dysautonomia, blood clotting). In most cases, Long Covid will destroy your ability to do any of these things regardless.
1/
Let me just say, as someone who got
#LongCovid
in the first wave of Covid in NYC in March 2020: You should let the fear of getting Long Covid ABSOLUTELY rule your life. Cause if you do get it, it will BECOME your life.
I'm mindblown at the response to our
#LongCovid
review - 402k views since Fri & in the top 0.000016 of 22.9m tracked papers. Hearing that it's circulating in the med field & giving researchers ideas to pursue. A huge sign of hope that change is happening!
New, very strong, meta-analysis published on 81 studies estimating
#LongCovid
prevalence!
Key findings:
32% of patients have fatigue at 12 weeks, 31% at 6+ months
22% have cognitive impairment at 12 weeks, 21% at 6+ months
Lots of additional info:
1/
she’s not a man who has sex with men, which is both stigmatizing and against the current guidelines (). If anyone can help, please reach out to
@longestrecovery
.
We’re repeating all the same testing mistakes we did in the early COVID days. 2/
It is so hard to communicate how post-viral illnesses like ME/CFS feel.
People understand broken bones, diabetes, even cancer.
They don’t understand how talking for 30 minutes can create a concussion-like feeling, or how doing the laundry can lead to a fever & flu symptoms.
The embarrassing & deeply sad story of Casper Schmidt, an AIDS denier who published an article in 1984 saying AIDS was psychosomatic.
In 3 decades, there will be articles like these about the individuals saying the same about
#LongCovid
. History repeats.
Healthy people lose about 7% of the blood flow to their brain when upright.
Two new studies show people with
#LongCovid
lose 30-40%+ of the blood flow to their brain when upright.
1)
2)
The brain's drainage system has been theorized to be dysfunctional in ME/CFS.
In fact, the first time Dr. Fauci mentioned
#LongCovid
in July 2020, he said that it looked like ME/CFS & that there might be cribriform drainage issues. 1/
Feeling angry about this today.
In a decade it will be *known* that COVID causes severe cognitive impairment & neurodegenerative disease; today millions of us are living it in reality, in our 20s + 30s + 40s, in what was supposed to be the beginning of our lives.
#LongCovid
Researchers find parallels between
#LongCovid
cognitive dysfunction & the early stages of Alzheimer's/dementia:
“[These peptides] formed very similar amyloid clumps, considered molecular hallmarks of the early stages of neurodegenerative disease.”
If you’re not wearing a mask in public indoor places, you’re sending a giant “Fuck you” to anyone nearby whose loved one is in the 900k dead, to the 15 million with
#LongCovid
, & to the immunocompromised. It is not a neutral act, even if you want it to be.
Polio disabled 35,000 Americans each year, which was enough to create a mass vaccination campaign to end it.
Covid has resulted in an average of 10 million Americans living with
#LongCovid
per year.
Things like driving - where you *have* to make fast decisions - are much scarier & often not possible at all. Common sense decision-making - like putting on potholders to take something out of the oven - are related to processing speed too, & are scary to find suddenly absent. 3/
Wow, this new paper is a huge deal! T cell activation & viral RNA persistence were found up to 2 years post acute infection in
#LongCovid
patients.
Patients with T cell activation in the spinal cord and gut wall were more likely to have Long Covid. 1/
I want to highlight a couple big findings in the new RECOVER
#LongCovid
paper (aside from the definition) that may be missed!
Journalists in particular, you may be interested:
1/
This is still happening to so many people, despite vaccination, despite pretending like the pandemic is over. The public deserves to know the actual risks of what can be lost.
7/
I also have a bunch of hyperactivated platelets.
I'm officially on
#TeamClots
& believe it's a vital and immediate research direction for
#LongCovid
& ME/CFS.
2/
Reports were created that included "comprehensive data & state-specific recommendations regarding the status of the pandemic". The WH refused to publish these publicly & in the fall 2020, changed the rules to only send them to states who asked for them.
4/
Processing speed impacts memory, because it impacts how fast you can register memories. It impacts emotional awareness & how fast it takes to know how you're feeling. The downstream impacts of having suddenly lower processing speed affect identity in a serious way.
#LongCovid
4/
SARS survivors 18 years later had:
1) persisting fatigue & osteoporosis
2) abnormal metabolism of amino acids & lipids
3) B-cell activation
4) cytotoxic CD8+ T cells & reduced immune function of some CD4+ T cells
5) mental health back to normal
#LongCovid
I'm honored to be on
@TIME
’s 2022
#TIME100NEXT
list, with a kind write-up by
@timkaine
.
Thousands of people are getting
#LongCovid
each day, many of which lead to ME/CFS, POTS, & other lifelong illnesses. We need clinical trials & treatments urgently!
1/
The rate of people experiencing
#LongCovid
has jumped to 6.8% of all US adults, up from 5.3% just four months ago.
That's 1 in 15 adults, and is the highest it's been since 2022.
We can reasonably expect a future increase from January's wave.
I just learned that only ~6% of medical schools fully teach post-viral issues like ME/CFS.
This is why so many doctors seem to be just learning about viral-onset issues for the first time - because they literally are!
This requires an urgent curriculum change.
#LongCovid
Intelligence tests aren't ideal & are rooted in problematic ideas, so I'm not suggesting they are key. But these processing speed drops are substantial & happening to many with
#LongCovid
, esp those with new ME/CFS, which has processing speed deficits as part of the illness.
6/
I guess this is the year everyone learns reinfections are common, even if you had COVID before or had it recently.
I wish we'd been listened to when we brought this up in summer 2020, seeing reinfections in first wavers. And I wish literally anything was done to prevent them.
The reason we can expect
#LongCovid
to happen with any variant is that many of the viral-onset conditions we see after COVID - dysautonomia, ME/CFS, & others - also happen after weaker viruses than COVID.
(It happens to about 10% of people infected with mono, for example).
1/
Processing speed impacts how much you can hold in your head, how you weave the world together and make sense of it, the thoughts that come up when you think about the people, places, ideas that you love. It turns those processes into just a void, a blank wall.
#LongCovid
5/
#LongCovid
patients have:
1. Functional impairment worse than stroke; comparable to Parkinson's
2. Worse quality of life than metastatic cancers
3. Worse fatigue than stroke, bowel disease, & end stage renal disease
We need clinical trials urgently!
I didn’t go to the
#time100next
gala tonight for covid safety reasons, but dressed up anyway (my partner got me a nice dinner 💕)
But feeling bummed about it, and bummed that high risk people are excluded from participating in society, seemingly indefinitely…
#LongCovid
On average, neurological symptoms from
#LongCovid
don’t start in the acute phase, but 4-8 weeks later. (For about 1/3, they happen earlier).
If you are recovering from COVID, resting for longer than you think you need can help prevent severe forms of Long Covid.
While this is exciting, it's also scary! For whatever reason, it seems like treatment is not straightforward for these clots; they seem to return after treatment, meaning it's likely a downstream finding of some other process. Finding a good treatment is an immediate goal!
4/
@itsbodypolitic
Also adding a fact I wish everyone knew:
#LongCovid
is associated with fewer (or no!) COVID antibodies.
( & )
Also high levels of autoantibodies seen in LC anticorrelate with protective COVID antibodies!
7/
“Many patients with high autoantibodies simultaneously have low (protective) antibodies that neutralize SARS-CoV-2, and that’s going to make them more susceptible to breakthrough infections,” said Daniel Chen, a co-first author of the paper.”
#LongCovid
3/
A year ago today I had my first COVID symptoms, and I never recovered.
It feels fairly impossible to process what being sick for a year has been like, and what this year of watching
#LongCOVID
awareness and advocacy unfold has been like, but some thoughts: 1/
The people who stay sick and develop ME/CFS after a virus are often referred to as the “Millions Missing” because they suddenly disappear from life.
I want to ask: who in your life is missing from your circles, events, communities after getting COVID?
#LongCovid
#pwME