Rajeev Jayadevan @RajeevJayadevan Twitter profile | Pikagi

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Rajeev Jayadevan

@RajeevJayadevan

11,958

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Medical doctor/specialist 🇮🇳🇺🇸🇬🇧🇮🇪🇳🇱 Author, Co-Chairman National IMA COVID Task Force & Past President, Indian Medical Association, Cochin

Cochin

https://t.co/G2OohjKtDX

Joined October 2012

Don't wanna be here? Send us removal request.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

My latest article on a special topic, close to my heart, also one which I have previously lectured on. “*How not to be fooled while reading research studies*” I have focused on some common tricks research authors use to exaggerate their findings.

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How not to be fooled while reading research studies

Often, research studies use terminology and jargon that decorates their findings, leading lay people to believe that the effect was much larger than.study. survey. research. data. analysis. studies

www.onmanorama.com

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

“Why are you still wearing a mask?” A doctor who I met at an indoor seminar asked me. “I use it like a seat belt. We don’t know when it will make a difference, but we wear it just in case. We also wear it only when the car is moving - see we’re indoors now, and it is crowded”

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Omicron can reinfect in 16 days. Thrice-vaccinated healthy 52 year-old man gets two separate infections by BA.1.1 and BA.2. Symptoms lasted 6 and 7 days. Reinfection used to be considered impossible/unlikely if anyone tested positive within 90 days. Times have changed. 1/3

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@Leseerlaubnis

LesenUndTeilen©  🌍 🇪🇺

1 year

Mit unterschiedlichen Omikron Varianten kann man sich im Abstand von 16 Tagen anstecken. Ein Hoch auf die hybride Immunität, die einfach gar nichts zu bringen scheint. Wann kapiert Deutschland das?

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

11 months

Hybrid immunity not protective, may worsen risk of infection 48-fold increased risk of getting a repeat Omicron infection among those who had prior Omicron infection Large study from McMaster University Canada on vaccinated older adults, includes immune response details👇 1/5

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

8 months

Long COVID study from Japan, published in Nature answers many questions 🔹At 1 year, 20.7% had it, higher in adults. 🔹Most initial infections (89%) were mild, 60% had Omicron 🔹Vaccine has no preventive effect 1/3

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

“We will continue to wear masks” - President of Osaka Gas, Japan “Our work is essential, and indispensable for people’s lives. Infection clusters should not happen”

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@triangle24

Takuro⚓️新型コロナ情報in全国/神奈川/横浜/川崎/東京/大阪/岐阜/広島/愛知/静岡

1 year

5/8月大阪ガス、従業員のマスク継続　社長「コロナ終わるわけではない」ガス会社の中心となる仕事は人々の日常生活に必要不可欠な「エッセンシャルワーク」だと指摘。「エネルギーを安定的に供給する観点から、クラスターを起こすべきではない」と話し、マスク着用を続ける

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

UK Cardiologist Rae Duncan explains Long COVID beautifully. Abnormal, prolonged immune response damages the inner lining of blood vessels. Micro clots form, of abnormal molecular structure, that the body’s usual mechanisms can’t get rid of. They show up in various organs. 1/2

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Omicron is a stealth virus Fascinating research from Germany reveals vital difference in antibody response to Omicron versus prior variants Ongoing study of 1850 children since 2020 Very few developed antibody after Omicron infection (18%), versus 68% for prior variants 1/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

9 months

Spent a week in Singapore, did not get COVID despite JN.1 surge. Sharing some travel tips to stay safe. Masks, worn according to situation, keep viruses away. Here is what we did. 1. Airports are high risk, hence kept them on all the time 2. High risk while boarding 1/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

The first series on “Black Fungus” mucormycosis courtesy Prof. VP Pandey Indore. 210 patients. Antibiotics had been used in 100% patients, steroids NOT used in 14%, 21% were NOT diabetic, 36% were @ home, oxygen only by 52%, Zinc status not checked. See thread for details. 1/n

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Bivalent booster fails against XBB Study from Cleveland clinic shows effectiveness of only 4% The failure was notable after recombinant variants arrived

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Arteries became stiffer after even mild COVID - among young healthy volunteers Study compared stiffness levels measured just prior to pandemic vs. well after COVID symptoms fully resolved The parameters only worsened with time, and did not improve. See long thread 👇

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

I recall writing repeatedly in 2020 that herd immunity is a myth in COVID-19. This Science paper buries herd immunity. Omicron is not a “natural booster”. It actually REDUCED immunity in past-infected triple-vaccinated people. Inconvenient but true.

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People who caught Covid in first wave get ‘no immune boost’ from Omicron

Study of triple vaccinated people also says Omicron infection does little to reduce chance of catching variant again

www.theguardian.com

@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

Past infection by certain variants appears to dampen (rather than strengthen) immune protection. Among 3-Vaxed who had 1st wave infection, the T cells couldn��t recognise Omicron. Omicron is poorly immunogenic against itself, leading to frequent reinfections at short intervals

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Past infection leads to more severe disease during reinfection, finds US study. 5.9% reinfections resulted in death, when the first infection was severe. Authors say the protective effect wanes after a few months, and the negative effects predominate afterwards. 1/2

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

A mask story Only two doctors wore a mask at a recent closed door meeting. They escaped COVID. Most others, especially in the front rows, got COVID after the meeting, which also spread to their families. A senior doctor in Kerala told me this on 11 April 2023.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

Reinfections can occur in less than 2 months. This study from Belgium shows their profile by vaccination status. It can occur among unvaccinated, vaccinated and boosted individuals, when sufficient exposure to virus aerosol load occurs.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

Immunology of Long COVID explained by Prof. Iwasaki Seen more: 1. Exhausted T cells (CD4 & CD8) 2. Activated B cells 3. Anti EBV 4. Anti Spike antibodies, low neutralising Seen less: 1. Cortisol 2. CD4 central memory cells Unchanged: Autoantibodies

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

Fascinating research from Stanford. 1. SARS-CoV2 virus 🦠 enters cells in the nose through hair-like projections called cilia (pink) 2. It then hijacks the cell machinery to massively enlarge and branch the microvilli (blue) 3. Virus spreads to nearby ciliated cells. See👇

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

Past infection by certain variants appears to dampen (rather than strengthen) immune protection. Among 3-Vaxed who had 1st wave infection, the T cells couldn’t recognise Omicron. Omicron is poorly immunogenic against itself, leading to frequent reinfections at short intervals

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@ScienceMagazine

Science Magazine

@ScienceMagazine

2 years

Analyzing how past #SARSCoV2 infection & vaccine history combined to influence Omicron immunity revealed Omicron infection boosted immunity against early variants but less against Omicron, perhaps explaining the occurrence of frequent Omicron reinfections.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

11 months

Intellectual disability after COVID: study among people with college degree. “10 years’ equivalent cognitive decline” Worse among people with Long COVID. Study included a non-infected control group, eliminating sampling bias. Study from Stony Brook University, US.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Long term effects of COVID on the heart revealed by research from DeBakey Heart & Vascular Center, Houston TLDR: Blood flow to heart muscle is expected to increase with exercise. When that does not occur, heart suffers from insufficient oxygen supply. This happens after COVID.

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@EricTopol

Eric Topol

1 year

Impaired heart small vessel blood flow ~6 months after Covid in 271 cases, 815 controls, by PET scan #LongCovid @almallahmo and colleagues

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Reinfections worse than first time COVID. More breathing difficulty, tiredness (Long COVID) after repeat COVID. Boosters waned/offered limited protection against long term symptoms. Study from National Institute for Public Health, Netherlands. 1/2

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Following COVID, 3 out of 100 athletes developed new ECG changes that never existed before 88% of these had heart inflammation on MRI The longer the symptoms, the more the changes No clinical symptoms in over a year on follow up Shows COVID is not a “common cold”

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

8 months

Lung 🫁 function declines long term - even after *mild* COVID. Major Denmark study measured PFT before, 6 months after and 2 years later. They compared with uninfected people. The speed of decline leveled off at 6 months, but failed to improve back to baseline. See graph. 1/4

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Higher antibody levels linked with Long COVID in children. Vaccination did not make a difference. Fatigue, cognitive impairment & breathing difficulty predominant. Post COVID immune dysfunction likely. This Norway study shows the importance of avoiding infection.

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@SGriffin_Lab

Stephen Griffin

1 year

"Our findings emphasise the importance of reducing the COVID-19 burden in young people" Omicron breakthrough in CYP with previous delta infection more likely to cause #LongCovidKids 😪 Yes, a 3.5 yr PHEIC is arbitrarily ended, but a pandemic remains 💔

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

“The risk of acute myocardial infarction was 93% higher in COVID-19 recovered patients compared to the general population” -Italy study addresses heart attack risk following COVID recovery

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

“COVID-19 is a substantial risk factor for certain fungal infections, particularly those caused by invasive molds, likely because of COVID-19-related immune system dysregulation and immunosuppressive therapies, such as corticosteroids or other immunomodulatory medications."

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@ahandvanish

Hannah Davis

1 year

CDC finds fungal infections are more deadly when COVID is involved - 48.5% mortality compared with 12.3% for non-COVID-associated fungal infections. Infections included aspergillosis, invasive candidiasis, mucormycosis, & unspecified mycoses. #LongCovid

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

One out of 7 reinfections occurred under 2 months This is consistent with other early reports, which were met with scepticism by herd immunity proponents. The reason is the virus is now evolving with immune escape as a priority, to be able to infect the host again and again

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@ejustin46

Emmanuel

1 year

REINFECTION EVERY 60 DAYS ? 😨 "Our findings indicate that the time between confirmed primary infections and reinfections with different Omicron subvariants is frequently shorter than the 90-day definition of reinfections used by the CDC."

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

XBB was born in summer 2022 by recombination This is a landmark event in the pandemic Until now, variants used individual mutations But XBB was born from “marriage” of two different viruses, getting a massive advantage at one shot It is now replacing earlier Omicrons 1/5

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@SystemsVirology

The Sato Lab (Kei Sato)

@SystemsVirology

1 year

BREAKING🔔 The 21st paper from G2P-Japan🇯🇵 is out at Nature Communications @NatureComms . We illuminated the virological characteristics of SARS-CoV-2 XBB variant (aka #Gryphon ), generated by the recombination of two #Omicron subvariants. Please RT! 1/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

Did elections contribute to the COVID-19 surge? We are always tempted to say yes. I decided to do a comparison. Surprisingly, the graphs I obtained from election & non election states are near-identical. This suggests that the wave is a seasonal surge in a geographic region. 1/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

“The only way to prevent Long COVID is to avoid COVID” The final report from the House Standing Committee on Health, Aged Care and Sport's Inquiry into Long COVID and Repeated COVID Infections was tabled in the Australian Parliament on 24 April.

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@Globalbiosec

Raina MacIntyre 😷💉💉💉💉

1 year

The government’s take on long Covid - the problem is, the medical community needs to go back a few steps and accept that 1. COVID is not a cold, but an illness that can result in serious chronic illness due to multi-organ effects. 🧵 via @SatPaper

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

NeoCov is all over the news. Some facts, before we panic. This “not so new virus” was identified around 2013 in bats in S Africa, while looking for ancestors of the MERS CoV. Note: This virus has not infected man, and has not killed anyone. 1/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

9 months

We only have experience with this virus over four years. We’re still learning about effects on nerves, mitochondria. “To pretend that we know everything that this 4 year-old virus is capable of doing, and be cavalier about getting repetitive infections is really a huge mistake”

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@JPWeiland

JWeiland

9 months

Wow, quite the interview of Dr. Deborah Birx (remember her?) from @ChrisCuomo discussing the failures of the early response, long covid, and complications from even mild infections. Worth a watch

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

7 months

Percentage of US adults currently having Long COVID goes up from 5.3% in 2023 to 6.8% in 2024

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@CoronaHeadsUp

CoronaHeadsUp

7 months

CDC: Big increase in those currently experiencing Long Covid H/t @ahandvanish CDC: Long COVID household Pulse Survey, to Jan 2024

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Dengue virus infects lab cells more easily in the presence of antibodies generated after COVID-19 2 types of cells K562 & U937 were used, findings compared with control serum. Evidence of ADE (antibody dependent enhancement) of Dengue, facilitated by SARS-CoV2 antibodies. 1/10

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

8 months

@99_n0va Vaccines prevent severe disease. It is important to understand Long COVID is a different disease and many studies show it is not prevented by vaccination. People shouldn’t be thinking “Gee I am vaccinated, so I can’t get Long COVID”. Hence the need for clear communication.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

COVID-19 can lead to a weak T cell response later, finds study Authors compared immune response to mRNA vaccination among past infected vs. non-infected people CD8 T cell response was muted in those who had infection prior. via @CBSNews

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COVID left some with damaged immune response, study finds

Scientists found a "major reduction" in a part of T cell responses in people who were infected before being vaccinated.

www.cbsnews.com

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

9 months

Currently Singapore, like many other countries, is going through a surge in cases driven by JN.1. However the ICU admission rate is low. In any case, it isn’t worth getting COVID and a few basic precautions can go a long way during a surge. Hope this helps. 9/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

Are Zinc supplements to blame for "Black Fungus"? (this is an interesting hypothesis, NOT an assertion) See thread for summaries of papers from 1996, 2013. Fact: Fungi feed on Zinc. Mammalian cells try to escape fungal invasion by "starving" the fungus of zinc, by hiding it. 1/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

WHO recommends making monovalent vaccines based on XBB.1 Monovalent means only one type is included. They acknowledge that including the old virus with the new (as in bivalent vaccines) steers antibody response in the wrong direction.

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@WHO

World Health Organization (WHO)

1 year

Current #COVID19 vaccines continue to be highly protective against severe disease & death. The updates to future vaccines take into account the evolution of the virus & the circulating variants, & aim to improve protection against symptomatic disease. 📌

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

8 months

🔹Risk higher in adults than children 🔹Adults 30-60 at high risk, women 2 x likely to get it 🔹Smokers, diabetics at higher risk 🔹If symptoms last more than 3 months, 60% continue to have it for over a year 🔹At 1 year, 13.4% had symptoms interfering with daily life 3/3

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

8 months

What happens when a person with Long COVID gets reinfection? If reinfection occurs: 1. When LC is active: LC gets worse 2. Among LC-recovered, 60% get LC again, of same severity on average

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

Herd immunity concept never applied to COVID-19, as a few of us wrote over a year ago. Now Iceland & US are discovering it. The reason we wrote it won’t work was because immunity against such viruses isn’t the sterilising type, & because vaccines won’t halt transmission. 1/21

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@ShamikaRavi

Prof. Shamika Ravi

3 years

Important evidence coming from Iceland - increased vaccine coverage might not lead to herd immunity (though it lowers severity of symptoms).

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

🔹Long COVID more frequent after reinfection 🔹More severe initial infection = more severe re-infection 🔹Mild initial infection doesn’t guarantee mild reinfection 🔹Two-thirds of severe reinfections had a mild initial episode

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

@sri_srikrishna The big mistake is calling this a “common cold”, @sri_srikrishna . That’s like calling polio a mild diarrhoea. What the virus does after the initial “cold symptoms” to the body is what matters. Comfort thinking can override science.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

11 months

Although done in older adults, the study challenges the existing dogma that hybrid immunity is the way out of the pandemic. More infections do not mean better immunity. ❗️The study also shows that time since last dose of vaccine did not affect infection risk. 5/5

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Bigger size of recent wave in India detected on waste water surveillance by @TIGS_India This is even bigger than the original Omicron wave of January 2022 Shows that the no. of reported cases is much smaller than the no. of infections in the community (due to low testing rate)

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@TIGS_India

Tata Institute for Genetics and Society, India

1 year

Realtime SARSCoV2 viral load in sewershed sites & reported COVID-19 cases. The viral load is now showing a downward trend. #Invisible #Wave Wastewater #surveillance helps to keep track of emerging pattern in #SARSCOV2 & must be used as a complementary tool to clinical testing.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

People with Long COVID made more antibodies after subsequent vaccination, compared to people who had fully recovered from COVID. (More isn’t necessarily better) This difference was sustained over time. This indicates persistent immune activation.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Japan wastewater monitoring picks up new signal 3 times increase over one week in Komatsu city Note Japan had 8 waves so far, this could be the 9th This is the reliable way to detect a surge, even without widespread clinical testing. Will tag @TIGS_India and @3RakeshMishra

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@triangle24

Takuro⚓️新型コロナ情報in全国/神奈川/横浜/川崎/東京/大阪/岐阜/広島/愛知/静岡

1 year

石川県小松市の下水モニタリングが急上昇している⚠️ 感染者数の発表がなくなってしまったが、大変気になるところ

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

COVID is not the common cold, it affects the endothelial lining of blood vessels. Repeated infections (especially common among young adults) could have a cumulative (additive) effect. COVID-19 is the new risk factor for cardiovascular disease, just like smoking was. 2/2

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Immune exhaustion proposed as mechanism of Long COVID by researchers from University of Utah They compared the cytokine* profile of people with Long COVID vs healthy controls, and discovered differences *see alt text commentary @fitterhappierAJ had said this earlier 1/2

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

People may go through several bouts of omicron infection, because the prior bout might not generate enough antibodies to prevent a subsequent infection. This could potentially explain the observation of intervals as short as one month between infections (prior tweets) 9/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

9 months

Spain holiday hotspots reintroduce mask mandate as Covid-19 cases rise

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Spain holiday hotspots reintroduce mask mandate as Covid-19 cases rise

A Spanish holiday hotspot is set to reintroduce face mask measures in response to increasing cold, flu and Covid-19 cases

www.walesonline.co.uk

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Flowers are traditionally banned in some hospital wards, apparently due to risk of fungus growing in the water in the vase, causing invasive infections in the immune-compromised. But Heather Bell raises a valid point: why are people maskless around such vulnerable patients? 1/2

@GoberLass

🌺 Heather Bell

1 year

Visited a dear friend in hospital with a small bunch of garden picked sweet pea. Approached by a nurse who politely said that no flowers were permitted on wards it was hospital policy “to prevent infection” So my immunocompromised friend is on a ward with no flowers & no masks

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

“The emergency phase is over, but the pandemic is not over” 👆A one-line summary of WHO’s update today I agree that an emergency, by definition, can’t be chronic Unfortunately many will misinterpret this announcement as “the end of COVID” via @statnews

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WHO declares end to Covid global health emergency

WHO announced the end of the Covid global health emergency three years after it was first declared.

www.statnews.com

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

11 months

Study was done from July to September 2022, when Canada was going through a 2nd Omicron wave. They wanted to find out who was at greater risk of getting a 2nd omicron infection. Surprisingly, authors found that those who had prior omicron infection where are FAR GREATER risk. 2/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

11 months

Effect of COVID on the brain: nerve cells can fuse together, which affects their function. SARS-CoV-2 is one of several viruses that show fusogenicity. This had previously been demonstrated in heart muscle. h/t @_CatintheHat

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@_CatintheHat

Cat in the Hat 🐈‍⬛ 🎩 🇬🇧

1 year

COVID & the BRAIN… a thread 🧵 Almost every week, a new study is published proving the undisputed harm that Covid causes to our vital organs. This latest study shows how Covid can cause our brain cells to fuse together causing cognitive impairment. 🔗

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

One out of six rats in New York sewers had prior SARS-CoV-2 virus infection. One out of 20 were actively carrying the virus (rtPCR positive). The remarkable ability of this virus to infect multiple animal species helps maintain a parallel, non-human reservoir.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

9 months

8. We walked an average of 10 km a day. Did not wear mask in less crowded, large indoor spaces and while outdoors. But in crowded stores and corridors, metro (MRT) and buses, ~everyone had their masks on. I noticed the masks were properly fitted, they know how to wear it. 5/9

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Rajeev Jayadevan

@RajeevJayadevan

9 months

6. Aircraft toilet is a tiny chamber, kept mask on. 7. After landing, until we reached a large enough space, masks stayed on. Soon after landing there is a period of low air exchange rate, and people talk. This is high risk. 8. Kept it on in the taxi, driver wore mask too 3/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

9 months

10. Singapore is a great place to visit. Clean, organised and tourist-friendly. This was our second visit in 11 years. I am posting this because over the years many acquaintances got COVID immediately after air travel to various destinations. 7/9

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Rajeev Jayadevan

@RajeevJayadevan

9 months

At the hotel, we chose less crowded timings for breakfast, arriving early than late. We wore masks in the lobby (a busy place always) and also mandatorily in the elevator. All staff wore masks at all times. 4/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

11 months

Paxlovid does not prevent Long COVID, finds study. Negative results are as important as positive results in medical research, because we also need to know what doesn’t work. It is impressive that it got published.

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@boulware_dr

David Boulware, MD MPH

11 months

Null study of #paxlvoid for #LongCovid Probably won't be quoted by @NIHCOVIDTxGuide Effectiveness of Nirmatrelvir–Ritonavir Against the Development of Post– #COVID19 Conditions Among U.S. Veterans: A Target Trial Emulation #IDTwitter

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

9 months

3. Airplane jet bridges are tiny tunnels that are crowded, kept masks on. 4. Until the plane takes off and is cruising, cabin isn’t well ventilated. People were coughing throughout, a common problem nowadays. Masks stayed on. 5. At meal times (cruising), masks came off. 2/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

But once omicron arrived, there was a distinct change in immune response, at least among children. ❗️❗️❗️For those who were encountering the virus for the first time, very few in fact developed antibodies in the plasma and saliva (in the case of Omicron) 6/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

11 months

The value of the study is that they meticulously measured antibody and T cell response of a large no. of older adults. They did not find any relation with age, frailty or comorbidity. The paper must be kept as a reference on how immune systems work in older people. 3/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

The study has several implications. We know that omicron is capable of repeatedly infecting people often without their knowledge. Authors believe that it is perhaps the failure of antibody response - rather than the quality of antibodies - that results in this phenomenon. 7/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Long COVID study from Germany Being vaccinated made no difference Prior infection reduced incidence but not severity of Long COVID

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@a_kruschke

A.Kruschke

1 year

New LongCovid study 🇩🇪 University of Halle 新しいLongCovid研究ウイルス変異種、ワクチン接種、過去の感染症、および新型コロナウイルス感染症後のリスクとの関連性 Association between virus variants, vaccination, previous infections, and post-COVID-19 risk

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Such meticulously planned studies will help unlock the mysteries of the pandemic. These authors have tracked 1850 children from the beginning of the pandemic, studying their immune response to infections by various forms of the virus. 2/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

5 months

This is a comprehensive message from Yale School of Public Health about how COVID affects the immune system

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@_CatintheHat

Cat in the Hat 🐈‍⬛ 🎩 🇬🇧

6 months

COVID’S EFFECT ON THE IMMUNE SYSTEM 🔥 This is an excellent series of graphics from @YaleSPH explaining what we do (and don’t) know about Covid’s effect on the immune system. Much of this is informed by the work of Dr. Akiko Iwasaki ( @VirusesImmunity ). 🧵 H/t @fitterhappierAJ

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

Unexpected finding: vaccine mRNA found even at 60 days after vaccination, inside lymph nodes. Cell paper from Stanford University changes what we know about mRNA vaccines. They aren’t “self-destructing, transient email messages sent to cells” any more.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

Three young people have died in Kerala in 8 months from food poisoning, linked with consuming “Arabic” style grilled chicken served with baked rice, locally made mayonnaise and salad. Devananda was only 16. The new year saw the deaths of Reshmi, 33 and Anjusree, 19. Thread 👇

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

Important immunology paper from University of Kiel, Germany Quality of immune response declines with age. Having more naive (fresh, not exposed) T cells available helps mount a better quality immune response when challenged. Old, previously stimulated T cells don’t help. 1/4

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

9 months

@BradBanko @TakeWeightOffMD You are partly right, @BradBanko , they do nothing when not used correctly.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

Rise in heart attack deaths since the pandemic more among young adults “The excess death rate was most pronounced for the youngest (25–44 years) aged decedents, ranging from 23% to 34% for the youngest compared to 13%–18% for the oldest age groups” 1/2

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

Dr Duncan’s talk at 33 minutes into the video, where she describes a young man who got COVID, which progressed to Long COVID. He not only lost his career, his engagement broke up. Dr Duncan is quoted in this Nature article. 2/2

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

“People run the risk of getting Long COVID each time they get infected” My article in Today’s @the_hindu science page, thanks @RPrasad12 for highlighting this “soft outcome” of the pandemic.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

6 months

Tuesday meeting highlights 17 April COVID returns sooner than expected. This week, 6.7 - 7.3% of COVID tests turned positive, compared to nil the month prior. Cases mild or asymptomatic (screening), severe disease not yet reported (The last wave collapsed December 21) 1/6

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

8 months

2/3 Link

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Natural course of post-COVID symptoms in adults and children

Scientific Reports - Natural course of post-COVID symptoms in adults and children

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

A study on Long COVID patients reveals abnormal types of clots that are hard to get rid of. See thread above for more.

@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

2 years

“Fibrin amyloid microclots that block capillaries and inhibit the transport of O2 to tissues, accompanied by platelet hyper activation” - These abnormal blood clots can’t be cleared by the body’s usual mechanisms. -an explanation for Long COVID.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Near where I live, there are several people who have been unable to go to work after a bout of COVID. These are people who live on the border of poverty. They don’t work, there is no food on the plate. I enquired when they got COVID. Some said 2022 (Omicron) or earlier. 1/2

@sachintaparia

Sachin Taparia

1 year

56% Delhi-NCR residents who had #Covid or similar symptoms in last 45 days have a lingering #cough . 22% also experienced lingering #breathlessness & #fatigue . Urgent need to study #xbb116 #ARCTURUS from a #LongCovid perspective @RajeevJayadevan @MeetJess

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

One other myth that needs to be busted is “more infections = greater immunity” Many people believe this - the result of faulty health messaging that occurred in the early part of the pandemic. The messaging should instead be “the fewer infections per person, the better” 13/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

94% people with two recorded infections had mild disease in both instances “Protective effect is short term, while harmful effect is long term” TLDR: Avoid reinfections Link to study

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

11 months

SARS-CoV2 virus can remain “alive” inside macrophages^ upto six months in monkeys This was associated with systemic inflammation More data accumulate that this isn’t a one-off infection that quickly leaves the body like a common cold ^ immune cells, also called ‘big eaters’

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@MarionKoopmans

Marion Koopmans, publications: https://pure.eur.nl

@MarionKoopmans

11 months

Study finds effect of SARS COV 2 infection in macaques on macrophages collected 221 days post infection. Effect more in wildtype infection than omicron. Remarkable: evidence of replication competent virus in macrophages. Worth studying in long COVID

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Also tells us that doing serology studies will not help determine how many had omicron infection, because of the failure to generate antibodies. (Of course this only applies to first immune exposure) 8/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

❗️Reinfection need not always be milder 🦠 High exposure load led to reinfection within 3 months Learning: 1. Prior immunity will not protect if we get exposed to lots of viruses (e.g. closed room, lots of people talking without masks) 1/5 (Imagine: Umbrella vs. hurricane)

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

6 months

Long COVID more common after reinfection. This specifically applies to Omicron. Although individually less severe at the outset, the large number of reinfections amounts to significant subsequent Long COVID burden in the population. via @IDSAInfo

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

They measured antibodies found in blood as well as saliva. Among children who never had prior infection or vaccination, there was a remarkable difference in their antibody response to various versions of this virus. 3/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 months

Defects in immune system at 10 months following COVID: research from Medical University Vienna 🔹Innate immunity diminished: ⬇️Natural Killer cells, neutrophils 🔹T cells, B cells diminished: ?Bone marrow effect 🔹TH1 to Th2 switch (shift towards allergic type of response) 1/5

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

11 months

They found that immune response was not the same among all participants. Authors argue that lower antibody levels might be a reason for getting reinfected. It is not due to underlying immunosuppression, they find. 4/

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

“An advantage of masks is that they are equally effective against all variants” I discuss masks in this article by @BShajan for @the_hindu By cutting off the medium of travel for the virus between people, masks reduce infection risk, see thread. 1/2

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Do I still need to wear my mask?

World-wide mask wearing became a part of our public life three years ago with the COVID-19 pandemic but late last week the World Health Organisation declared that COVID-19 no longer qualifies as a...

www.thehindu.com

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

How effective is vaccination in preventing death? 95% for 2 doses 82% for 1 dose Study of 117,524 police personnel, Tamil Nad Published in IJMR by Dr Jayaprakash Muliyil & team (Both vaccines used, no breakdown available between covishield & covaxin)

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Cruise ships see COVID, yet again

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Princess Cruises Advises Mask Wearing on One Ship

Due to recent positive cases, Princess Cruises is recommending mask wearing aboard one of its smallest cruise ships.

www.cruisehive.com

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

1 year

Link to study See detailed thread above

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Antibody Levels After Primary Infection With Omicron Variants of SARS-CoV-2 Infection in Germany

This cross-sectional study evaluates IgG antibody levels in children and adolescents in Germany following SARS-CoV-2 infection.

jamanetwork.com

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

SARS-CoV-2 virus has interesting differences from SARS virus of 2003. Its spike protein overall has ~lower affinity to the ACE-2 receptor but its RBD has HIGHER affinity. That is because its RBD is ‘hidden away’ often, helping it evade immunity. 🧵 1/9

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

8 months

Large study on side effects following COVID vaccination Myocarditis: reported with mRNA vaccine CVST: 1 out of 40,000 ChAdOx1 doses Guillain Barré syndrome: known to rarely occur with vaccines. Context: “the risk of neurological event following COVID is 617 times higher” 1/2

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

8 months

Mitochondrial dysfunction occurs during active SARS-CoV-2 infection, and recovers upon recovery. But in some individuals, it stays impaired.

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

7 months

Vitamin D deficiency is being over-diagnosed: the “normal range” is set too high Latest India data among healthy people show that if these levels are used, then 98% will be “insufficient or deficient” TLDR: The reference range has to be customised for India. See slide. 1/3

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

3 years

3. Excessive steam inhalation: widespread practice in India Steam in excess can damage the delicate mucus layer and even cause burns along the mucosa, making it easy for fungus to breach our natural defence. Note: Burns caused 10-20% of past mucormycosis in India 👇 6/8

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@RajeevJayadevan

Rajeev Jayadevan

@RajeevJayadevan

8 months

Chronic cough following acute respiratory infection (flu, COVID) is now common among previously healthy individuals, a finding we had repeatedly reported at our Tuesday COVID meetings at Kochi. @NehaMadaanTOI writes about similar observations elsewhere.

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Cough lasting up to 3 months baffles medical practitioners this flu season | Pune News - Times of...

PUNE: A lingering cough lasting up to three months has flummoxed city doctors this flu season.

timesofindia.indiatimes.com

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