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Let's cover health risks after getting COVID (diabetes! heart disease!). This, along with the high incidence of LongCOVID (prior thread below) are two massive reasons you don't want COVID for yourself or your loved ones. First, diabetes. 🧵
twitter.com/grahamwalker/status/1521278371212132354
I should start out by saying that just like with LongCOVID, I don't think anyone has a clear understanding of the *reason* for higher risk of disease <X> after a COVID infection. As with many things in medicine, we have ideas and hypotheses, but little hard evidence.
In addition, we've known for a long time that lots of viral infections can cause lots of bad things — not just COVID. Enteroviruses (and others) can lead to Type 1 diabetes, along with some subtypes of influenza. (Get your flu shot!) ncbi.nlm.nih.gov/pmc/articles/PMC6096634/
And something that I see frequently as an ER doctor is the stress of a viral infection on the body causing dehydration and kidney failure, strokes, heart attacks, etc. These may be directly due to the virus, due to our immune systems fighting the virus, or both.
So to be clear, this is not *just* COVID. But since COVID has infected billions of people, even a small uptick in risk of serious diseases like diabetes or strokes will cause HUGE numbers of people to be sicker than they would have been otherwise.
First, diabetes. Props to the VA — we have huge datasets from them and great analyses that have really helped to inform this area of study. Any study where you can look at almost 3 million patients is already impressive.
pubmed.ncbi.nlm.nih.gov/35085391/
This study found that one's risk of developing diabetes was more than doubled if you had a positive COVID test when compared if you didn't have a positive COVID test. Now the notes:
1️⃣Don't panic. Risk went from 0.3% to 0.6%. (But again, with billions of people infected...)
2️⃣The study did not find this link in women. (The VA cares for predominantly men due to its military association; in this study 86% of the patients were men.)
3️⃣This study found this risk was higher if you were hospitalized for COVID more than hospitalization for other reasons.
4️⃣Since diabetes is diagnosed by lab tests and can start silently in many people, this study controlled for this. Brilliant! They made sure that they weren't just diagnosing more diabetes because they were following up closer with COVID patients and doing more lab tests on them.
I should just say that you *really* don't want diabetes. (And if you have it, you should work your hardest to get your sugar/A1C levels down as well as you safely can.) Diabetes causes problems with EVERY. SINGLE. ORGAN. AND SYSTEM. IN. YOUR. BODY.
Next, let's talk about the heart🫀, because COVID messes with that as well. There's a great Nature Medicine paper (again from VA data) that I'll be referencing, suggesting even if you had mild COVID, your heart-related illness risk goes up up up.
nature.com/articles/s41591-022-01689-3.pdf
A quick summary: your risk of stroke goes up. Along with arrhythmias, heart attacks, blood clots, and heart failure. (You know myocarditis—the one you've heard so much about on social media? It goes up markedly with COVID; much more than the risk from a vaccine.)
Why does this matter? Because all of these diseases take healthier people and make them MUCH sicker. Permanently. Have an arrhythmia? You'll be permanently on blood thinners. Heart failure? The most common reason for admission to the hospital. Blood clots? More blood thinners.
This is a nice graph showing the "excess burden" due to COVID, per 1,000 people. Again, 10 more cases per 1,000 people sounds small, but multiply that by our population size, it's probably many MILLIONS of people with heart attacks and blood clots that wouldn't have had them.
This study compared people who had COVID to those who didn't have COVID, those hospitalized vs. not-hospitalized from COVID, and also historical controls (2017) to try to correct for any data problems. AND, like the diabetes study, risk was much higher if you had severe COVID...
Shown nicely on this graph. Purple is "you were in the ICU due to COVID." Such a trend is no surprise to those of us in medicine, but I just wanted to point it out to not terrify people.
I think the other *really* important thing to note here is that this is risk up to a YEAR after these VA patients' had their COVID, and is 30 days after their COVID infection as well.
Finally: If we just do back of the envelope calculations:
~60% of the US has had COVID
In total 45 extra diagnoses in this study (just looking at heart disease!) per 1,000 people:
8,896,500 extra people have heart problems now because of their COVID infection.
I want to wrap up this 🧵 with some hope, because I know the numbers probably sound scary or depressing. The Good News? A lot of diabetes and heart problems can be managed with good medical care and medications, and SO MUCH of our health risk is under our control with lifestyle.
At almost 42 years-old, my middle-aged, recently COVID+ self has higher risks of medical problems later in my life. So I'm trying to do something about it:
👉Try to get 8 hours of sleep
👉Eating healthier
👉Reducing unnecessary stress in my life and improving my mental health
👉I wear a KN-94 indoors to protect myself from other infectious diseases circulating, like Influenza
👉I don't smoke but if I did, there's almost no health benefit better for you than stopping smoking
👉I try to spend some time outdoors with nature when I can
🏃♂️And maybe most importantly, I try to exercise daily. I like to run, but sometimes it's walking, or biking, or yoga from Youtube.
There is *no* drug that exists with all the benefits of exercise:
🫀Heart health
🧠Mental health
😴Better sleep
👍Confidence/self-esteem