geoffrey modest medical blogs

  The New York Times had a long but intriguing article on the post-Covid syndrome (see   https://www.nytimes.com/2021/01/21/magazine/covid-aftereffects.html?referringSource=articleShare  ), making several strong points: -- many patients from diverse backgrounds (including doctors and nurses) develop long-standing symptoms after Covid infection (“long haulers”, or "long Covid"), with many individuals profiled in this article -- Mount Sinai Hospital in New York developed its Center for Post-Covid Care last May, now with more than 1600 patients -- patients experience a diverse set of symptoms including fatigue, pain, shortness of breath, light sensitivity, exercise intolerance, insomnia, tachyarrhythmias, diarrhea/cramping, and memory  problems/”brain fog”, with examples of people who cannot put a cogent sentence together, get trapped in their shower because they can’t remember how to get out, need to write themselves notes to remind themselves when to eat, unable to mu...

A recent study from Wuhan found that markers of cardiac injury were common and associated with increased mortality (see  covid cardiac injury inc mortality jamacard2020  in dropbox, or doi:10.1001/jamacardio.2020.0950) Details: -- over a three-week period in January 2020, a single hospital assessed 416 consecutive hospitalized patients with Covid -- median age 64, 51% female -- symptoms in whole sample: fever in 80%, cough in 35%, shortness of breath in 28%, fatigue in 13% -- lab tests assessed: leukocyte count, C-reactive protein, pro-calcitonin, CK-MB, high-sensitivity troponin-1, BNP, AST, creatinine; also chest x-ray -- cardiac injury was defined as increased high-sensitivity troponin-1, above the 99 th  percentile of the upper reference limit, independent of EKG and echocardiography Results: -- 82 patients (20%) had evidence of cardiac injury      -- overall, patients were older (74 vs 60 years old, p<0.001)  ...