3 ms·

I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all. All my patients got a higher dose of Lovenox (anticoagulant)

I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all. All my patients got a higher dose of Lovenox (anticoagulant) as soon as they hit the unit. The trick is balancing risk vs. benefits. Anticoagulants and antiplatelet will kill a 30 yo healthy person who slips on ice and hit his head. Your mild concussions are now massive brain bleeds.

dpark 5y ago
> I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all. Sorry, what? You’re telling us that you were treating long COVID patients in the ICU when the pandemic started? I don’t know if you misspoke or misread the headline or what, but in no way is it possibly true that you were treating long COVID with anything in the ICU at the beginning of the pandemic, or any time for that matter.
- GenerocUsername 5y ago
  I can tell you with absolute certainty that there are circles of of the web which knew incredible amounts of very accurate and precise details about COVID in Feb/March of 2020. The early mistreatments accounted for vast amounts of preventable deaths while people proposing the eventual correct solutions were deplatformed
  - dpark 5y ago
    1. I would love some actually citations rather than a hand-wavey claim that sounds like conspiracy theory. This sounds like you’re talking about hydroxychloroquine. 2. None of this matters to the claim I addressed. Long COVID it’s not something that would be treated in an ICU. It’s also not something that even had a name “when COVID hit”.
    - surgeryres 5y ago
      The problem the paper is addressing is fibrin micro clots, which occurs in long Covid. This also occurs in acute Covid. The treatment is similar - anti coagulation. We (doctors) knew this from the beginning (1). Chill out bubba. (1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378457/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378457/ Attached article was written during initial outbreak
      - dpark 5y ago
        I find this to be such a bizarre statement. “What causes long COVID?” has been a common question for a year and a half now. Someone publishes results indicating it might be X and treatable with Y and we get a couple of people chiming in with “yeah, we knew that already”. You knew the solution to long COVID and just kept it quiet? The NIH was publishing guidance to give anticoagulants to hospitalized acute COVID patients but just neglected to tell people the cure to long COVID? I’ve got no dispute that you knew to give hospitalized patients anticoagulants early on. My statement is that this is a different thing than knowing to treat long COVID with a related protocol. This study hasn’t even been published yet, has it? This is a preprint we’re discussing. Have there been a bunch of other studies showing this is a viable treatment I’m unaware of (this is certainly possible)? Or is this new data?
        surgeryres 5y ago
        All your question marks makes brain hurt. This study is not establishing a new treatment protocol by any means. It’s also a tiny number of people. This study raises the question maybe we should design bigger trials to investigate treating long COVID with blood thinners.
        dpark 5y ago
        > This study is not establishing a new treatment protocol by any means. So this was a known treatment protocol? That’s interesting. I hadn’t heard much about long COVID that wasn’t “we have no real idea”.
- jonathan-adly 5y ago
  One of the underlying problems of COVID is an excessive immune system response, which we have known for 10+ years that it leads to coagulation issues. Long COVID or acute COVID - it is fundamentally your body fighting a battle in the wrong way. So, in that specific way, COVID is COVID.
  - dpark 5y ago
    So…you misspoke? I also find this a really odd line to draw. The fact that treating ICU patients with anticoagulants is standard does not automatically mean it’s useful for long COVID patients. If it turns out that it’s useful, awesome, but it’s not obvious a priori.
    - edmcnulty101 5y ago
      I didn't see them misspeak. They just clarified. Their follow up statement was right in line with their original. Pretty cool that they're ahead of the curve on this. Even if they didn't know about long covid officially, they followed the known science up to that point, and this is incompletely but interesting new data that's showing it's helping more than possibly known at the time.
      - dpark 5y ago
        They’re not ahead of the curve. This long COVID treatment experiment is new and they equated it with an entirely different treatment. Saying “we knew this 2 weeks in” is dismissive and absurd. Knowing that NIH recommends anticoagulants for acute hospitalized COVID is entirely different than knowing that anticoagulants are useful for treating long COVID. If someone published a study that CTE resolves with a month of Tylenol supplementation, this would be huge news. The fact that acute concussion pain is treated with Tylenol in no way implies this result.
        edmcnulty101 5y ago
        They stated they knew from the scientific literature that anticoagulants were beneficial so I'm assuming they werent referring to long covid but to just general efficacy against covid, because long covid hadn't been discovered yet. In that sense they were ahead of the curve because its looking like it is helpful with long covid as well, which is great news!

dpark 5y ago

> I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all. Sorry, what? You’re telling us that you were treating long COVID patients in the ICU when the pandemic started? I don’t know if you misspoke or misread the headline or what, but in no way is it possibly true that you were treating long COVID with anything in the ICU at the beginning of the pandemic, or any time for that matter.

GenerocUsername 5y ago
I can tell you with absolute certainty that there are circles of of the web which knew incredible amounts of very accurate and precise details about COVID in Feb/March of 2020. The early mistreatments accounted for vast amounts of preventable deaths while people proposing the eventual correct solutions were deplatformed
- dpark 5y ago
  1. I would love some actually citations rather than a hand-wavey claim that sounds like conspiracy theory. This sounds like you’re talking about hydroxychloroquine. 2. None of this matters to the claim I addressed. Long COVID it’s not something that would be treated in an ICU. It’s also not something that even had a name “when COVID hit”.
  - surgeryres 5y ago
    The problem the paper is addressing is fibrin micro clots, which occurs in long Covid. This also occurs in acute Covid. The treatment is similar - anti coagulation. We (doctors) knew this from the beginning (1). Chill out bubba. (1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378457/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378457/ Attached article was written during initial outbreak
    - dpark 5y ago
      I find this to be such a bizarre statement. “What causes long COVID?” has been a common question for a year and a half now. Someone publishes results indicating it might be X and treatable with Y and we get a couple of people chiming in with “yeah, we knew that already”. You knew the solution to long COVID and just kept it quiet? The NIH was publishing guidance to give anticoagulants to hospitalized acute COVID patients but just neglected to tell people the cure to long COVID? I’ve got no dispute that you knew to give hospitalized patients anticoagulants early on. My statement is that this is a different thing than knowing to treat long COVID with a related protocol. This study hasn’t even been published yet, has it? This is a preprint we’re discussing. Have there been a bunch of other studies showing this is a viable treatment I’m unaware of (this is certainly possible)? Or is this new data?
      - surgeryres 5y ago
        All your question marks makes brain hurt. This study is not establishing a new treatment protocol by any means. It’s also a tiny number of people. This study raises the question maybe we should design bigger trials to investigate treating long COVID with blood thinners.
        dpark 5y ago
        > This study is not establishing a new treatment protocol by any means. So this was a known treatment protocol? That’s interesting. I hadn’t heard much about long COVID that wasn’t “we have no real idea”.
jonathan-adly 5y ago
One of the underlying problems of COVID is an excessive immune system response, which we have known for 10+ years that it leads to coagulation issues. Long COVID or acute COVID - it is fundamentally your body fighting a battle in the wrong way. So, in that specific way, COVID is COVID.
- dpark 5y ago
  So…you misspoke? I also find this a really odd line to draw. The fact that treating ICU patients with anticoagulants is standard does not automatically mean it’s useful for long COVID patients. If it turns out that it’s useful, awesome, but it’s not obvious a priori.
  - edmcnulty101 5y ago
    I didn't see them misspeak. They just clarified. Their follow up statement was right in line with their original. Pretty cool that they're ahead of the curve on this. Even if they didn't know about long covid officially, they followed the known science up to that point, and this is incompletely but interesting new data that's showing it's helping more than possibly known at the time.
    - dpark 5y ago
      They’re not ahead of the curve. This long COVID treatment experiment is new and they equated it with an entirely different treatment. Saying “we knew this 2 weeks in” is dismissive and absurd. Knowing that NIH recommends anticoagulants for acute hospitalized COVID is entirely different than knowing that anticoagulants are useful for treating long COVID. If someone published a study that CTE resolves with a month of Tylenol supplementation, this would be huge news. The fact that acute concussion pain is treated with Tylenol in no way implies this result.
      - edmcnulty101 5y ago
        They stated they knew from the scientific literature that anticoagulants were beneficial so I'm assuming they werent referring to long covid but to just general efficacy against covid, because long covid hadn't been discovered yet. In that sense they were ahead of the curve because its looking like it is helpful with long covid as well, which is great news!