THREAD: Covid twitter: A tale of two hearts

1. Back last year, there was much consternation about the risk of myocarditis (inflammation of the heart) in young athletes

This was amplified by some prominent accounts (sorry to pick Ding again, but it's a perfect illustration)

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This was tweeted & retweeted to millions- Covid caused heart damage, no one was safe. It was even picked up by some of the press. Even at the time, some urged caution, but they were generally ignored, & the churn of Covid panic continued ever on.

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Fast forward nearly a year- to a new study, on Covid related heart issues in young athletes which has just been released.

It's a decent study- 42 colleges/universities, 19,378 athletes tested in total, 3018 positive for covid, which were then evaluated.

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Of the 3018 that tested positive, 1774 had symptoms- here's an interesting chart (no wonder bath bombs were so unpopular in 2020!)

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They employed a mixture of testing/screening, which is a bit complex, but essentially they used both a triad of tests (ecg, troponin- a blood test, & an echo (ultrasound of the heart), & they also used cardiac MRI for some.

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The method is all somewhat technical for those non medically minded (it's cardiology, standard), & I'd advise anyone who's interested, to give the study a read.

https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.121.054824

I'll summarise some of the key outcomes:

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Some outcomes:

- Definite/probable/possible SARS-COV-2 cardiac involvement was identified in 21/3018 (0.7%) athletes

-No athlete diagnosed with definite/probable/possible cardiac involvement had an adverse cardiac event through the available follow-up period (median 113 d)

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- In the cohort, there was 1 cardiac event (a successfully resuscitated cardiac arrest, likely unrelated to Covid)

-Interestingly, 56/3018 (1.9%) had cardiac abnormalities unrelated to Covid, which were a mixture of new & pre existing diagnoses

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Here's a list- I assume the bovine aortic arch was already known. Heh.

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Here is a nice table outlining the results (again, note the triad of tests vs Cardiac MRI, which is explained more in depth in the method. Including use of the Lake Louise criteria to diagnose myocarditis on MRI which may be the prettiest name for a lake ever.)

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So this study is overall, very reassuring. 35% of young adults *do not* appear to have cardiac related complications of Covid based on these findings!

Yay!

So, dear Zebra, I hear you cry, why has this not spread round twitter like wildfire?

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Now that is a question. A cursory glance at certain twitter timelines suggest the conversation has moved on, after warning young adults that they likely had a 1 in 3 change of *heart problems*, the discussion is now on double mutant variants taking over the world.

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I cannot see that this study has ever been tweeted by some very prominent covid accounts, which all too readily tweeted on the risks last year. And that is borne out by the stats on the studies page.

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Now, obviously, informing people of risk is important. Blind optimism is just as damaging as blind pessimism

However, it is arguably negligent to inform someone of a likely terrible outcome, & then not to follow up when data comes out to suggest that things aren't so bad

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Just as we would criticise someone ignoring warning signs, we should also criticise people who fail to acknowledge when they've got things wrong, & predictions have been too dire.

I'm not going to go into the reasons why certain things may get more traction than others

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Other than to note it is likely multifactorial.

Bad news does get retweets, & we all have pre existing biases & a tendency to select for & amplify information that conforms to them.

But I do think it's important, for those with large platforms to reflect.

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I also think that if people are following individuals who focus on bad news, & do not admit when data changes, they should also reflect on who they are putting their trust in.

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