As a clinician, I've seen young patients die of sepsis from atypical organisms with lymphopoenia weeks after acute COVID. I've seen deaths from TB and endocarditis. I've treated multidermatomal shingles. I routinely look out for post-COVID lymphopoenia nature.com/articles/s4159…

Our mortality and morbidity meetings are full of cases of young patients dying of sepsis shortly after a COVID infection. Irrespective of what the underlying mechanism is, post-COVID immunosuppression is a phenomenon readily observable to the clinician.

If not my patients, then friends spontaneously ask me why they get unrelenting non-COVID viral infections and UTIs etc they have never previously had soon after a COVID infection. Like other COVID-cautious people who have never had COVID, I do not experience this.

You're exaggerating if you insist post-COVID immunosuppression could only be real if it was so severe it was like myeloablative chemotherapy followed by total body irradiation (bone marrow transplantation preconditioning). Immunosuppression comes in shades of grey

Most immunocompromised patients aren't as severely immunosuppressed as patients with untreated SCID, end-stage AIDS, or after myeloablative therapy. A study of IgA nephropathy showed mild immunosuppression from long-term steroids increased mortality from opportunistic infections.

I teach my junior staff to beware of patients presenting with sepsis and post-COVID lymphopoenia. Extra vigilance is required in these cases, as their clinical course is often worse. The literature to support this vigilance is extensive and grows daily. twitter.com/AndrewEwing11/…

If you see non-clinicians decry post-COVID immunosuppression as a “conspiracy theory”, ask yourself why they're the same lot who've spent years pushing mass infection propaganda—herd/hybrid immunity, children-don't-spread-COVID…and now “immunity debt”. twitter.com/toshiakima/sta…

It's so weird. If I wrote on Twitter that (just as a made-up example) I noticed that chronic kidney disease patients with calciphylaxis had higher rates of stroke and MI, suggesting increased thromboinflammation, nobody would accuse me of “fearmongering”.

I wouldn't get a non-clinician like Bollox telling me I am propagating conspiracy theories, followed soon by a physics professor and a paediatrics registrar nodding in agreement, while lay trolls like Taipan jeered.