Dr Graham Lloyd-Jones

Not as much as there should have been.
Do you have something in mind?
Or a question?

True.
Just saying, to study the gut microbiome without also studying the oral microbiome is like studying the tubes of a trombone without its mouthpiece and wondering where the music comes from.
The oral microbiome determines the gut microbiome.
And the oral microbiome translocates systemically.

Inflammation-type dysbiosis of the oral microbiome associates with the duration of COVID-19 symptoms and long COVID In the COVID-19 pandemic, caused by SARS-CoV-2, many individuals experience prolonged symptoms, termed long-lasting COVID-19 symptoms (long COVID). Long COVID is thought to be linked to immune dysregu...

Hi David.

Correct!

But the gut microbiome is downstream from …

The oral microbiome.

See this study from 2021
👇
pmc.ncbi.nlm.nih.gov/articles/PMC...

And remember …
👇
Oral pathobionts have direct systemic vascular entry (bypassing the liver) via oral mucosa/diseased gums.

Published today after 2years of work behind the scenes by us at WHN/DELPHI Executive team : Our Global Expert DELPHI Consensus document on Long Covid. 179 Experts from 28 countries around the Globe Participated. Please share. Happy Easter!

link.springer.com/article/10.1...

Dear #MedBlueSky

Black and white EITHER/OR debates limit us.

Nuanced AND/BOTH debates provide answers.

Let's not oversimplify the human body. It is too complicated to be understood in terms of binary EITHER/OR stances.

The nuance of AND/BOTH is the way forward.

Thanks

… to ensure correct language is used to describe a disease (not old and potentially misleading language)

And …

To allow challenges to incorrect concepts, to stop them propagating and becoming fixed dogma in the medical literature.

25/25

I'm now working with likeminded radiologists on an invited review of #COVID imaging for a major radiology journal.

We propose formation of a system by which all medical/scientific specialties collaborate to build understanding when we encounter a new disease …

24/25

My frustration with the world of medicine (my world) is that we are pathologically unable/unwilling to shift ideas or to see the body holistically.

Our blinkered and siloed approach kills people!

Oral health is the most siloed of all areas of medicine.

23/25

In summary, gum disease bacteria escape the mouth all the time and are directly implicated in biological mechanisms of numerous common diseases of the body including cardiovascular disease, diabetes,

22/25

YouTube video by Salisbury District Hospital COVID-19 and the Salisbury Oral Care Pathway

What have I learned from COVID-19? …

That our lack of understanding of the biology of the mouth and the importance of #OralHealth is the biggest missing link in the whole of medicine.

youtu.be/yLhtBZIaAIk
21/25

The concept of pathogens escaping the mouth and travelling to the rest of the body is now my major area of interest (writing a book).

20/25

This question led to hypothesizing that the virus is getting to the lungs from the upper respiratory tract (nose and mouth) via the bloodstream.

And this explains why gum disease is a major risk factor for death from COVID-19.

link.springer.com/article/10.1...

19/25

The pattern of lung disease we saw on medical imaging in people with #COVID-19 tells us that the disease is NOT pneumonia, it is a vasculopathy (disease of blood vessels).

This raises another question …

How does this happen?
18/25

You might think that medical organisations asked – what are we dealing with?

They didn’t!

They assumed it was just like influenza. They kept calling the disease ‘pneumonia’.

This was a fatal error.
17/25

At the outset of the pandemic, ‘experts’ were called on to advise on population level planning.
This is fine (if you like graphs), but we also need a multidisciplinary approach to attempt to understand the biological mechanisms of the disease we are dealing with.

16/25

Not ...
What old language can we use to describe this disease?

But ...
What is different?

What is new?

What don't we understand?

And ...
How can we collaborate to build a multidisciplinary understanding of diseases processes?

15/25

I am posting this story now so that we (humans) can learn some lessons.

When we encounter a new disease, we should all stop and ask ....

What are we dealing with?

Not ...
How is this similar to other diseases we know about?

14/25

Here is our conclusion …

(Remember, this is 2020 data which could have been published in early 2021)

13/25

After many attempts to get published we were eventually accepted this month (April 2025!) in an institutional journal.

(Thanks to @UMJBelfast. And thanks especially to my colleague Alastair Watson for not giving up hope of publication.)

bit.ly/4j6fIpx

12/25

The airways of the lungs were NORMAL!
Unlike influenza, there was no inflammation in the lung airways in people with #COVID-19.

The blood vessels were damaged.

And yet the world of medicine carried on treating it as if it were flu.

11/25

This led to an invitation to join the REACT COVID-19 research group based in Southampton, UK. I was initially the sole radiologist on the project.

People from across the world sent me examples of COVID-19 cases. I looked at thousands of images. The same pattern was repeated …

10/25

YouTube video by Radiology Masterclass COVID-19 Lung Disease: A Pulmonary Vasculopathy

In November 2020 I was invited to speak at the @BritSocHaem annual conference.

The talk highlights that #COVID-19 is NOT a pneumonia. It is a pulmonary vasculopathy (disease of the lung blood vessels).

youtu.be/2jROYLwUK20
9/25

So I published informally as a blog on the Radiology Masterclass website and shared my ideas widely.

bit.ly/3E6PX9D

8/25

In June 2020 I wrote to a UK radiology journal to raise the alert.

The title of my letter was – ‘Acute COVID-19 lung disease: A pulmonary vasculopathy not a pneumonia’

I was told it would be too ‘time-consuming’ to be put forward for publication.

7/25

Soon the autopsy papers showed that clotting in the lungs was occurring in the capillaries (the smallest blood vessels). This means that we would not be able to detect clotting in the lungs using standard imaging techniques.
bit.ly/3XSg8aM
6/25

I wanted to know WHY #COVID-19 caused this weird ‘pneumonia’.

The areas of lung damage looked like what we see when someone has blood clots in the lungs.

bit.ly/4j6fIpx
5/25

The early papers from China showed distinct patterns of lung damage on CT scans which helped to make the diagnosis, but this was not the main question I had.

bit.ly/43PTfZi

4/25

COVID-19 Image Gallery

In early 2020 I had an obvious job to do – teach doctors to make the diagnosis of COVID-19 on a chest X-ray or CT scan.

Making the diagnosis is easy because COVID-19 causes a lung disease which is totally unlike other ‘pneumonias’.
bit.ly/3XSvMmr

3/25

Firstly, who am I?

I am an educator in medical imaging, best known for founding Radiology Masterclass, a leading online resource for radiology education.
www.radiologymasterclass.co.uk
2/25

If in Dec 2020 you had told me it would take until April 2021 to get my #COVID research published, I’d have been disappointed.

It has now been published (April 2025), 4 years later.

bit.ly/4j6fIpx
👇
Here's my epic COVID-19 failure story …

Long thread 1/25