Ziyad Al-Aly, MD Profile picture
Apr 22, 2021 10 tweets 8 min read Read on X
Happy to share the latest paper from our team in @nature

A comprehensive characterization of post acute sequelae of COVID-19

#longcovid #PASC

nature.com/articles/s4158…

@VAResearch @vahsrd @WUSTL @WUSTLpubhealth @WUSTLmed @WUSTLnews @VREFSTL @Biostayan @BCBowe
#Longcovid is a multifaceted disease; it can affect multiple organ systems including respiratory, cardiovascular, nervous, mental health, metabolic, gastrointestinal, kidneys, and other organ systems.
People with #longcovid have increased risk of incident use of several therapeutics including pain medications (opioids and non-opioids), antidepressants, anxiolytics, antihypertensives, and oral antihyperglycemics and evidence of laboratory abnormalities in multiple organ systems
#Longcovid is evident even in those who had mild acute disease which did not require hospitalization during the acute phase of the infection
Burden of #longCOVID increases substantially in those who required hospitalization, and is most pronounced in those who needed ICU care during the acute phase of the infection
When comparing the post-acute sequelea of COVID vs flu, COVID exhibited remarkably higher burden of post-acute sequalae. Both the magnitude of risk AND extent of organ system involvement were much higher than post-acute flu manifestations.
People with #longcovid need multidisciplinary care.
If there ever was an exemplar in clinical medicine that best illustrates the importance of integrated multidisciplinary care, it is #longcovid. Health systems should quickly adapt to this reality.
I can’t believe that I have to say this, but yes, #longcovid is real. People with long covid should be listened to, and their experiences must be honored.
We got caught unprepared for Covid. Let’s not drop the ball on long Covid
nytimes.com/2021/04/22/hea…
Illustration by Sara Moser @WUSTL

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More from @zalaly

Mar 18
What happens to the heart when people stop GLP-1 drugs?
The short answer: nothing good.
New from our team: a study of 330,000+ people in @BMJMedicine
🧵 Image
About 1 in 8 U.S. adults has taken a GLP-1 drug. But 36–81% of users stop within the first year. Most studies have focused on weight regain after stopping. We focused on what happens to the heart. Image
We followed 333,000+ adults with type 2 diabetes for 3 years, emulating a randomized trial across 16 treatment scenarios with different durations of use, discontinuation, and interruption.
Read 13 tweets
Mar 4
📢NEW: In a study of 600,000 people published today in @bmj_latest, we found GLP-1 drugs (Ozempic, Wegovy, Mounjaro) associated with reduced risk of addiction across alcohol, opioids, cocaine, cannabis, nicotine—and 50% fewer substance-related deaths.
🧵
bmj.com/content/392/bm…Image
We used VA data—one of the largest healthcare systems in the world—to emulate 8 randomized trials.
600,000 people. 3 years of follow-up. Over 1.5 million person-years.
Two questions: Do GLP-1 drugs prevent addiction? And do they reduce harm in people already struggling with it?
Among people with no prior addiction, GLP-1 drugs were associated with lower risk of addiction across substances:
▸ Opioids: 25%
▸ Cocaine: 20%
▸ Nicotine: 20%
▸ Alcohol: 18%
▸ Cannabis: 14%
Consistent across every substance we tested.
Read 10 tweets
Jan 20, 2025
1. What are the benefits and risks of GLP1?

Our new study in @naturemedicine comprehensively maps all the benefits and risks of GLP-1 receptor agonists (GLP-1) (Ozempic, Wegovy, Mounjaro, Zepbound).

By @Biostayan, Taeyoung Choi and me
🧵

nature.com/articles/s4159…
2. Why we did this study?

We saw that GLP1 use has substantially increased, and reports emerged about some off-target effects. But we realized that no one had comprehensively investigated effectiveness & risks of GLP-1 across all possible health outcomes
nature.com/articles/s4159…
3. So, we decided to do the comprehensive study!

We did a discovery analysis which comprehensively examined 175 possible health outcomes (leaving no stone unturned) in 215,970 people on GLP1 and more than 2 million individuals not on GLP1

nature.com/articles/s4159…Image
Read 16 tweets
Dec 30, 2024
How the Pandemic Increased US Deaths!
Visualized in 8 charts by @jwgale in @business

1. The Covid Pandemic Fueled a 4-Year Mortality Surge in the US Image
2. Heart disease has long been the leading cause of death in the US and globally. The Covid pandemic worsened its effects. Image
3. Deaths From Heart Disease Accelerated as Covid Spread Image
Read 10 tweets
Oct 15, 2024
🚨 Long COVID is a significant health crisis in China too!

My commentary on the largest Chinese study to date, involving 74,075 participants, which found that 10-30% of them reported long COVID symptoms such as fatigue and brain fog #LongCovid

thelancet.com/journals/lanwp…
The features of Long Covid reported in this Chinese study are remarkably similar to those reported in studies conducted in other parts of the world.

This underscores the consistency of Long Covid features across national borders and cultures!!!

thelancet.com/journals/lanwp…
The study also shows that:

🔸Reinfections increase risk of Long Covid
🔸Vaccines reduce risk of Long Covid

This is also consistent with evidence from studies performed in other parts of the world.

thelancet.com/journals/lanwp…
Read 6 tweets
Sep 23, 2024
Here are key slides of my talk at the NIH-RECOVER-TLC
#RECOVERTLC
nature.com/articles/s4159…
Image
The number of people with Long Covid is huge. This demands global attention. nature.com/articles/s4159…
Image
The economic toll of Long Covid is significant.

nature.com/articles/s4159…
Image
Read 11 tweets

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