Eric Topol Profile picture
Jul 28, 2021 6 tweets 4 min read Read on X
Very important @NEJM paper today on breakthrough infections (BTI) post-vaccination in Israeli health care workers.
5 key points:
1. Of ~1500 people, 0.4% had BIs, sequenced to be Alpha 85% (this was pre-Delta)
nejm.org/?query=feature…
2. All these BTIs were mild (67%) or without symptoms (33%), done due to routine testing. No hospitalizations.
3. 7 of 36 (19% ) of BTIs had "persistent symptoms" > 6 weeks. Table below
An indicator for the potential of #LongCovid in BTIs in a few of these people at > 6 weeks, but that's a very limited and early time for assessment.
4. There were NO secondary attacks, no indication of transmission of BTIs.
5. The neutralizing antibody levels in the people with BTIs were lower than matched controls, raising the question of need for a booster dose. Unsettled.
#LongCovid from breakthrough infections?
We needed time to determine whether they can occur post-vaccination. This is the 1st report I've seen that suggests that can occur, a preliminary assessment.
All this pertains to Alpha, not Delta, which, of course, will not be as favorable
More insight on this @npr by @robsteinnews who spoke with the senior author @G_RegevY on their findings
npr.org/sections/healt… @npratc #LongCovid

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More from @EricTopol

Jun 12
For medical information, general AI frontier models (Google, OpenAI, Anthropic) outperformed specialized @EvidenceOpen and @UpToDate as assessed by 12 US clinicians, randomized and blinded to which model and extensive testing/benchmarks. This was not anticipated. @NatureMedicine
nature.com/articles/s4159…Image
>65% of US physicians use OpenEvidence, with 27 million prompts in April
nbcnews.com/tech/tech-news…Image
This exemplifies the paradox of medical AI implementation
erictopol.substack.com/p/the-paradox-…Image
Read 4 tweets
Jun 2
A new study links GLP-1 drugs and 30-35% reduced incidence of breast cancer, using matched-pair propensity analysis

Confirms other association studies but still no proofascopubs.org/doi/10.1200/OP…
Very good review on this topic, by @DanielJDrucker @NatureCancer
nature.com/articles/s4301…Image
@DanielJDrucker @NatureCancer Maybe
jamanetwork.com/journals/jaman…Image
Read 4 tweets
Apr 19
If you're interested in how AI grew up over the past 15 years, and where it's headed, this new book tells the story in a riveting, page-turner way. In the new Ground Truths with @scmallaby Image
In 2010, when @GoogleDeepMind was formed, well before deep learning was taking hold, @demishassabis predicted AGI by 2030 and called out the use of agents
@GoogleDeepMind @demishassabis This is pretty striking
(please excuse typo, DeepMind's) Image
Read 5 tweets
Jan 20
Physical activity and the reduction of all-cause mortality, from 2 very large prospective cohorts
1. The relationship is non-linear, suggesting a threshold effect for many types of exercise as seen below Image
2. Engaging in > 1 type of physical activity was generally correlated with better outcomes compared with 1 type (T1,2,3) Image
The @BMJMedicine was supposed to post this paper 2 hours ago but has failed to do. It is being covered by other means medicalxpress.com/news/2026-01-p…
Someday the link will be active!
dx.doi.org/10.1136/bmjmed… Image
Read 5 tweets
Jan 1
People age 70+ should not be taking aspirin at any dose for prevention. Results of randomized trials show higher risk of all-cause mortality, major bleeding events and deaths from cancer. p 153, SUPER AGERS bookImage
President Trump takes 325 mg aspirin/day. The randomized trials tested 75-81 mg/day. His doctors recommended low-dose aspirin for heart event prevention. That recommendation is ill-founded based upon best evidence in older individuals.
nejm.org/doi/full/10.10…
academic.oup.com/eurheartj/arti…Image
Aspirin dosing information
wsj.com/us-news/as-sig…
Read 4 tweets
Aug 14, 2025
As I wrote in SUPER AGERS, the immune system is the key to modulating our aging process and the opportunity to extend healthspan. Today @NatureAging 7 new articles, summarized here, that reinforce its central role
nature.com/articles/s4358…Image
Inflammaging: with aging comes untoward inflammation, a summary graphic
nature.com/articles/s4358…Image
The potential consequences of too youthful immune system in an older person —> autoimmunity
nature.com/articles/s4358…Image
Read 5 tweets

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