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Eric Topol Profile picture
@EricTopol
Jan 28, 2022 • 7 tweets • 5 min read • Read on X
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Brief update on Omicron, and its BA.1 and BA.2 lineages (sisters)
1. Origin—the 3 theories for how this hyper-mutated version of the virus evolved
nature.com/articles/d4158… @nature
2. A great annotated graphic by @firefoxx66 of @nextstrain conveying the antigenic distance of Omicron's BA.1 and BA.2 from prior variants
nextstrain.org/ncov/gisaid/gl…
3. The BA.2 variant is spreading widely, throughout many countries in Europe and Asia, out-competing BA.1, indicating higher transmissibility. But the good news from yesterday's @UKHSA: vaccination + boost is holding up quite well; there's no indication of more immune evasion
4. Some countries where BA.2 (light purple) is making or has already made major inroads outcompeting BA.1 (purple) covariants.org
5. And there's a new thread from @trvrb covering these points and many others, with the conclusion that BA.2's impact of extending the length of time (longer tail) for the Omicron wave
6. More on this and it's excellent, by @Dereklowe
science.org/content/blog-p…
7. A new BA.2 dedicated report today from @UKHSA
The secondary attack rate for BA.2 compared with BA.1 is roughly 30% increased, reflecting a transmission edge
assets.publishing.service.gov.uk/government/upl…
And another invaluable @kallmemeg🧵takes you through the rest of it

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More from @EricTopol

Eric Topol Profile picture
Nov 13
New @NEJM
A whopping (~90%) reduction of progression to Type 2 diabetes with tirzepatide (GLP-1 drug, dual receptor) vs placebo in a randomized trial of >2,500 participants with obesity, absolute reduction of 10/100 treated

by @AniaJastreboff and collaboratorsnejm.org/doi/full/10.10…Image
In other GLP-1 new publications today
—Country-wide Sweden reduced hospitalizations for alcohol or substance abuse with these drugs
jamanetwork.com/journals/jamap… @JAMAPsych
—Concerns about discontinuation
jamanetwork.com/journals/jama/… @JAMA_current Image
Other new anti-obesity drugs in the pipeline, one that also increases energy expenditure
@NatureNV nature.com/articles/d4158…Image
Read 4 tweets
Eric Topol Profile picture
Nov 13
A dedicated issue of @ScienceTM on #LongCovid
—Sex-specific differences, with perspective by @VirusesImmunity and @SilvaJ_C
—Insights for therapies @AndreaCoxMDPhD
—Deconvoluting "Osler's Web" @MichaelPelusoMD @DeeksSteven @DrMaureenHanson @SaydahSharon
—+RECOVER Trial, Lyme diseaseImage
Image
Image
science.org/toc/stm/16/773
Where we have failed to date: finding an effective therapy. That has to change
science.org/doi/epdf/10.11…Image
Read 4 tweets
Eric Topol Profile picture
Oct 19
An elegant @Nature study by @AkassoglouLab has illuminated our understanding of the role of fibrin (component of blood clots), #SARSCoV2, and brain inflammation in Covid and #LongCovid.
This discovery and more in the new Ground Truths podcast, with transcript, key figures (such as as the one below) and citations. Open-access. Link in my profile.Image
Image
A clip from our conversation. Unknowingly, @AkassoglouLab was gearing up for understanding this complex pathophysiology for many years before Covid hit
For treatment, it's not just as simple as preventing fibrin clots. It's isolating the pro-inflammatory action of fibrin, targeted by the antibody
Read 4 tweets
Eric Topol Profile picture
Oct 9
Covid and increased risk of major adverse cardiovascular events (MACE) 3-years out

2-fold increased for any severity of Covid
~4-fold increase for Covid requiring hospitalization
"a coronary artery disease equivalent"
interaction with non-O blood types
@uk_biobankahajournals.org/doi/10.1161/AT…Image
"A major finding from our analyses was that the risk
of MACE among the subset of hospitalized COVID-
19 cases without known CVD (ie, primary prevention
patients) was comparable to (or even slightly higher than) the risk in patients with CVD, PAD, or diabetes but without COVID-19."
"one of the first examples of a gene-pathogen exposure interaction for thrombotic events"
I think it's the first one documented, likely others to be unraveled
Read 4 tweets
Eric Topol Profile picture
Aug 2
New US Covid genomic surveillance
The KP.3.1.1 variant is on the move to become dominant, more of a challenge to our immune response than KP.3 and prior variants (especially without new KP.2 booster when we need it for high-risk individuals) Image
It's the deletion 31/31 that makes the KP.3.1.1 spike different, but otherwise 2 mutations away from KP.2 (R346T and Q493E) Image
Buckle up; this wave isn't over yet d/t KP.3.1.1's emergence
Read 4 tweets
Eric Topol Profile picture
Jul 21
The new boosters (vs. KP.2) should be available the first week of September. It takes ~90 days make them from the FDA decision on June.

But it didn't have to be that way.......1/5nbcnews.com/health/health-…
We've known about KP.3's marked growth advantage since April and could have made the call then to make the new booster. That would have been aligned well with the current wave (available in July) 2/5 erictopol.substack.com/p/are-we-flirt…
Image
But the FDA has tried to force fit Covid into an annual shot like flu, even though all data tells us it doesn't follow an annual pattern. Even the CDC acknowledges this now
3/5cdc.gov/ncird/whats-ne…
Read 5 tweets

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