Ziyad Al-Aly, MD Profile picture
Nov 10 13 tweets 9 min read
Here is the latest from our team in @NatureMedicine

Should you protect yourself from Covid-19 reinfection


Reinfection is not benign; it is best to avoid it

by @BCBowe @Biostayan @zalaly

A thread 🧵

In this study of 5.8 million people

41k with reinfection

444k with 1 infection (no reinfection)

5.3 million non-infected controls

Compared to no reinfection, reinfection increased risk of death, hospitalization, and other adverse health outcomes

nature.com/articles/s4159… Image
Compared to people who did not get reinfection, those with reinfection had

2 fold increased risk of death

3 fold increased risk of hospitalization

3 fold increased risk of heart problems

3 fold increased risk of blood clotting

nature.com/articles/s4159… Image
Reinfection also increased risk of

Kidney problems
Mental health disorders
Musculoskeletal problems
Neurologic disorders
Lung problems

nature.com/articles/s4159… Image
Reinfection was associated with adverse health outcomes in


those who had 1 vaccine shot

those who had 2+ vaccine shots

nature.com/articles/s4159… Image

Reinfection increased the risks of death, hospitalization and organ injury in the acute and post-acute phase


the elevated risks remained evident at 6 months after reinfection

Reinfection increases the risk of acute and #LongCovid

nature.com/articles/s4159… ImageImage
Compared to noninfected controls, cumulative risks of repeat infection increased according to the number of infections

Every reinfection contributes additional risk

3 infections worse than 2

2 infections worse than 1

1 infection worse than none

nature.com/articles/s4159… Image
For the half a billion people who had #COVID19 once, the question of whether a second infection carries additional risks is important

We show that reinfection increases risks of adverse outcomes in acute and post-acute phases of COVID-19

What does this mean for you?

If you have Covid once, twice, three or more times,


even if you are vaccinated and boosted

It is absolutely worth it to protect yourself from getting covid again

What are the broader implications?

Reinfection will add to the pandemic's high and growing toll of death, disease, and disability

Prevention of infection and reinfection with SARS-CoV-2 should continue to be the goal of public health policy

How do we move forward?

Reinfections are not benign and will continue to happen until

We have vaccines that

a. block transmission
b. offer durable protection
c. variant proof

We also need prevention and treatment strategies for #LongCovid

Thanks to the amazing @sourwine for developing this press release (link below).

A clear accounting of the findings.


Thanks to our reviewers, editors, and all those who supported us in this project.



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More from @zalaly

Nov 5
The high & growing toll of #longCOVID calls for an urgent need to understand how to prevent and treat it

The care needs of people with long COVID must be addressed

Comment in @NatRevNeph by @anupamuab @Dr2NisreenAlwan @valerie_luyckx and me


The patient community who, to their credit, first recognized and reported this new syndrome used the term ‘long COVID’ to describe the post-acute and chronic sequelae of SARS-CoV-2 infection


Long COVID can affect people across the lifespan — children, young adults and older adults — and across sex, race and ethnicity, and baseline health status


Read 12 tweets
Sep 22
The latest from our team in @NatureMedicine

The long-term neurologic consequences of #COVID19

A thread 🧵


by @evanjxu @Biostayan @zalaly
In this study of 11.6 million people:

154k with COVID-19,
5.6 million contemporary controls, and
5.8 million historical controls

We show increased risk of an array of post-acute neurologic disorders

The risk was increased 42%

This translated into 7 cases per 100 individuals with COVID-19

nature.com/articles/s4159… Image
Read 16 tweets
May 25
The latest from our team in @NatureMedicine

Does vaccination protect from #LongCovid?

Vaccines modestly reduce but do not eliminate risk of Long Covid

@VAResearch @vahsrd @WUSTLmed @WUSTLnews @VREFSTL

@Biostayan @BCBowe


A thread 🧵
In this study of more than 13 million people

Long Covid after breakthrough infection (vaccinated people who subsequently got SARS-CoV-2 infection) is indistinguishable in terms of clinical features from Long Covid in unvaccinated people

In comparisons vs several uninfected controls
(contemporary, historical, and vaccinated controls)

people with breakthrough infection consistently had higher risk of death and Long Covid sequelae in nearly every organ system

Read 16 tweets
Mar 21
Can Covid-19 lead to diabetes?

New from our team on risk and burden of diabetes in Long Covid at 1 year

In @TheLancetEndo

@VAResearch @vahsrd @WUSTLpubhealth @WUSTLmed @WUSTLnews @VREFSTL


A thread 🧵

In this study of more than 8.5 million people: 181 k with COVID-19 and more than 8 million controls without evidence of infection

We show increased risk of new onset diabetes at 1 year

The risk was evident even among people who did not need hospitalization during the acute phase of SARS-CoV-2 infection — this group represents most people with COVID-19

Read 15 tweets
Feb 7
The latest from our team on the long-term cardiovascular consequences of Covid-19 in @NatureMedicine

@VAResearch @vahsrd @WUSTLpubhealth @WUSTLmed @WUSTLnews @VREFSTL @NaturePortfolio

@Biostayan @BCBowe

A thread

In a cohort of more than 153 k people with COVID-19, 5.6 million contemporary controls, and 5.8 million historical controls without evidence of infection

We show increased risks of a wide range of cardiovascular diseases at 1 year
These include cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease.
Read 12 tweets
Sep 1, 2021
The latest from our team:

A deep dive into the long-term consequences of #COVID19 on kidney function and disease

#longcovid #PASC

@VAResearch @vahsrd @WUSTL @WUSTLpubhealth @WUSTLmed @WUSTLnews @VREFSTL
@Biostayan @BCBowe @JASN_News @ASNKidney


We previously provided a high dimensional characterization of post-acute sequelae of COVID-19

We showed that #LongCovid can affect nearly every organ system.

@Nature @NaturePortfolio


What happens to long term kidney function in people who survive acute #COVID19 ?

And are they at increased risk of #kidney disease?

To address this, we built a cohort of 89,216 US veterans with #COVID19 and 1,637,467 non-infected controls.

Read 9 tweets

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