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Ziyad Al-Aly, MD Profile picture
@zalaly
Nov 10, 2022 • 13 tweets • 9 min read • Read on X
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Here is the latest from our team in @NatureMedicine

Should you protect yourself from Covid-19 reinfection

Yes!

Reinfection is not benign; it is best to avoid it

by @BCBowe @Biostayan @zalaly

A thread 🧵

nature.com/articles/s4159…
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

Diabetes
Fatigue
Kidney problems
Mental health disorders
Musculoskeletal problems
Neurologic disorders
Lung problems

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

unvaccinated

those who had 1 vaccine shot

those who had 2+ vaccine shots

nature.com/articles/s4159… Image
Importantly,

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

and

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

nature.com/articles/s4159…
What does this mean for you?

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

and

even if you are vaccinated and boosted

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

nature.com/articles/s4159…
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

nature.com/articles/s4159…
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

nature.com/articles/s4159…
Thanks to the amazing @sourwine for developing this press release (link below).

A clear accounting of the findings.

@WUSTLnews
@WUSTLmed

medicine.wustl.edu/news/repeat-co…
Thanks to our reviewers, editors, and all those who supported us in this project.

@WUSTL
@WUSTLmed
@WUSTLnews
@VREFSTL
@sourwine
@VAResearch
@vahsrd

nature.com/articles/s4159…

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More from @zalaly

Ziyad Al-Aly, MD Profile picture
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
Ziyad Al-Aly, MD Profile picture
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
Ziyad Al-Aly, MD Profile picture
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
Ziyad Al-Aly, MD Profile picture
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
Ziyad Al-Aly, MD Profile picture
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
Ziyad Al-Aly, MD Profile picture
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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