WesElyMD Profile picture
Dec 30, 2022 3 tweets 2 min read
1/🧵 COVID XBB1.5 at 40%

This leaves no room for Complacency in 2023👇

📍XBB1.5 is already causing higher hospitalizations in NY+ than seen in a year
📍Data from NEJM (next tweet) tell us the vaccine gives protection for this Omicron variant

go.nature.com/3WFhv9Z
2/These @NEJM data tell us:

“Persons who received the bivalent booster had better neutralizing activity against all omicron subvariants (especially against BA.2.75.2, BQ.1.1, and XBB) than those who received either one or two monovalent boosters.”

bit.ly/3Gtd0cN
3/fin
The rapidly emerging Omicron subvariant XBB.1.5 accounts for 40.5% of U.S. COVID cases - CDC

✔️What will this variant do to Long COVID rates?
✔️ Be smart in enclosed public spaces 😷
✔️Use the new Vaccine data above
✔️Bi-valent #boost‼️

reut.rs/3VuFN5j

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More from @WesElyMD

Dec 29, 2022
1/🧵Diabetes is part of Long COVID & a diabetes drug reduces Long COVID⁉️

📌 Studies of MILLIONS show COVID ⬆️ risk of new onset Diabetes by…
📌60%!! 🤯
📌 #Diabetes 1 & 2 are solidly documented components of #LongCOVID

👇 I unpack data & what this means & why should you care?
2/ First, this is fascinating & scary. Check it…

✔️COVID is vascular disease
✔️Diabetes is a vascular disease
✔️COVID causes a chronic immune disorder
✔️Diabetes is a chronic immune disorder.
✔️A diabetes drug with immune mechanisms may help both in unrelated ways
3/ This meta-analysis of 9 studies of ~40m people found 50% increased risk of DM type 1 (insulin dependent) & 70% higher risk of DM type 2 across age groups & sex - plus way more risk than general upper respiratory infections.
 
bit.ly/3G0j4bC
Read 9 tweets
Dec 27, 2022
1/🧵Can a Diabetes drug prevent Long COVID?
 
Most solid data yet of a medication preventing #LongCOVID from quadruple blinded, non-pharma sponsored COVID-OUT trial N=1,125.

A 42% relative ⬇️ in clinician diagnosed LC was seen (10.6% down to 6.3%).
 
bit.ly/3jvvKj4
2/ Metformin’s success (1 LC prevented for every 23 pts treated) could save millions from suffering.

<$1 per course = very cost effective.
 
Too good to be true?  Maybe but very solid science.

Let me unpack a bit more…

bit.ly/3jvvKj4
3/ This trial had 6 groups of patients because 3 meds (metformin/fluvoxamine/ivermectin) were randomized vs. placebo.
 
The other drugs showed no benefit toward Long COVID reduction.
 
Metformin also looked good for Acute COVID.
Read 9 tweets
Dec 13, 2022
1/🧵Our speed in understanding Long COVID is accelerating‼️
 
Here I cover a smorgasbord of recent COVID data on…
📍Brain Aging
📍Genetics
📍Epidemiology
📍PEM
📍Self-Protection
 
Knowledge is Power.

We are all at risk of losing Brain Power from #LongCOVID.

Let’s learn…
2/ COVID ages our brains 😫
 
Cognitive decline is part of growing old, but this is scary.
 
Hot new data w age-matched uninfected control ICU patients show how COVID is associated w Molecular Signatures of an Aging Brain.
 
See Fig 2 a/b/c BELOW
 
go.nature.com/3UHvyKh
3/ Genetics

This study included normal controls. Gene expression changes occur during acute COVID19 in hospital that are associated w subsequent LongCOVID.

This was especially seen in antibody producing Plasma Cells, which explained symptom clusters.
 
go.nature.com/3FMcois
Read 21 tweets
Dec 12, 2022
1/🧵 Next Generation COVID Vaccines:

📌BF.7 & BQ1.1 have ⬆️ viral evasiveness
📌New variants pop up every 3-4 mos
📌All made worse by vaxx hesitancy & misinformation

We need a vaccine w longer protection & greater scope

But how?

bit.ly/3Bsf3v4
2/ New Vaccine Targets❓
 
🔹S protein viral sequences that are immutable, immunogenic & accessible to neutralizing Abs
🔹SARS viral membrane, envelope or nucleocapsid proteins & structurally hidden epitopes
🔹Vaccines based on T-cell receptor constructs

go.nature.com/3YaEGKt
3/fin
What would define Vaccine success?

✔️75% Protection >1 Year
✔️Not just help w death & hospitalizations
✔️Protect vs symptomatic disease
✔️Less viral transmission
✔️Fewer adverse events like myocarditis

TO DO:
Remain hopeful
Puh-leaze GET #BOOSTED

bit.ly/3hh5l7S
Read 4 tweets
Dec 9, 2022
1/🧵 Grasping for help in LC

📍as a #LongCovid patient you admitted on embarking to Turkey for pheresis that
📍this Tx was an UN-established long shot
📍but your life w this syndrome had devolved
📍as a scientist you now found yourself willing
📍while others conduct trials
2/ I see your choices in seeking therapy for #LongCOVID as brave & honest w cautious expectations cognitively & physically.

Most importantly, you’re demonstrating hope & a desire never to give up.

Knowing you, @pamelarbishop, and calling you friend is a gift beyond measure.
3/ For anyone who chides a highly intelligent person for pursuing alternative approaches to solving health problems #medicine scoffs at, seek empathy & read these truth-telling books 📚

@DouthatNYT @meghanor are my teachers…

#LongLyme #MECFS #LongCovid #Fibromyalgia
Read 4 tweets
Dec 7, 2022
1/🧵 Micro Clots & Endothelial Dysfunction in Long COVID

Plus new Epidemiology in @JAMA_current some say proves #LongCOVID is a hoax⁉️
 
Truth is…endothelial dysfunction plus inflammation can lead to life-altering brain & body dz.
 
Let’s explore data

Pic H/T @VirusesImmunity
2/ Remember that Vascular flow problems don’t occur in isolation from inflammation.

This new piece by @Jamie_Ducharme balances the discussion well.
 
It’s time for great studies & NOT immediate widespread treatment with blood thinners that might harm.
 
bit.ly/3He2FCj
3/ The urgency is that people are living w what amounts to newly acquired #dementia.
 
This WaPo piece starts w “Haze. Slow. Drunk. Lost.”
 
Our patients are adamant that descriptors like #fatigue & #brainfog don’t do justice to what makes them suicidal.
 
wapo.st/3YbRJLQ
Read 22 tweets

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