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Ziyad Al-Aly, MD Profile picture
@zalaly
Mar 23, 2023 • 14 tweets • 9 min read • Read on X
Paxlovid can prevent #LongCovid

The latest from our team in @JAMAInternalMed

by @Biostayan @TaeyoungChoi93 @zalaly

A thread

jamanetwork.com/journals/jamai…
In this study of 281,793 people with SARS-CoV-2 infection who are eligible for Paxlovid

35,717 received Paxlovid

246,076 received no antiviral treatment

We show that people who got treated with Paxlovid had 26% reduced risk of developing Long Covid

jamanetwork.com/journals/jamai…
Paxlovid reduced risk of 10 of 13 components of Long Covid including

Dysrhythmia
Ischemic heart disease
Pulmonary embolism
Deep vein thrombosis
Fatigue & mailaise
Acute kidney disease
Muscle pain
Neurocognitive impairment
Dysautonomia
Shortness of breath

ja.ma/ziyad
Paxlovid use was also associated with

47% reduced risk of post-acute death

and

24% reduced risk of post-acute hospitalization

jamanetwork.com/journals/jamai…
The reduced risk of #LongCovid was evident in people who were

Unvaccinated
Vaccinated
Boosted

and in people with

Primary SARS-CoV-2 infection
&
Reinfection

jamanetwork.com/journals/jamai…
The risk reduction was also evident in people with

1-2 risk factors

3-4 risk factors

5 or more risk factors

jamanetwork.com/journals/jamai…
Risk reduction was evident in subgroups based on age, race, sex, and other common conditions

jamanetwork.com/journals/jamai…
How might Paxlovid reduce risk of #LongCovid ?

It is possible that hitting the virus early with an antiviral might reduce inflammation/organ damage and reduce chance of viral persistence leading to less risk of Long Covid

jamanetwork.com/journals/jamai…
What does this mean for you?

Paxlovid use in the early days after infection can reduce risk of Long Covid

The decision to use Paxlovid should consider its effectiveness in reducing risk of death & disease in both acute and post-acute phases of COVID-19

jamanetwork.com/journals/jamai…
We also learned that among people who are eligible for Paxlovid

12.67% were prescribed Paxlovid

87.33% received no antiviral treatment

This suggests the need to improve uptake of antiviral treatment

jamanetwork.com/journals/jamai…
These results apply to people who are eligible for Paxlovid under the current FDA EUA - that is people with at least 1 risk factor for progression to severe COVID-19

Whether Paxlovid reduces risk of #LongCovid in people at low risk remains to be studied

jamanetwork.com/journals/jamai…
Thanks to the amazing @sourwine for developing this press release (link below).

A clear accounting of the findings.

@WUSTLnews

@WUSTLmed

medicine.wustl.edu/news/paxlovid-…
Thank you to our reviewers, editors, and those who supported us in this project

jamanetwork.com/journals/jamai…

@WUSTL
@WUSTLmed
@WUSTLnews
@VREFSTL
@VAResearch
@vahsrd
Editorial by @DrKatzNYCHH

jamanetwork.com/journals/jamai…

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More from @zalaly

Ziyad Al-Aly, MD Profile picture
Jan 20
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
Ziyad Al-Aly, MD Profile picture
Sep 10, 2024
Here is the first randomized trial to show that an antiviral can prevent Long Covid.

In the PANORAMIC trial, people randomized to molnupiravir had less risk of Long Covid than people who received no antivirals

My comment in the link below. A short🧵
thelancet.com/journals/lanin…
The study included people with at least one risk factor for progression to severe COVID-19 illness.

People randomized to molnupiravir or usual care (no antivirals) were followed for 6 months

thelancet.com/journals/lanin…
People who were randomly assigned to molnupiravir during the acute phase of COVID-19 had better outcomes at 3 months and 6 months than those randomly assigned to usual care

thelancet.com/journals/lanin…
Read 9 tweets
Ziyad Al-Aly, MD Profile picture
Sep 1, 2024
400 million reasons to care about #LongCovid

ICYMI: our review on #LongCovid in @NatureMedicine

Long Covid has affected at least 400 million people worldwide at a cost of $1 trillion per year.

#LongCovid is a defining health crisis of our time!

nature.com/articles/s4159…Image
We review the mechanisms of Long Covid including viral persistence, immune dysfunction, thrombo-inflammation, neuronal inflammation, and microbiome dysbiosis.
nature.com/articles/s4159…
Image
We review the devastating impacts of Long Covid on individuals and communities, health systems, economies, and global health metrics.

nature.com/articles/s4159…
Read 6 tweets

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