Ziyad Al-Aly, MD Profile picture
Dec 16 10 tweets 2 min read Twitter logo Read on Twitter
Some people objected to use of the term “long flu”

Let me explain

A thread

thelancet.com/journals/lanin…
Lets start with the evidence about health loss

higher in post-acute flu than acute flu

higher in post-acute covid (long covid) than acute covid

In both acute and post-acute phases, burden of health loss was higher in covid than flu

thelancet.com/journals/lanin…
For me, a big revelation from the study was:

the realization that when you measure it, the burden of health loss is higher in post-acute (long) phase of illness than acute phase of illness

I knew this about covid
I did not know this about flu
Bottom line

Covid is worse than flu
Acute covid is worse than acute flu
post-acute covid (long covid) is worse than post-acute flu

thelancet.com/journals/lanin…
The headline in the Daily Mail is not an accurate depiction of the evidence.
It is reckless and irresponsible.
They never spoke to me about this. Image
Patients with ME/CFS and other infection-associated chronic illnesses have been telling us all along that infections (even ones that are thought to be acute) can lead to chronic illnesses.
I have learned from them about long flu, long ebola, long polio, long EBV, etc

These terms are meant to communicate that acute infections can also cause chronic disease.

This is a major lesson I learned in this pandemic.
My team and I work very hard to advance our understanding of Long Covid.

We draw lessons from ME/CFS and other infection associated chronic illnesses & grateful for the wisdom and knowledge shared with us by the patient community
We are committed to continuing to do our best to advance our understanding of Long Covid. This will also help us understand other infection-associated chronic illnesses.
We have been doing Long Covid work for only 4 years

We want to continue to learn and do better.

Our ears, minds and hearts are open for advice, guidance, and constructive dialogue.

• • •

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More from @zalaly

Dec 14
📣 New from my team in @TheLancetInfDis

Long-term outcomes of people hospitalized for COVID-19 vs seasonal influenza

A 🧵

thelancet.com/journals/lanin…
The study included:

81,280 individuals hospitalized for SARS-CoV-2
&
10,985 individuals hospitalized for seasonal influenza

We followed them for 1.5 years to characterize the risks of death, health care utilization & 94 health outcomes

thelancet.com/journals/lanin…
Covid had higher risk of death, healthcare utilization and sequelae in most organ systems than flu

This was evident in pre-delta, delta, and omicron; and also evident in vaccinated and unvaccinated individuals.

thelancet.com/journals/lanin…

Image
Image
Read 9 tweets
Aug 21
1/ 📣 New from my team in @NatureMedicine

In a study of 6 million people, we examined risk trajectories of 80 components of Long Covid over 2 years post-infection

📌 Risks remained elevated for many Long Covid conditions even 2 years infection

A 🧵

nature.com/articles/s4159…
2/ The study included:

138,818 individuals with SARS-CoV-2
&
5,985,227 non-infected controls

We followed them for 2 years to characterize the risk trajectories of death, hospitalization and 80 components of Long Covid

nature.com/articles/s4159…
3/ In people who were not hospitalized during the acute phase of COVID (the majority)

risk of death remained elevated up to 6 months

risk of hospitalization remained elevated up to 19 months

risks remained elevated for 31% of sequelae during the 2-year

nature.com/articles/s4159…
Image
Read 22 tweets
May 10
My piece in @TheLancetInfDis

Reflections on Long Covid prevention: progress and challenges

A thread

thelancet.com/journals/lanin…
LongCovid does not only affect patients and their life expectancy, but also societal wellbeing and economic indicators (labour participation and economic productivity).

Preventing long COVID should be a public and a global health priority.

thelancet.com/journals/lanin…
All evidence points in the same direction—SARS-CoV-2 antivirals might be important tools for prevention of Long Covid

Paxlovid reduced the risk by 26%

Molnupiravir reduced the risk by 14%

Ensitrelvir may also reduce the risk

thelancet.com/journals/lanin…
Read 12 tweets
Apr 22
Here is a new thread on our latest study without the full C word - to avoid suppression by the algo

C=kovd

Is C still deadlier than the flu in 2023?

The short answer is yes

New from our team in @JAMA_current

By @Biostayan, Taeyoung Choi and @zalaly

jamanetwork.com/journals/jama/…
In this study of 11,399 people

8996 hospitalized for C & 2403 hospitalized for flu

5.9% died in the C group vs 3.7% died in the flu group

That is a difference of 2.23% deaths

This translates into 60% higher risk of death in C vs flu

jamanetwork.com/journals/jama/…
The 60% higher risk of death in people hospitalized for C vs flu should be interpreted in the context of 2-3 times more hospitalization for C than hospitalization for flu

This compounds the rates of death due to C vs flu

jamanetwork.com/journals/jama/…
Read 8 tweets
Apr 6
Is covid still deadlier than the flu in 2023?

The short answer is yes

New from our team in @JAMA_current

By @Biostayan Taeyoung Choi and @zalaly

A thread 🧵

jamanetwork.com/journals/jama/…
In this study of 11,399 people

8996 hospitalized for COVID-19 & 2403 hospitalized for flu

5.9% died in the COVID-19 group vs 3.7% died in the flu group

That is a difference of 2.23% deaths

This translates into 60% higher risk of death in COVID vs flu

jamanetwork.com/journals/jama/…
The 60% higher risk of death in people hospitalized for COVID vs flu should be interpreted in the context of 2-3 times more hospitalization for covid than hospitalization for flu

This compounds the rates of death due to COVID vs flu

jamanetwork.com/journals/jama/…
Read 7 tweets
Mar 23
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
Read 14 tweets

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