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Ziyad Al-Aly, MD Profile picture
@zalaly
Sep 23, 2024 • 11 tweets • 6 min read • Read on X
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Here are key slides of my talk at the NIH-RECOVER-TLC
#RECOVERTLC
nature.com/articles/s4159…
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The number of people with Long Covid is huge. This demands global attention. nature.com/articles/s4159…
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The economic toll of Long Covid is significant.

nature.com/articles/s4159…
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Multiple mechanisms at play
science.org/doi/10.1126/sc…
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The impacts of Long Covid.
nature.com/articles/s4159…
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Number of approved medications for Long Covid is zero. This MUST change.

nature.com/articles/s4159…
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A policy roadmap.

nature.com/articles/s4159…
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Research roadmap
nature.com/articles/s4159…
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Input from the community


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Lessons learned
nature.com/articles/s4159…
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RECOVER-TLC must succeed.
I end with a quote from @loscharlos "the stakes for RECOVER couldn't be higher"
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 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

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