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Eric Topol Profile picture
Eric Topol
@EricTopol
physician-scientist, author, editor. Ground Truths: https://t.co/YhatcBT0hA
513 subscribers
Dec 9 • 4 tweets • 2 min read
We're learning how to control the immune response, like a rheostat, even in the brain. Implications for understanding the basis and potential treatment of autoimmune conditions like multiple sclerosis, #LongCovid, #MECFS, and brain cancer.
A brief review of 6 recent, important reports
in the new Ground Truths, open-accessImage Such as Programming T cells with brain-specific proteins and payloads
@ScienceMagazine science.org/doi/10.1126/sc…
Nov 13 • 4 tweets • 2 min read
New @NEJM
A whopping (~90%) reduction of progression to Type 2 diabetes with tirzepatide (GLP-1 drug, dual receptor) vs placebo in a randomized trial of >2,500 participants with obesity, absolute reduction of 10/100 treated

by @AniaJastreboff and collaboratorsnejm.org/doi/full/10.10…Image In other GLP-1 new publications today
—Country-wide Sweden reduced hospitalizations for alcohol or substance abuse with these drugs
jamanetwork.com/journals/jamap… @JAMAPsych
—Concerns about discontinuation
jamanetwork.com/journals/jama/… @JAMA_current Image
Nov 13 • 4 tweets • 2 min read
A dedicated issue of @ScienceTM on #LongCovid
—Sex-specific differences, with perspective by @VirusesImmunity and @SilvaJ_C
—Insights for therapies @AndreaCoxMDPhD
—Deconvoluting "Osler's Web" @MichaelPelusoMD @DeeksSteven @DrMaureenHanson @SaydahSharon
—+RECOVER Trial, Lyme diseaseImage
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Image science.org/toc/stm/16/773
Oct 19 • 4 tweets • 2 min read
An elegant @Nature study by @AkassoglouLab has illuminated our understanding of the role of fibrin (component of blood clots), #SARSCoV2, and brain inflammation in Covid and #LongCovid.
This discovery and more in the new Ground Truths podcast, with transcript, key figures (such as as the one below) and citations. Open-access. Link in my profile.Image
Image A clip from our conversation. Unknowingly, @AkassoglouLab was gearing up for understanding this complex pathophysiology for many years before Covid hit
Oct 9 • 4 tweets • 2 min read
Covid and increased risk of major adverse cardiovascular events (MACE) 3-years out

2-fold increased for any severity of Covid
~4-fold increase for Covid requiring hospitalization
"a coronary artery disease equivalent"
interaction with non-O blood types
@uk_biobankahajournals.org/doi/10.1161/AT…Image "A major finding from our analyses was that the risk
of MACE among the subset of hospitalized COVID-
19 cases without known CVD (ie, primary prevention
patients) was comparable to (or even slightly higher than) the risk in patients with CVD, PAD, or diabetes but without COVID-19."
Aug 2 • 4 tweets • 2 min read
New US Covid genomic surveillance
The KP.3.1.1 variant is on the move to become dominant, more of a challenge to our immune response than KP.3 and prior variants (especially without new KP.2 booster when we need it for high-risk individuals) Image It's the deletion 31/31 that makes the KP.3.1.1 spike different, but otherwise 2 mutations away from KP.2 (R346T and Q493E) Image
Jul 21 • 5 tweets • 2 min read
The new boosters (vs. KP.2) should be available the first week of September. It takes ~90 days make them from the FDA decision on June.

But it didn't have to be that way.......1/5nbcnews.com/health/health-… We've known about KP.3's marked growth advantage since April and could have made the call then to make the new booster. That would have been aligned well with the current wave (available in July) 2/5 erictopol.substack.com/p/are-we-flirt…
Image
Jun 21 • 4 tweets • 2 min read
New CDC genomic data shows continued rise of the KP.3 variant that accounts for 1 of 3 Covid cases.
LB.1 is gaining, too, as JN.1 fades away Image This variant growth advantage plot by @BenjMurrell (H/T @siamosolocani) shows why this is the case. Note KP.3 is the one at far left w/ almost 3-fold advantage to JN.1.
Reinforces why the decision to develop the KP.2 vaccine booster (instead of JN.1) was a good one Image
May 16 • 5 tweets • 2 min read
The connection between #SARSCoV2 and neurodegeneration
@TheLancetNeuro
Quotes below:
1. SARS-CoV-2 infection should be considered as a risk factor for Alzheimer’s disease, even though the distinction between causation versus disease acceleration is not clear.thelancet.com/journals/laneu…Image 2. Inflammation in patients with COVID-19, and controlled experiments show prolonged neuro-inflammation after mild SARS-CoV-2 infection
in macaques.
Apr 26 • 5 tweets • 2 min read
The FLiRT variant KP.2 begins its takeover for Covid cases in the US, now accounting for 1 in 4 cases
covid.cdc.gov/covid-data-tra…
Image I've reviewed the FLiRT variants and their implications in a Ground Truths (link in profile) Image
Jan 22 • 4 tweets • 2 min read
Breaking down the risks and benefit for lecanemab, the amyloid beta-directed antibody vs Alzheimer's drug approved @US_FDA last year. It doesn't look good.

@AnnalsofIM acpjournals.org/doi/10.7326/M2…
Image A new systematic review of these antibodies looks even worse @AnnFamMed doi.org/10.1370/afm.30…



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Jan 4 • 4 tweets • 2 min read
My oped on the JN.1 variant and the 2nd biggest US wave of infections (after Omicron) since the pandemic began
@latimes @latimesopinion #LongCovid latimes.com/opinion/story/…
Image Recent @CDCgov #SARSCoV2 wastewater data for current wave (vs Omicron Jan 2022 and subsequent waves), graph by @luckytran Image
Nov 23, 2023 • 6 tweets • 3 min read
3 New #LongCovid reports
1. Vaccination protection—1 dose 21%, 2 doses 59%, 3 doses 73% among ~590,000 people in Sweden (strong association)
bmj.com/content/383/bm…
Image 2. 3-year prospective follow up of a cohort of ~1350 participants, hospitalized in China
—Lung function restored back to baseline in most
—Higher risk of reinfection that people w/o Long Covid
—Half w/ persistent symptoms
thelancet.com/journals/lanre…
Aug 25, 2023 • 4 tweets • 2 min read
Big news #ESC2023 and @NEJM
In a placebo-controlled randomized trial of people with obesity + heart failure (with preserved ejection fraction). semaglutide (Wegovy) markedly improved symptoms, exercise time, reduced inflammatory markers (and weight loss)
nejm.org/doi/full/10.10…

Image
Image This also tells us something about the underlying mechanism of heart failure with preserved EF—metabolic dysfunction and attendant systemic inflammation—not previously acknowledged or confirmed
Aug 21, 2023 • 5 tweets • 2 min read
Two new papers @NatureMedicine and @JAMAInternalMed shed light on #LongCovid at 2-years. But there's no shortage of known unknowns.
Reviewed in a new Ground Truths (link in my profile, because that would be it X-suppressed) Image Links to the new reports
@NatureMedicine by @zalaly and colleagues
@JAMAInternalMed nature.com/articles/s4159…
jamanetwork.com/journals/jamai…
Image
Aug 4, 2023 • 5 tweets • 2 min read
The EG.5 variant continues to show a growth advantage in the latest US genomics surveillance, from 11->17% in past 2 weeks
FL.1.5.1 also on the rise. The XBBs are on the wane. https://t.co/50Eq338zXLcovid.cdc.gov/covid-data-tra…
Image EG.5.1 rise seen in many other places, nicely summarized in @kallmemeg 's thread about the new @UKHSA report
https://t.co/Ba3GZmwVWF
Image
May 10, 2023 • 4 tweets • 4 min read
I wrote about 2 groundbreaking pancreatic cancer studies this week: #AI identifying high-risk individuals and a vaccine clinical trial published @Nature today
erictopol.substack.com/p/a-one-two-pu… On the new @Nature individualized vaccine clinical trial vs pancreatic cancer
nature.com/articles/d4158… @NatureNV @NeehaZaidi Image
May 3, 2023 • 4 tweets • 4 min read
A fascinating report @Nature today on the bidirectional interaction of brain/mind and cancer
nature.com/articles/d4158…
nature.com/articles/s4158… Image "These two ghosts in the machine, the mind
and the tumour, whispering to each other
in the dark recesses of the brain, engage in a
conversation that could be well worth eavesdropping on."
Apr 21, 2023 • 4 tweets • 2 min read
The US transition to the XBB.1.16 variant continues, the variant driving a new wave in India (see🧵by @akshathk5), but unlikely to have such impact here
covid.cdc.gov/covid-data-tra… Image Spike mutation maps for XBB.1.5 and XBB.1.16 show the 2 added (E180V, K478R)
by @firefoxx66
Image
Apr 17, 2023 • 4 tweets • 4 min read
A group of infectious disease specialists argue that universal face masks in health care settings is no longer necessary
acpjournals.org/doi/10.7326/M2…
@AnnalsofIM
by @ericashenoy @h_babcock @KarenBrustMD @CalderwoodMD @ShiraDoronMD @wbranchelliman ImageImage Here is the counterargument from @ct_degroot
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Apr 10, 2023 • 4 tweets • 2 min read
This is big, folks. The @WhiteHouse is supporting next generation—nasal and variant-proof Covid vaccines —and therapies with a $5 billion program by @ddiamond
Thanks to the relentless efforts of @AshishKJha46 and @WHCOVIDResponse👍washingtonpost.com/health/2023/04… The background and rationale for this important initiative
https://t.co/CrEaqcJkXeerictopol.substack.com/p/project-next…