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) 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)

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…

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 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

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… 2. Inflammation in patients with COVID-19, and controlled experiments show prolonged neuro-inflammation after mild SARS-CoV-2 infection
in macaques.

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…
I've reviewed the FLiRT variants and their implications in a Ground Truths (link in profile)

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

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/…
Recent @CDCgov #SARSCoV2 wastewater data for current wave (vs Omicron Jan 2022 and subsequent waves), graph by @luckytran

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…
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…

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…


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

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) Links to the new reports
@NatureMedicine by @zalaly and colleagues
@JAMAInternalMed nature.com/articles/s4159…
jamanetwork.com/journals/jamai…

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…
EG.5.1 rise seen in many other places, nicely summarized in @kallmemeg 's thread about the new @UKHSA report
https://t.co/Ba3GZmwVWF

https://twitter.com/kallmemeg/status/1686785744508010501

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…

https://twitter.com/EricTopol/status/1655639657995210752

On the new @Nature individualized vaccine clinical trial vs pancreatic cancer
nature.com/articles/d4158… @NatureNV @NeehaZaidi

A fascinating report @Nature today on the bidirectional interaction of brain/mind and cancer
nature.com/articles/d4158…
nature.com/articles/s4158… "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."

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… Spike mutation maps for XBB.1.5 and XBB.1.16 show the 2 added (E180V, K478R)
by @firefoxx66

https://twitter.com/firefoxx66/status/1611387920207708163

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 Here is the counterargument from @ct_degroot

https://twitter.com/ct_degroot/status/1647296232375590912

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…

Important new report on #LongCovid and the brain demonstrating persistence of the virus spike protein, throughout the body and particularly the skull-meninges axis, both in humans and the mouse model
biorxiv.org/cgi/content/sh… by @erturklab @zhouyi_rong @HongchengM
@Sakethkapoor

https://twitter.com/erturklab/status/1643902019088908289

Heart attacks, strokes and other major adverse outcomes doubled in people post-Covid at 1 year compared with matched uninfected controls #LongCovid, replicating previous reports
jamanetwork.com/journals/jama-… @JAMAHealthForum Table of the various 1-year adverse outcomes for both full cohort and those hospitalized along with all-cause mortality graph

New @TheLancet
Prior Covid provided high protection vs severe disease, including Omicron BA.1 ( ~90% at 10 months post-infection), as determined by systematic review of 65 studies
Protection vs reinfection was high (~78% at 10 months) until Omicron,⬇️to ~44% w/ more rapid⬇️ Link thelancet.com/journals/lance…
Graph shows comparison vs vaccination for different outcomes over time
Conclusion👇pulls a lot of data all together
Work by @IHME_UW team

The RSV virus was discovered in 1956 and sequenced in 1982. Only now do we have effective vaccines. Today @NEJM results for age 65+ randomized trial
nejm.org/doi/full/10.10… Another RSV vaccine much larger randomized trial (also of 1 dose) with very high efficacy in people age 60+
nejm.org/doi/full/10.10…

The XBB.1.5 variant now accounts for ~75% of new cases in the United States, with no other variant showing gains (including CH.1.1)
covid.cdc.gov/covid-data-tra… All regions are XBB.1.5 dominant except the Northwest