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
🧵 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.

📢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… 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?

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…

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 2. Heart disease has long been the leading cause of death in the US and globally. The Covid pandemic worsened its effects.

🚨 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…

Here are key slides of my talk at the NIH-RECOVER-TLC
#RECOVERTLC
nature.com/articles/s4159…
The number of people with Long Covid is huge. This demands global attention. nature.com/articles/s4159…

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…

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… We review the mechanisms of Long Covid including viral persistence, immune dysfunction, thrombo-inflammation, neuronal inflammation, and microbiome dysbiosis.
nature.com/articles/s4159…

🧵1/ A Significant surge in the number of people with a disability in the U.S.

The @stlouisfed just released an analysis using data from the Current Population Survey (CPS), revealing some concerning trends. Here’s what they found:

#Disability #DisabilityJustice #LongCovid 2/ Above Trend Increase in Disability
Since 2019, the number of disabled individuals has surged beyond the expected trend by nearly 2 million. This isn't just a statistical anomaly—it's a huge indicator of a deeper, underlying health crisis.

ICYMI #LongCovid is a defining crisis of our time

Long Covid affects at least 400 million people globally with an economic cost of $1 trillion/yr

Addressing Long Covid requires a coordinated—but so far absent—response strategy

Our review @NatureMedicine
nature.com/articles/s4159… ロングコビッドは、私たちの時代を決定づける危機です。

ロングコビッドは、世界中で少なくとも 4 億人に影響を与え、年間 1 兆ドルの経済的損失を招いています。

@NatureMedicine での私たちのレビュー

nature.com/articles/s4159…

📢Our review "Long COVID science, research and policy" is out in @NatureMedicine

By @zalaly @ahandvanish @LisaAMcCorkell @leticiasaurus @swulfie @VirusesImmunity @EricTopol

A thread
nature.com/articles/s4159… In this review, we provide (1) a synthesis of the state of science on Long COVID; (2) assess the impacts of Long COVID on individuals, health systems, the economy & global health metrics; and (3) provide a forward-looking research & policy roadmaps nature.com/articles/s4159…

My Statement on the introduction of the Long COVID Research Moonshot Act #LongCovidMoonshot

I fully support this bill and urge the U.S. Congress and our community to support it.

Short thread: Today U.S. Senator Bernie Sanders @SenSanders formally introduced the Long COVID Research Moonshot Act. This marks a historic moment, the culmination of relentless effort and dedication from countless individuals. #LongCovidMoonshot

COVID increases risk of diabetes.

This has now been demonstrated in many studies including the largest (more than 16 million) in @TheLancetEndo

Paper

My comment here
doi.org/10.1016/S2213-…
doi.org/10.1016/S2213-… Perhaps most alarmingly, the authors report that the
risk of type 2 diabetes remained high beyond the first
year after SARS-CoV-2 infection.

This is yet another study showing the long risk horizon of COVID-19

doi.org/10.1016/S2213-…

📣 Our new paper in @NEJM

Has the risk of #LongCovid changed over the course of the pandemic?

By @Biostayan, Taeyoung Choi and me

A 🧵
nejm.org/doi/full/10.10… We enrolled people who had SARS-CoV-2 infection in the pre-delta, delta and omicron eras (441,583 people) and built 3 era-specific controls

We assessed the cumulative incidence of #LongCovid at 1 year after infection by pandemic era & vaccination status

nejm.org/doi/full/10.10…

📣 New paper in @NatureMedicine

Three-year outcomes of post-acute sequelae
of COVID-19

By Miao Cai @Biostayan @EricTopol and me

A 🧵

nature.com/articles/s4159… In a study of 5.3 million people including 135,161 people with SARS-CoV-2 infection and 5,206,835 non-infected controls.

We examined risk trajectories of 80 components of Long Covid over 3 years post-infection

nature.com/articles/s4159…

Is Covid still deadlier than the flu in 2024?

The short answer is yes!

In 2024, Covid remains deadlier than flu.

New research from my team in @JAMA_current

By @Biostayan Taeyoung Choi and @zalaly

A thread with the correct links🧵

jamanetwork.com/journals/jama/… In this study of 11,272 people

8625 hospitalized for COVID-19
2647 hospitalized for flu

jamanetwork.com/journals/jama/…

Is Covid still deadlier than the flu in 2024?

The short answer is yes!

In 2024, Covid remains deadlier than flu.

New research from my team in @JAMA_current

By @Biostayan Taeyoung Choi and @zalaly

A thread 🧵

jamanetwork.com/journals/jama/… In this study of 11,272 people

8625 hospitalized for COVID-19

2647 hospitalized for flu

jamanetwork.com/journals/jama/…

📣 New in @ScienceMagazine

I teamed up with @EricTopol to write this #SciencePerspective on Long Covid

Solving the puzzle of #LongCovid

A long 🧵

science.org/doi/10.1126/sc… First, what is Long Covid?

It is a complex nonmonolithic multisystemic disease with sequelae across almost all organ systems

It can manifest across the life span (from children to older adults) and across race & ethnicity, sex, & baseline health status

science.org/doi/10.1126/sc…

3 key messages from our recent paper in @TheLancetInfDis

1. Covid is worse than flu

Covid remains a much more serious threat to human health than the flu

thelancet.com/journals/lanin… 2. Comparing the two:

COVID is more multisystemic
Flu is more respiratory

thelancet.com/journals/lanin…

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…

📣 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…