Notices by Eric Topol (erictopol@mstdn.social), page 2

Paxlovid didn’t provide any benefit in a placebo-controlled randomized trial in lower risk (mean age 42 years) outpatients with mild-to-moderate Covid

https://www.nejm.org/doi/full/10.1056/NEJMoa2309003

Covid vaccination markedly reduced blood clots, heart attacks, heart failure, stroke and other adverse cardiovascular outcomes, as seen from over 20 million people, about half of whom were vaccinated https://heart.bmj.com/content/early/2024/01/24/heartjnl-2023-323483

Beyond ~30 million excess deaths, "The COVID-19 pandemic caused the most severe drops in life expectancy seen in 50+ years."
https://healthdata.org/research-analysis/library/mortality-life-expectancy-and-population

https://thelancet.com/journals/lancet/article/PIIS0140-6736(24)00476-8/fulltext

The dose-response relationship between education and improved survival, quantified for the first time. For each additional year of schooling, an associated reduction of mortality risk of 1.9%, higher with younger ages https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00306-7/fulltext

Diagnosing Alzheimer’s disease with only a blood test (p-tau217) and no symptoms has big (and negative) implications

https://www.nytimes.com/2024/03/04/health/alzheimers-amyloid-diagnosis.html?searchResultPosition=1

2 important large prospective cohort studies of cognitive deficits with Long Covid were just published. I reviewed them in a new Ground Truths post

https://erictopol.substack.com/p/long-covid-and-cognitive-deficits

Ultra-processed foods are ultra bad for your health. Consistent evidence of adverse impact for > 30 health outcomes from a comprehensive umbrella review

https://bmj.com/content/384/bmj-2023-077310

If you want to understand how Long Covid affects the brain, or the neuroscience of cancer, there's nobody better than Prof/Dr Michelle Monje to learn from.

https://erictopol.substack.com/p/michelle-monje-the-brain-in-long

This week in LongCovid:
✓ Leaky blood-brain barrier
✓ Interferon-γ as a potential biomarker
✓ Persistent infections and >50%⬆️risk
✓ Vaccination protection in adults and kids >40%
✓ Our perspective published in Science
All in the new Ground Truths
https://erictopol.substack.com/p/towards-solving-the-long-covid-puzzle

Disruption of the blood brain barrier (-> leaky) in #LongCovid in individuals with brain fog
https://nature.com/articles/s41593-024-01576-9
Assessment with MRI, brain-specific S100β protein, RNA-seq indicates dysregulation of clotting system and pro-inflammatory endothelial cells

Niacin, the B vitamin that was previously used to improve lipid profiles and reduce the risk of heart disease, promotes arterial inflammation and cardiovascular risk through its metabolites

https://www.nature.com/articles/s41591-023-02793-8

An effective treatment for depression from a systematic review of >200 unique RCTs: Exercise.

Benefit proportional to intensity of exercise prescribed

https://www.bmj.com/content/384/bmj-2023-075847

The CDC's new policy to spread Covid

https://washingtonpost.com/health/2024/02/13/covid-isolation-guidelines-cdc-change/?utm_source=alert&utm_medium=email&utm_campaign=wp_news_alert_revere&location=alert

Long Covid in kids: a state of the science review

https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2023-062570/196606/Postacute-Sequelae-of-SARS-CoV-2-in-Children?autologincheck=redirected

The risk of new-onset dementia after Covid in older adults (age 60+) from a systematic review of 11 studies vs controls is ~60% increased; after severe Covid, a 17-fold increased risk; shows up at 6 months
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4716751 (preprint)

Important discovery related to LongCovid: Fragments of SARS-CoV-2 virus can reassemble into "zombie" complexes (XenoAMP-dsDNA) and induce a major and sustained immune response, affecting healthy, uninfected cells, not seen with common cold coronaviruses

https://www.pnas.org/doi/10.1073/pnas.2300644120

The XBB.1.5 "updated" Covid vaccine booster provided ~54% increased protection *against symptomatic infections* (including vs. JN.1 variant) compared with not getting it.

https://cdc.gov/mmwr/volumes/73/wr/mm7304a2.htm?s_cid=mm7304a2_e&ACSTrackingID=USCDC_921-DM121333&ACSTrackingLabel=This%20Week%20in%20MMWR%3A%20Vol.%2073%2C%20February%201%2C%202024&deliveryName=USCDC_921-DM121333

So much new on Long Covid. I've tried to pull it all together in a new Ground Truths

https://erictopol.substack.com/p/lighting-up-long-covid

Protection against #LongCovid in kids with vaccination from a cohort of over 1 million https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2023-064446/196419/Vaccine-Effectiveness-Against-Long-COVID-in?searchresult=1

Among 67 million people in the UK, consequences of not getting a Covid vaccine, especially among older adults, age 75+:
Missing 1 shot had a similar risk of severe Covid as missing all 4 shots (2.7 vs 3.1-fold, respectively), emphasizing waned immunity
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02467-4/fulltext