Thank you so much for your vigilance on the dangers of contracting COVID, which all too many would prefer to forget. Thanks also for your persistent beating of the drum on getting a nasal vaccine. It is shameful that we have failed so far in the US to provide sufficient resources to get this done.
Your work and writing on the dangers of COVID are invaluable. But it would be so appreciated if you could also write about possible therapies for those suffering from long COVID- especially the fatigue and cognitive challenges. Hope for recovery is much needed for this group.
@erictopol: a GLP-1 trial focusing on a therapeutic may be needed if nothing more than to utilize repurposed comparators with potent anti-inflammatory repurposed drugs in 2nd or 3rd arms. More specifically, I once again refer you (and your readers) to a drug with over 4 decades of use for disorders that manifest many of the exact same pathophysiological mechanisms seen in progressive acute COVID19 as well as the PASC events of the brain. Potent inhibition of Multisystemic inflammation esp endotheliitis resulting in vasoconstriction, pro-coagulation, severe tissue hypoxia are all critical areas of focus. Immune enhancement with accelerated IgM to IgG switch are also demonstrated pharmacodynamics of hydroxyUREA/hydroxyCARBAMIDE. Further, HU triggers multisystemic a7NAChR’s contiguous with multisystemic ACE2 receptors the virus’ gateway. Published documentation identifies triggering uniquitous a7NAhRs (mitochondrial and microglial) blocks the viral RBD-ACE2 link to prevent viral entry. See ref previously submitted by Palladin Institute NAS scientists Lyhkmus, Kalashnyk, Skok et al. The PASC article by M. Skok also describes unique mechanisms that can explain many events seen with PASC and the HU dynamics. It appears that this seminal work is being ignored in favor of new drug discoveries. We agree there really is an urgency to assess and clarify the utility of certain classes of therapeutics and that urgency should include the repurposing of HU for the benefit of current and future victims of both acute and long Covid. Surely some entity sees great value in critiquing and replicating these discoveries and moving forward. At the very least it’s also important to categorically conclude HU might not really do what is claimed by a handful of practicing physicians (and thrice the number of grateful family members) who have consistently identified pos outcomes in excess of 2,500 survivors of mild, moderate and severe COVID19 thru every variant to date. It’s time to define HU for this pandemic virus. HU is readily available, safe, inexpensive, and a declared WHO essential drug for the proxy disorder SCD used by many worldwide for a lifetime of crisis mitigation. There is an urgent need to compare its multifunctional dynamics against pure antivirals, the anti-inflammatories Janus kinase inhibitors, and ultra expensive GLP-1 products. Who can make it happen?
Thank you for your continued thoughtful posts. I am so disappointed in the lack of urgency for nasal vaccines as well - as an average citizen, is there anything I can do or people/organizations I can contact (and encourage others to as well) to push this issue??
I am so grateful to the many researchers and their persistence in the face of how little the US is now paying attention. Since my daughter has Ehlers-Danlos syndrome (neuroinflammation, neuropathy, etc) and mitochondrial dysfunction the interventions mentioned could benefit her as well. I wish society would better acknowledge folks with chronic conditions who are not in the majority and whose symptoms are not worn on the outside.
Can you talk about the IgG4 switch with the vaccines? It’s been hard to cut through the noise and I know people hesitant to get the vaccine because of this
You can tell your friends if they're concerned about IgG4 switching, to get Novavax, since so far, that hasn't happened with it or other traditional vaccines. I agree this is a subject that Dr. Topol should discuss further, as it seems like not enough is known about it at this point. My guess is that, as usual, this type of switching could have different results in different people. I'd love to hear him discuss this with an expert on the topic, maybe Paul Offit or an immunologist. Here's the best article I could find on the topic:
This risks from Covid are well published by you & others and yet even the medical community is nonchalant about Covid precautions. Healthcare conferences themselves are super spreader events. How do we get the public onboard to care & change their behavior when healthcare leaders & the government avoid the topic?
As I mentioned on your post on that other horrid platform, my doctor completely shut down our visit when I mentioned Covid, long before I could give her any reference to your invaluable work. That’s not like her, and she has had Covid. She’s changed. I don’t think she can see it. She certainly didn’t see how she completely contradicted her earlier statements about a medication she has prescribed for me. I’ve also told you how my pulmonologist said she worships you & was well aware of your post about the U.S. lagging in all areas of health & mortality, yet she had nothing in her exam room that might mitigate the spread & claimed she read all about it in 2011. What? That particular post you cited was dated September 2024.
How will what you work so hard to discover & share have an impact when our doctors themselves are impaired?
Thanks to you, I have been on a GLP-1, but it took months to be prescribed a therapeutic dose. Finally got it when a sympathetic NP upped it while my PCP was on vacation. When Prozac first came out, the most common comment I heard was “I feel like myself again.” That’s exactly how I feel with the increased GLP-1 dose, exactly what my daughter claims. Neither of us have lost more weight (not sure we need to), just better, coming back to ourselves. She’s even been given a significant promotion and baffled at how she can now handle so many new demands & information.
I do apologize for bursting on here with personal, anecdotal stories, but I do need to vent as I await, after a YEAR of extensive testing & lost records, to finally see a cardio thoracic surgeon for probable major surgery. I’ve lost trust. Google has him identified as a vascular surgeon. It’s gotten beyond confusing.
I don’t exactly worship you (much lol), but without you & a few others, I’d have no idea what to ask for, what to demand, or have any clue of what to question. You’ve been a godsend in the wilderness. And my gratitude is endless.
Eric Topol, Thank you for this post. However, several words seem to have been entered incorrectly. Probably your computer misinterpreted them and changed them and you didn't notice. I suggest you ask someone to proofread your posts before you send them out. I think the meanings were clear...maybe not at one spot.
I revised th e post to point out the protection data is extrapolated from the previous 2023 booster publications (direct against the XBB.1.5 spike). Agree about the J&J vaccine.
Thank you so much for your vigilance on the dangers of contracting COVID, which all too many would prefer to forget. Thanks also for your persistent beating of the drum on getting a nasal vaccine. It is shameful that we have failed so far in the US to provide sufficient resources to get this done.
Your work and writing on the dangers of COVID are invaluable. But it would be so appreciated if you could also write about possible therapies for those suffering from long COVID- especially the fatigue and cognitive challenges. Hope for recovery is much needed for this group.
We’re trying to get a large GLP-1 trial started. We’ve published many papers on the long list of possibilities but this is our top candidate
Thanks. Any views on current non-pharmaceutical therapies for the autonomic dysfunction that seems to be common among LT COVID sufferers?
@erictopol: a GLP-1 trial focusing on a therapeutic may be needed if nothing more than to utilize repurposed comparators with potent anti-inflammatory repurposed drugs in 2nd or 3rd arms. More specifically, I once again refer you (and your readers) to a drug with over 4 decades of use for disorders that manifest many of the exact same pathophysiological mechanisms seen in progressive acute COVID19 as well as the PASC events of the brain. Potent inhibition of Multisystemic inflammation esp endotheliitis resulting in vasoconstriction, pro-coagulation, severe tissue hypoxia are all critical areas of focus. Immune enhancement with accelerated IgM to IgG switch are also demonstrated pharmacodynamics of hydroxyUREA/hydroxyCARBAMIDE. Further, HU triggers multisystemic a7NAChR’s contiguous with multisystemic ACE2 receptors the virus’ gateway. Published documentation identifies triggering uniquitous a7NAhRs (mitochondrial and microglial) blocks the viral RBD-ACE2 link to prevent viral entry. See ref previously submitted by Palladin Institute NAS scientists Lyhkmus, Kalashnyk, Skok et al. The PASC article by M. Skok also describes unique mechanisms that can explain many events seen with PASC and the HU dynamics. It appears that this seminal work is being ignored in favor of new drug discoveries. We agree there really is an urgency to assess and clarify the utility of certain classes of therapeutics and that urgency should include the repurposing of HU for the benefit of current and future victims of both acute and long Covid. Surely some entity sees great value in critiquing and replicating these discoveries and moving forward. At the very least it’s also important to categorically conclude HU might not really do what is claimed by a handful of practicing physicians (and thrice the number of grateful family members) who have consistently identified pos outcomes in excess of 2,500 survivors of mild, moderate and severe COVID19 thru every variant to date. It’s time to define HU for this pandemic virus. HU is readily available, safe, inexpensive, and a declared WHO essential drug for the proxy disorder SCD used by many worldwide for a lifetime of crisis mitigation. There is an urgent need to compare its multifunctional dynamics against pure antivirals, the anti-inflammatories Janus kinase inhibitors, and ultra expensive GLP-1 products. Who can make it happen?
Thank you for your continued thoughtful posts. I am so disappointed in the lack of urgency for nasal vaccines as well - as an average citizen, is there anything I can do or people/organizations I can contact (and encourage others to as well) to push this issue??
Excellent summary. Thank you Dr. Topol!
Thank you. Your summaries are outstanding.
I am so grateful to the many researchers and their persistence in the face of how little the US is now paying attention. Since my daughter has Ehlers-Danlos syndrome (neuroinflammation, neuropathy, etc) and mitochondrial dysfunction the interventions mentioned could benefit her as well. I wish society would better acknowledge folks with chronic conditions who are not in the majority and whose symptoms are not worn on the outside.
Can you talk about the IgG4 switch with the vaccines? It’s been hard to cut through the noise and I know people hesitant to get the vaccine because of this
It’s just noise. No established clinical significance
You can tell your friends if they're concerned about IgG4 switching, to get Novavax, since so far, that hasn't happened with it or other traditional vaccines. I agree this is a subject that Dr. Topol should discuss further, as it seems like not enough is known about it at this point. My guess is that, as usual, this type of switching could have different results in different people. I'd love to hear him discuss this with an expert on the topic, maybe Paul Offit or an immunologist. Here's the best article I could find on the topic:
https://www.science.org/doi/10.1126/sciimmunol.adg7327
This risks from Covid are well published by you & others and yet even the medical community is nonchalant about Covid precautions. Healthcare conferences themselves are super spreader events. How do we get the public onboard to care & change their behavior when healthcare leaders & the government avoid the topic?
As I mentioned on your post on that other horrid platform, my doctor completely shut down our visit when I mentioned Covid, long before I could give her any reference to your invaluable work. That’s not like her, and she has had Covid. She’s changed. I don’t think she can see it. She certainly didn’t see how she completely contradicted her earlier statements about a medication she has prescribed for me. I’ve also told you how my pulmonologist said she worships you & was well aware of your post about the U.S. lagging in all areas of health & mortality, yet she had nothing in her exam room that might mitigate the spread & claimed she read all about it in 2011. What? That particular post you cited was dated September 2024.
How will what you work so hard to discover & share have an impact when our doctors themselves are impaired?
Thanks to you, I have been on a GLP-1, but it took months to be prescribed a therapeutic dose. Finally got it when a sympathetic NP upped it while my PCP was on vacation. When Prozac first came out, the most common comment I heard was “I feel like myself again.” That’s exactly how I feel with the increased GLP-1 dose, exactly what my daughter claims. Neither of us have lost more weight (not sure we need to), just better, coming back to ourselves. She’s even been given a significant promotion and baffled at how she can now handle so many new demands & information.
I do apologize for bursting on here with personal, anecdotal stories, but I do need to vent as I await, after a YEAR of extensive testing & lost records, to finally see a cardio thoracic surgeon for probable major surgery. I’ve lost trust. Google has him identified as a vascular surgeon. It’s gotten beyond confusing.
I don’t exactly worship you (much lol), but without you & a few others, I’d have no idea what to ask for, what to demand, or have any clue of what to question. You’ve been a godsend in the wilderness. And my gratitude is endless.
Eric Topol, Thank you for this post. However, several words seem to have been entered incorrectly. Probably your computer misinterpreted them and changed them and you didn't notice. I suggest you ask someone to proofread your posts before you send them out. I think the meanings were clear...maybe not at one spot.
> If you haven’t, please consider getting the new booster. Not only will it provide some (~50%) protection from infection for 4-6 weeks
Wondering how you derived this timeline and efficacy?
Pleased to see the nasal vaccine data from China after the disappointment of the ChadOx1 attempt. Pity we didn't give J&J's AD26 vaccine a go.
I revised th e post to point out the protection data is extrapolated from the previous 2023 booster publications (direct against the XBB.1.5 spike). Agree about the J&J vaccine.