Researcher explores the long and short of COVID-19 in public lecture

Most Americans have already had COVID-19 at least once with infections lasting a few weeks. But roughly 10 percent of patients have never fully recovered.

Ziyad Al-Aly is a global expert in long COVID, a condition that has left 65 million people worldwide reeling with fatigue, cardiovascular problems, shortness of breath, cognitive impairments, and chronic pain – even months or years after infection.

At first, Al-Aly didn’t believe what the data and patient accounts told him: that COVID-19 could wreak havoc on multiple organ systems long after the acute infection phase.

“From all my education, we're not trained to think that viruses, especially respiratory viruses, have these myriad effects in all these organ systems. So I doubted it for the longest time, but the results came back exactly consistent every single time,” Al-Aly said on the "Ground Truths" podcast in September. He directs the Clinical Epidemiology Center and is chief of the Research and Development Service at the U.S. Department of Veterans Affairs St. Louis Health Care System.

Al-Aly will explain his latest findings during a public presentation titled “Long COVID: The Lasting Legacy of the COVID-19 Pandemic,” at 5:30 p.m. Thursday, Jan. 25, at the Fralin Biomedical Research Institute at VTC in Roanoke.

“Dr. Al-Aly is a world-class physician-scientist and an emerging thought leader examining the hidden population health consequences of the pandemic,” said Michael Friedlander, executive director of the Fralin Biomedical Research Institute (FBRI) and Virginia Tech’s vice president for health sciences and technology. “We are especially excited to hear from him and share ideas as many of our researchers here at the FBRI are carrying out research on some of the key systems that are impacted by COVID-19 including the brain and the heart and vascular systems. Moreover, our molecular diagnostics COVID-19 testing team is very connected to his work. We expect to learn a great deal from his lecture and are honored to host such an eminent thought leader with our community, particularly as we see Centers for Disease Control data on COVID-19 severity indicators trending up yet again.”

Over the past three years, Al-Aly has analyzed health data from millions of veterans nationwide. He has published evidence in top-tier journals that the virus leads to an increased risk of diabetes onset, long-term neurological symptoms, dyslipidemia, cardiovascular disorders, and a wide range of gastrointestinal disorders.

Al-Aly’s pioneering research also involves one of the world’s largest longitudinal studies to evaluate COVID-19’s long-term impacts. His team found that even patients with mild infections remained at higher risk of developing post-acute symptoms and health conditions.

But if you’ve already had a mild infection, what’s the harm in getting COVID-19 again? Al-Aly’s research published in Nature last year demonstrated how reinfection increases risks of death, hospitalization, and disease.

“The results are very, very clear that a second infection or reinfection is consequential,” Al-Aly said. “I think the best interpretation for this is for people to think that two infections are worse than one and three are worse than two.”

Before the pandemic, Al-Aly’s research focused on the impact of various health conditions, including kidney diseases, on a population level. He analyzed veterans’ health and satellite air quality data from NASA in a series of studies to define a link between air pollution and chronic kidney disease, obesity, interstitial lung disease, and rheumatoid arthritis.

He also has evaluated the efficacy and long-term side effect profile of a variety of commonly prescribed therapeutics, ranging from metformin for diabetes and proton pump inhibitors for acid reflux to newer drugs marketed to treat diabetes and weight loss, such as GLP-1 receptor agonists like Ozempic.

Al-Aly’s research program is funded by the National Institutes of Health to conduct randomized trials comparing the impacts of these various drug classes on cardiovascular and kidney health.

“Most clinical trials for these things track them for 30 days or at the most for a few months. The long-term risk profiles of these medications have not been characterized previously,” Al-Aly said.

Raised in Lebanon, Al-Aly completed his medical degree at the American University of Beirut and his residency and fellowship at Saint Louis University. He has authored over 112 peer-reviewed scientific papers, amassing over 108,000 citations. He holds a faculty appointment at the Washington University School of Medicine in St. Louis and is a member of the American Society of Nephrology.

The institute’s free public lecture series is made possible by Maury Strauss, a longtime Roanoke businessman and benefactor who recognizes the importance of bringing leading biomedical research scientists to the community.

The public is welcome to attend the lecture, including a 5 p.m. reception with refreshments in the Fralin Biomedical Research Institute at 2 Riverside Circle in Roanoke. Al-Aly’s talk will be streamed live via Zoom and archived on the institute’s website.