Ziyad Al-Aly is an American physician and clinical epidemiologist who is currently Director of the Clinical Epidemiology Center and Chief of the Research and Development at the Veterans Affairs St. Louis Health Care System. [1] [2] [3] He is also a clinical epidemiologist at Washington University in St. Louis. [2] He has led multiple studies on long covid and its sequelae. [4]
Al-Aly was born in Tripoli, Lebanon to teachers. [5] He grew up during the Lebanese civil war which dominated Lebanon from 1975 to 1990, [5] emigrating to the United States in 2000.
Al-Aly holds a medical degree from the American University of Beirut. [6] He completed his post-graduate medical education at Saint Louis University and Washington University in St. Louis.
Al-Aly's research work has been cited more than a 120,000 times and he has an h-index of more than 80 according to Google Scholar. [7]
Al-Aly led work which provided the first systematic characterization of the post-acute sequelae of SARS-CoV-2 infection. [8] He subsequently led work which characterized the increased risks of cardiovascular disease, [9] neurologic disorders, [10] mental health disorders, [11] gastrointestinal disorders, [12] diabetes, [13] dyslipidemia, [14] and kidney disease [15] following SARS-CoV-2 infection. His lab also produced evidence characterizing the effects of COVID-19 vaccines on long COVID [16] and the health consequences of repeated infections with SARS-CoV-2. [17]
In 2024, Al-Aly testified before the U.S. Senate Health, Education, Labor and Pensions Committee as an expert witness on Long Covid. He called for the establishment of an NIH institute to address Long Covid and Infection-Associated Chronic Conditions (IACCs) — also called post-acute infection syndrome — with a funding of at least $1 billion per year. [18]
Including work characterizing the adverse health effect of proton pump inhibitors and comparative effectiveness of antihyperglycemic medications. His work also included examining the effectiveness of COVID-19 antivirals including paxlovid (nirmatrelvir/ritonavir) and molnupiravir on acute COVID-19 outcomes [19] [20] and long COVID. [21] [22]
Including work which evaluated the effect of air pollution on kidney health, [23] diabetes, [24] and early mortality. [25]
In 2023, Al-Aly was awarded the U.S. Department of Veterans Affairs Secretary's Award — the highest VA award — for outstanding contributions to research. He was named one of the 100 most influential people in health in 2024 by TIME100 Health.
Proton-pump inhibitors (PPIs) are a class of medications that cause a profound and prolonged reduction of stomach acid production. They do so by irreversibly inhibiting the stomach's H+/K+ ATPase proton pump.
Hyperglycemia or Hyperglycaemia is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/L (200 mg/dL), but symptoms may not start to become noticeable until even higher values such as 13.9–16.7 mmol/L (~250–300 mg/dL). A subject with a consistent fasting blood glucose range between ~5.6 and ~7 mmol/L is considered slightly hyperglycemic, and above 7 mmol/L is generally held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person, mainly due to the person's renal threshold of glucose and overall glucose tolerance. On average, however, chronic levels above 10–12 mmol/L (180–216 mg/dL) can produce noticeable organ damage over time.
Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, fatigue and unexplained weight loss. Symptoms may also include increased hunger, having a sensation of pins and needles, and sores (wounds) that do not heal. Often symptoms develop slowly. Long-term complications from high blood sugar include heart disease, stroke, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.
A Brodie abscess is a subacute osteomyelitis, appearing as an accumulation of pus in bone, frequently with an insidious onset. Brodie's abscess is characterized by pain and swelling without fever, often resulting from diabetic wounds, fracture-related bone infection, or haematogenous osteomyelitis.
Immunization during pregnancy is the administration of a vaccine to a pregnant individual. This may be done either to protect the individual from disease or to induce an antibody response, such that the antibodies cross the placenta and provide passive immunity to the infant after birth. In many countries, including the US, Canada, UK, Australia and New Zealand, vaccination against influenza, COVID-19 and whooping cough is routinely offered during pregnancy.
Chronic systemic inflammation (SI) is the result of release of pro-inflammatory cytokines from immune-related cells and the chronic activation of the innate immune system. It can contribute to the development or progression of certain conditions such as cardiovascular disease, cancer, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease, autoimmune and neurodegenerative disorders, and coronary heart disease.
Obesity is a risk factor for many chronic physical and mental illnesses.
A high-risk pregnancy is a pregnancy where the mother or the fetus has an increased risk of adverse outcomes compared to uncomplicated pregnancies. No concrete guidelines currently exist for distinguishing “high-risk” pregnancies from “low-risk” pregnancies; however, there are certain studied conditions that have been shown to put the mother or fetus at a higher risk of poor outcomes. These conditions can be classified into three main categories: health problems in the mother that occur before she becomes pregnant, health problems in the mother that occur during pregnancy, and certain health conditions with the fetus.
Diabetes mellitus, often known simply as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body becoming unresponsive to the hormone's effects. Classic symptoms include thirst, polyuria, weight loss, and blurred vision. If left untreated, the disease can lead to various health complications, including disorders of the cardiovascular system, eye, kidney, and nerves. Diabetes accounts for approximately 4.2 million deaths every year, with an estimated 1.5 million caused by either untreated or poorly treated diabetes.
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the coronavirus SARS-CoV-2. The first known case was identified in Wuhan, China, in December 2019. Most scientists believe the SARS-CoV-2 virus entered into human populations through natural zoonosis, similar to the SARS-CoV-1 and MERS-CoV outbreaks, and consistent with other pandemics in human history. Social and environmental factors including climate change, natural ecosystem destruction and wildlife trade increased the likelihood of such zoonotic spillover. The disease quickly spread worldwide, resulting in the COVID-19 pandemic.
COVID-19 infection in pregnancy is associated with several pregnancy complications. However, pregnancy does not appear to increase the susceptibility of becoming infected by COVID-19. Recommendations for the prevention of COVID-19 include the same measures as non-pregnant people.
The symptoms of COVID-19 are variable depending on the type of variant contracted, ranging from mild symptoms to a potentially fatal illness. Common symptoms include coughing, fever, loss of smell (anosmia) and taste (ageusia), with less common ones including headaches, nasal congestion and runny nose, muscle pain, sore throat, diarrhea, eye irritation, and toes swelling or turning purple, and in moderate to severe cases, breathing difficulties. People with the COVID-19 infection may have different symptoms, and their symptoms may change over time. Three common clusters of symptoms have been identified: one respiratory symptom cluster with cough, sputum, shortness of breath, and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; and a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea. In people without prior ear, nose, or throat disorders, loss of taste combined with loss of smell is associated with COVID-19 and is reported in as many as 88% of symptomatic cases.
The Zoe Health Study, formerly the COVID Symptom Study, is a health research project of British company Zoe Limited which uses a mobile app that runs on Android and iOS.
The treatment and management of COVID-19 combines both supportive care, which includes treatment to relieve symptoms, fluid therapy, oxygen support as needed, and a growing list of approved medications. Highly effective vaccines have reduced mortality related to SARS-CoV-2; however, for those awaiting vaccination, as well as for the estimated millions of immunocompromised persons who are unlikely to respond robustly to vaccination, treatment remains important. Some people may experience persistent symptoms or disability after recovery from the infection, known as long COVID, but there is still limited information on the best management and rehabilitation for this condition.
The transmission of COVID-19 is the passing of coronavirus disease 2019 from person to person. COVID-19 is mainly transmitted when people breathe in air contaminated by droplets/aerosols and small airborne particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing. Transmission is more likely the closer people are. However, infection can occur over longer distances, particularly indoors.
Long COVID or long-haul COVID is a group of health problems persisting or developing after an initial period of COVID-19 infection. Symptoms can last weeks, months or years and are often debilitating. The World Health Organization defines long COVID as starting three months after the initial COVID-19 infection, but other agencies define it as starting at four weeks after the initial infection.
There is increasing evidence suggesting that COVID-19 causes both acute and chronic neurologicalor psychological symptoms. Caregivers of COVID-19 patients also show a higher than average prevalence of mental health concerns. These symptoms result from multiple different factors.
Laura C. A. Rosella is a Canadian epidemiologist who is an Associate Professor at the Dalla Lana School of Public Health in the University of Toronto. She studies public health and the social determinants of health. Rosella holds a Canada Research Chair in Population Health Analytics.
Biological inequity, also known as biological inequality, refers to the “systematic, unfair, and avoidable stress-related biological differences which increase risk of disease, observed between social groups of a population”. The term developed by Centric Lab aims to unify societal factors with the biological underpinnings of health inequities – the unfair and avoidable differences in health status and risks between social groups of a population — such that these inequalities can be investigated in a holistic manner.
Post-acute infection syndromes (PAISs) or post-infectious syndromes are medical conditions characterized by symptoms attributed to a prior infection. While it is commonly assumed that people either recover or die from infections, long-term symptoms—or sequelae—are a possible outcome as well. Examples include long COVID, Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and post-Ebola virus syndrome. Common symptoms include post-exertional malaise (PEM), severe fatigue, neurocognitive symptoms, flu-like symptoms, and pain. The pathology of most of these conditions is not understood and management is generally symptomatic.