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EricTopol's profile
Eric Topol
Eric Topol
Eric Topol
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@EricTopol

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Eric TopolVerified account

@EricTopol

physician-scientist, author, editor http://drerictopol.com 

La Jolla, CA
scripps.edu/translational
Joined November 2009

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    Eric Topol‏Verified account @EricTopol 6 Jun 2020

    How can a virus leave some people without any symptoms and kill others? A thread about #SARSCoV2 and what we know and need to do about asymptomatic infections Starting with our @AnnalsofIM paper this week, w/ @danieloran https://www.acpjournals.org/doi/10.7326/M20-3012 …

    1:05 PM - 6 Jun 2020
    • 1,073 Retweets
    • 1,980 Likes
    • Vangrunderbeeck Ayman Magd S. Mackie Brenda Goodman DeepVard Linda Vivek Pandit Fatih Rachel Carter
    50 replies 1,073 retweets 1,980 likes
      1. New conversation
      2. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        We reviewed 16 different cohorts (Table) 3 were especially helpful for being representative (R) samples: Iceland, Vo-Italy, and Indiana 5 provided longitudinal (L) follow-up to help sort out the confounding issue of conversion from pre-symptomaticpic.twitter.com/tF1Z3Wb1eA

        4 replies 56 retweets 204 likes
        Show this thread
      3. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        The representative samples help establish that the rate of having a #COVID19 infection but not having symptoms is about 40-45% The longitudinal (serial) assessment helps anchor that rate since 0-10% turned out to convert, with only 1 exception, the Kings County nursing facility

        3 replies 69 retweets 232 likes
        Show this thread
      4. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        This 40-45% rate is striking for being so high and it's hard to come up with another pathogen with the spectrum: from no symptoms to being lethal. But it's also notable that "silent" infections may not be so silent after all

        7 replies 60 retweets 250 likes
        Show this thread
      5. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        There are now 2 series of people who were asymptomatic but had lung CT scans Diamond Princess https://pubs.rsna.org/doi/10.1148/ryct.2020200110 … Korea https://www.medrxiv.org/content/10.1101/2020.05.09.20096370v1 … Both showed a high % of abnormalities, ground-glass opacities c/w #COVID19pic.twitter.com/a4Rtzq9fuk

        8 replies 169 retweets 352 likes
        Show this thread
      6. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        So these asymptomatic infections may not be so benign in the people who have them. Can they transmit the infection to others? The viral load of asymptomatic compared with symptomatic has consistently been shown to be similar in multiple studies https://arxiv.org/pdf/2003.09320.pdf …pic.twitter.com/irymxPpRnB

        7 replies 124 retweets 341 likes
        Show this thread
      7. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        But viral load is not the same as transmissibility, which hasn't been adequately studied. Ideally with genomics of the virus for precision. The cohorts we reviewed certainly support spread and perhaps > 14 days (e.g. USS aircraft). A v large, random sample to study this is needed

        4 replies 58 retweets 255 likes
        Show this thread
      8. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        For now, it is appropriate to assume anyone (you or others) can be asymptomatic and masks are essential. And physical distancing. Consideration for eye protection, too, in light of the recent @TheLancet reviewpic.twitter.com/ywBWgSUBTf

        21 replies 552 retweets 965 likes
        Show this thread
      9. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        In order to get our arms around this critical issue, we need to find asymptomatic people to avoid spread = #TestTraceIsolate. In the US w/ 330 million people that'll be exceedingly difficult, no less with one-off testing which requires repetition every week. Add false negatives.

        4 replies 63 retweets 252 likes
        Show this thread
      10. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        One ironically attractive option is 💩 monitoring to find communities that are showing evidence of ⬆️ virus. We should be doing that but we're not.pic.twitter.com/Se7wH0FbrU

        6 replies 113 retweets 410 likes
        Show this thread
      11. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        Another is body temperature since one would expect that it way be more sensitive than symptoms. @Kinsa has presented some data for that, unpublishedpic.twitter.com/5ufR9WLmTs

        6 replies 45 retweets 199 likes
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      12. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        The best way may be passive use of a smartwatch or fitness band that captures heart rate and more data. The @detect_study has more than 30,000 people donating their data. Resting heart rate should help detect people who are presymptomatic (HR ⬆️ before fever) and asymptomatic.pic.twitter.com/JvwZpUVzNA

        15 replies 102 retweets 344 likes
        Show this thread
      13. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        Most people with #COVID19 don't have fever so we need a better way to find them. Over 100 million Americans have a smartwatch or fitness band. Maybe you can help us. For more on this, our presentation this wk (starts at ~6 min) https://www.youtube.com/watch?v=Sc5ULh7jzpo&feature=youtu.be … has slides, references, ++pic.twitter.com/5xvKc8aaPU

        12 replies 170 retweets 403 likes
        Show this thread
      14. Eric Topol‏Verified account @EricTopol 6 Jun 2020

        And why people can go w/o symptoms is unknown. Many theories: cross-reactive coronavirus antibodies, cellular immunity, less nasal ACE expression, non-type A blood, genomics https://time.com/5848949/covid-19-asymptomatic-spread/ … @TIME https://www.nytimes.com/2020/06/03/health/coronavirus-blood-type-genetics.html … @NYTScience We really need to find that out!pic.twitter.com/hdMR0QepMa

        Carl Zimmer and Alice Park
        17 replies 174 retweets 459 likes
        Show this thread
      15. End of conversation

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