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Renowned Long Covid researcher Dr. Ziyad Al-Aly discusses what we’ve learned about Long Covid over the past six years in this interview with B.C. family physician Dr. Susan Kuo. Dr. Al-Aly discusses his research; the benefits of Paxlovid during the acute phase of Covid-19 infection, and the potential that the diabetes drug Metformin may also be beneficial; researchers’ efforts to discover the mechanisms behind Long Covid in order to support the development of treatments; how people can protect themselves from Long Covid; and more. Dr. Al-Aly is a clinical epidemiologist with the Washington University in St. Louis and the Director of the Clinical Epidemiology Centre and Chief of the Research and Development at the Veteran’s Affairs St. Louis Health Care System. He led work which provided the first systematic characterization of the after effects of a Covid-19 infection. He then led work which characterized the increased risks of cardiovascular disease, neurologic disorders, mental health disorders, gastrointestinal disorders, diabetes, dyslipidemia and kidney disease following Covid infection. His lab also produced evidence characterizing the effects of Covid-19 vaccines on Long Covid and the health consequences of repeated Covid infections. Learn more at https://covidsociety.ca/ REFERENCES: August 2024 article by Dr. Al-Aly et al.: Al-Aly, Z., Davis, H., McCorkell, L., Soares, L., Wulf-Hanson, S., Iwasaki, A. et Topol, E. J. (2024). Long COVID science, research and policy. Nature Medicine, 30. https://doi.org/10.1038/s41591-024-03... September 2024 Mayo Clinic study: Soucheray, S. (2024). Study puts understanding of long COVID and vaccination into question. Center for Infectious Disease Research and Policy. https://www.cidrap.umn.edu/covid-19/s... September 2025 systematic review: Hou, Y., Gu, T., Ni, Z., Shi, X., Ranney, M. L. et Mukherkee, B. (2025). Global Prevalence of Long COVID, Its Subtypes, and Risk Factors: An Updated Systematic Review and Meta-analysis. Open Forum Infectious Diseases, 12(9). https://doi.org/10.1093/ofid/ofaf533 Canadian Paediatric Society Position Statement: Saunders, N. R., Kawamura, A., MacLeod, O., Nieuwesteeg, A., De Souza, C., Canadian Paediatric Society Mental Health and Developmental Disabilities Committee. (2024). Somatic symptom and related disorders: Guidance on assessment and management for paediatric health care providers. Canadian Paediatric Society, 30(4). https://cps.ca/en/documents/position/... February 2026 BMJ feature: Lang, K. (2026). Why covid-19 is “a vascular disease masquerading as a respiratory one”. BMJ, 392. https://doi.org/10.1136/bmj.s31 Immune system damage study: Phetsouphanh, C., Darley, D. R., Wilson, D. B., Howe, A., Mee Ling Munier, C., Patel, S. K., Juno, J. A., Burrell, L. M., Kent, S. J., Dore, G. J., Kelleher, A. D. et Matthews, G. V. (2022). Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection. Nature Immunology, 23. https://doi.org/10.1038/s41590-021-01... Cancer risk study: Tyagi, S., Tyagi, N., Singh, A., Gautam, A., Singh, A., Jindal, S., Singh, R. P., Chaturvedi, R. et Ritturaj Kushwaha, H. (2025). Linking COVID-19 and cancer: Underlying mechanism. Biochimica et Biophysica Acta - Molecular Basis of Disease, 1871(1). https://doi.org/10.1016/j.bbadis.2024... January 2024 USC San Francisco study on Paxlovid: Durstenfeld, M., Peluso, M. J., Lin, F., Peyser, N. D., Isasi, C., Carton, T. W., Henrich, T. J., Deeks, S. G., Olgin, J. E., Pletcher, M. J., Beatty, A. L., Marcus, G. M. et Hsue, P. Y. (2024). Association of nirmatrelvir for acute SARS-CoV-2 infection with subsequent Long COVID symptoms in an observational cohort study. Journal of Medical Virology, 96(1). https://doi.org/10.1002/jmv.29333 November 2025 study on Metformin: Bramante, C., Buse, J. B., Huling, J. D., Lindsell, C., Stewart, T., Rothman, R. L., Shaner, D., Dunsmore, S. E., Topol, E., Wiggen, T. D., Makkar, S., Toler, A., Estepp, T. et Johnson, S. (2025). Metformin at the time of Covid-19 infection and risk of Long Covid: A Target Trial Emulation Study. Authorea. https://www.authorea.com/doi/full/10.... MIT Physics Professor Dr. Yaneer Bar-Yam interview: Nikiforuk, A. (2025). This Physicist Says We Don’t Take COVID Seriously Enough. The Tyee. https://thetyee.ca/Analysis/2025/10/3... Economic burden of Long Covid: Bansal, A. (2025). Economic burden of long COVID: macroeconomic, cost-of-illness and microeconomic impacts. npj Primary Care Respiratory Medicine, 35(53). https://www.nature.com/articles/s4153...