Chest Medicine
Review: Ethics in extracorporeal life support.
23 Jul, 2021 | 10:29h | UTCEthics in extracorporeal life support: a narrative review – Critical Care
Study shows AstraZeneca and Pfizer vaccines are effective against Delta variant, but both doses are needed.
22 Jul, 2021 | 11:16h | UTCCommentaries: Study Finds Pfizer And AstraZeneca Vaccines Effective Against The Delta Variant — As Long As You Get Both Doses – Forbes AND Pfizer’s COVID-19 vaccine works very well against the Delta variant — but only after 2 doses – Insider
Related: [Preprint] 2 doses of Covid vaccines (Pfizer-BioNTech or Oxford-AstraZeneca) highly effective against hospitalization from Delta variant. AND Reduced sensitivity of SARS-CoV-2 variant Delta to antibody neutralization. AND Should I get my second AstraZeneca dose? Yes, it almost doubles your protection against Delta.
Commentary on Twitter
https://twitter.com/hildabast/status/1417964189566472195
COVID-19 antibodies persist at least nine months after infection – “98.8 percent of people infected in February/March showed detectable levels of antibodies in November”.
22 Jul, 2021 | 11:14h | UTCNews release: COVID-19 antibodies persist at least nine months after infection – Imperial College London
Original study: SARS-CoV-2 antibody dynamics and transmission from community-wide serological testing in the Italian municipality of Vo’ – Nature Communications
RCT: Dapagliflozin in patients with cardiometabolic risk factors hospitalized with COVID-19 – safe, but no statistically significant risk reduction in organ dysfunction or death.
22 Jul, 2021 | 11:08h | UTCCommentary: Dapagliflozin in patients with COVID-19: truth or dare – The Lancet Diabetes & Endocrinology
Review: Personalized mechanical ventilation in acute respiratory distress syndrome.
22 Jul, 2021 | 10:40h | UTCPersonalized mechanical ventilation in acute respiratory distress syndrome – Critical Care
Related: M-A of randomized trials: In patients with acute respiratory distress syndrome, there was no difference in mortality between higher vs. lower positive end-expiratory pressure strategies. AND Seminar | Acute respiratory distress syndrome. AND Short review: Diagnosis and management of acute respiratory distress syndrome
WHO Guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination to prevent coronavirus disease (COVID-19).
20 Jul, 2021 | 10:29h | UTCRelated Guidance: AHA/ASA Guidance: Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Thrombotic Thrombocytopenia – “No heparin products in any dose should be given.” AND ISTH Interim Guidance for the Diagnosis and Treatment on Vaccine Induced Immune Thrombotic Thrombocytopenia
WHO warns that HIV infection increases risk of severe and critical COVID-19.
20 Jul, 2021 | 10:24h | UTCNews release: WHO warns that HIV infection increases risk of severe and critical COVID-19 – World Health Organization
Commentary on Twitter (thread – click for more)
🆕 report confirms that #HIV infection is a significant independent risk factor for both severe/critical #COVID19 presentation at hospital admission & in-hospital mortality. 23.1% of all people living with HIV who were hospitalized with COVID-19, died.
👉 https://t.co/UBd0OyFKnd pic.twitter.com/UHLo9RPa1g
— World Health Organization (WHO) (@WHO) July 16, 2021
What vaccinated people should know about Covid-19 exposure, tests and more.
20 Jul, 2021 | 10:17h | UTCWhat vaccinated people should know about Covid-19 exposure, tests and more – CNN
ALA/ATS Response to Philip Morris International’s (PMI) Purchase of British Producer of Respiratory Treatments – “The announcement that PMI wants to acquire an inhaled medicine company is the latest reprehensible choice from a company that has profited from addicting users to its deadly products”.
20 Jul, 2021 | 10:12h | UTC
RCT: more data showing Azithromycin is not better than placebo in patients with Covid-19.
18 Jul, 2021 | 23:54h | UTCRelated: RCT: Another study shows Azithromycin does not improve outcomes in patients with Covid-19. (several articles on the subject)
Commentary on Twitter
Among outpatients with #SARSCoV2 infection, treatment with a single dose of oral #azithromycin compared with placebo did not result in a greater likelihood of being free of symptoms at day 14 https://t.co/dYDcSyGtwd #COVID19
— JAMA (@JAMA_current) July 16, 2021
Review: Symptoms, complications and management of long COVID.
18 Jul, 2021 | 23:46h | UTCCommentary: Long COVID: More likely in patients with 5+ symptoms in first week of infection – SAGE Publications
Commentary on Twitter
Pooled prevalence data in this review showed the 10 most prevalent reported symptoms of long covid were: fatigue, shortness of breath, muscle pain, joint pain, headache, cough, chest pain, altered smell, altered taste and diarrhoea.
https://t.co/ww5HM1s7vm— KK Cheng (@KKCheng4) July 16, 2021
Position Paper: Recommendations for the use of topical inhalant budesonide in COVID-19.
18 Jul, 2021 | 23:53h | UTCRecommendations for use of topical inhalant budesonide in COVID-19 – HNO
Related: RCT: Inhaled budesonide shortens recovery time in non-hospitalized patients with COVID-19 AND Phase 2 RCT: Inhaled budesonide shows promise for the treatment of early COVID-19
Studies elucidate poorly understood long COVID.
18 Jul, 2021 | 23:42h | UTCStudies elucidate poorly understood long COVID – CIDRAP
Long Covid: fatigue, post-exertional malaise, and cognitive dysfunction are the most common symptoms, according to an international survey.
18 Jul, 2021 | 23:44h | UTCCommentaries: Identification of over 200 long COVID symptoms prompts call for UK screening programme – University College London AND A survey of long-haulers found 66 symptoms that lasted more than 6 months. Tiredness and brain fog were most common. – Insider AND Long Covid has more than 200 symptoms, study finds – The Guardian
CDC warns Covid-19 vaccines might not protect people who are immunocompromised – “CDC is looking into ongoing research exploring the possibility that immunocompromised could benefit from an additional dose”.
18 Jul, 2021 | 23:38h | UTCCDC warns Covid-19 vaccines might not protect people who are immunocompromised – CNN
Study: Pooled saliva analysis is a low-cost and effective strategy for surveillance of Covid-19 in schools and universities and allows to rapidly assess transmission and adjust prevention protocols.
18 Jul, 2021 | 23:37h | UTCRelated: Pooling of Samples for Testing for SARS-CoV-2 in Asymptomatic People AND Implementation of a Pooled Surveillance Testing Program for Asymptomatic SARS-CoV-2 Infections on a College Campus — Duke University, Durham, North Carolina, August 2–October 11, 2020 – CDC Morbidity and Mortality Weekly Report
Why was a major study on ivermectin for covid-19 just retracted?
16 Jul, 2021 | 11:11h | UTCWhy Was a Major Study on Ivermectin for COVID-19 Just Retracted? – Grifter Analysis and Review
See also: Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns – The Guardian AND Some problems in the dataset of a large study of Ivermectin for the treatment of Covid-19 – Nick Brown’s Blog AND Is Ivermectin for Covid-19 Based on Fraudulent Research? – Gideon M-K; Health Nerd
Commentary on Twitter (thread – click for more)
So, one of the biggest studies to date on ivermectin for COVID-19 has issues significant enough that, if not fraud, are so serious that it invalidates the study without further explanation
I promised a thread
Here we go 1/n https://t.co/L9QOChmGtA
— Health Nerd (@GidMK) July 16, 2021
Heterologous Oxford–AstraZeneca and Moderna Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.
16 Jul, 2021 | 11:02h | UTCHeterologous ChAdOx1 nCoV-19 and mRNA-1273 Vaccination – New England Journal of Medicine
Related: [Preprint] Mixing Covid jabs has good immune response, study finds – “The Com-Cov trial looked at the efficacy of either two doses of Pfizer, two of AstraZeneca, or one of them followed by the other. All combinations worked well, priming the immune system”. AND Phase 2 RCT: Immunogenicity and reactogenicity of a Pfizer-BioNTech booster in patients that have received a single dose of AstraZeneca vaccine – “BNT162b2 (Pfizer) given as a second dose in individuals prime vaccinated with ChAdOx1-S (AstraZeneca) induced a robust immune response, with an acceptable and manageable reactogenicity profile”. AND RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.
Commentary on Twitter
Health care workers who had received a dose of ChAdOx1 nCoV-19 were offered either ChAdOx1 nCoV-19 or mRNA-1273 9 to 12 weeks later. Levels of S-specific and RBD-specific IgG increased by a factor of 5 after ChAdOx1 nCoV-19 and by a factor of 115 to 125 after mRNA-1273.
— NEJM (@NEJM) July 14, 2021
Heterologous Oxford–AstraZeneca and BioNTech/Pfizer Vaccination induce increased levels of neutralizing antibody compared to 2 doses of Oxford–AstraZeneca.
16 Jul, 2021 | 11:00h | UTCHeterologous ChAdOx1 nCoV-19 and mRNA-1273 Vaccination – New England Journal of Medicine
Related: [Preprint] Mixing Covid jabs has good immune response, study finds – “The Com-Cov trial looked at the efficacy of either two doses of Pfizer, two of AstraZeneca, or one of them followed by the other. All combinations worked well, priming the immune system”. AND Phase 2 RCT: Immunogenicity and reactogenicity of a Pfizer-BioNTech booster in patients that have received a single dose of AstraZeneca vaccine – “BNT162b2 (Pfizer) given as a second dose in individuals prime vaccinated with ChAdOx1-S (AstraZeneca) induced a robust immune response, with an acceptable and manageable reactogenicity profile”. AND RCT: Mixing 2 different Covid vaccines is associated with increased risk of side effects.
Commentary on Twitter
https://twitter.com/EricTopol/status/1415297187718696964
AAFP Guideline: Pharmacologic Management of COPD Exacerbations.
16 Jul, 2021 | 10:51h | UTC
M-A of randomized trials: In patients with acute respiratory distress syndrome, there was no difference in mortality between higher vs. lower positive end-expiratory pressure strategies.
16 Jul, 2021 | 10:43h | UTC
RCT: Bamlanivimab plus Etesevimab reduce mortality and hospitalization in ambulatory patients with early Covid-19 (within 3 days of a positive test) who are at risk for clinical deterioration (i.e., older people, obese, diabetics, immunocompromised, with CV disease).
15 Jul, 2021 | 09:26h | UTCBamlanivimab plus Etesevimab in Mild or Moderate Covid-19 – New England Journal of Medicine
Study shows the viral loads in the Delta infections are ~1000 times higher than those in the earlier strain infections on the day when viruses are firstly detected.
15 Jul, 2021 | 09:20h | UTCCommentary: The Delta Variant Isn’t Just Hyper-Contagious. It Also Grows More Rapidly Inside You – NPR
Related: WHO: Delta variant is ‘most transmissible’ identified so far. AND Increased transmissibility and global spread of SARS-CoV-2 variants of concern – “Estimated transmissibility increases of alpha 29% (95% CI: 24–33), beta 25% (95% CI: 20–30), gamma 38% (95% CI: 29–48) & delta 97% (95% CI: 76–117)”.
Commentary on Twitter
Part of the challenge that Delta presents may be tied to this finding
The variant's viral load ~1,000X higher than previous strains (reflected by low CTs), more infectious in the early stages of the illnesshttps://t.co/09CDQFwCSV pic.twitter.com/mjIfcNTYlO— Eric Topol (@EricTopol) July 9, 2021
Sarcoidosis: A clinical overview from symptoms to diagnosis.
15 Jul, 2021 | 08:58h | UTCSarcoidosis: A Clinical Overview from Symptoms to Diagnosis – Cells
RCT: Lopinavir-ritonavir and hydroxychloroquine worsened outcomes in critically ill patients with COVID-19.
14 Jul, 2021 | 11:25h | UTC
Commentary on Twitter (thread – click for more)
Results of @remap_cap #Covid_19 #Antiviral Domain released Online First @yourICM: Among critically ill patients with COVID-19, #lopinavir-ritonavir, #HydroxyChloroquine, or combination therapy worsened outcomes compared to no antiviral therapy
— remap-cap (@remap_cap) July 13, 2021