Chest Medicine
CDC Study showing decline in SARS-CoV-2 antibodies after infection suggests antibody surveys underestimate infections
26 Nov, 2020 | 09:08h | UTCCommentary: COVID-19 antibody surveys underestimate infections: study – MedicalXpress
Commentary on Twitter (Thread – Click for more)
1/📌Precipitous decline in #SARSCoV2 antibodies: study participants who'd been infected and had detectable antibodies were retested 60 days later. 94% showed antibody decline & 28% had no detectable antibodies. They had "seroreverted". How that impacts reinfection risk is unknown pic.twitter.com/QsvQTE9jVH
— Dr. Ali Nouri (@AliNouriPhD) November 25, 2020
Randomized trial: Nebulized magnesium does not benefit children with acute refractory asthma treated in the emergency department
26 Nov, 2020 | 08:58h | UTCEffect of Nebulized Magnesium vs Placebo Added to Albuterol on Hospitalization Among Children With Refractory Acute Asthma Treated in the Emergency Department: A Randomized Clinical Trial – JAMA (free for a limited period)
Commentary: Nebulized Magnesium Of Little Value for Emergency Tx of Kids’ Asthma Attacks – Physician’s Weekly
Commentary on Twitter
This RCT found that nebulized magnesium does not decrease hospitalization for children with refractory acute asthma in the emergency department, compared to albuterol or placebo https://t.co/9NjgPztY6V @sickkids #VisualAbstract
— JAMA (@JAMA_current) November 24, 2020
Randomized trial: Convalescent Plasma does not improve clinical status or overall mortality in severe Covid-19 pneumonia
25 Nov, 2020 | 09:17h | UTCCommentary: New trial of convalescent plasma for covid-19 falls flat, another setback for hyped treatment – Brief19
Commentary on Twitter
A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia @NEJM A well conducted RCT shows no significant differences in clinical status or overall mortality between patients treated with CP and those who received placebo. https://t.co/C6NylbO2At
— Carlos del Rio (@CarlosdelRio7) November 24, 2020
Cluster-randomized trial: Postexposure hydroxychloroquine does not prevent Covid-19 in healthy persons exposed to a PCR-positive case patient
25 Nov, 2020 | 09:15h | UTC
Commentary on Twitter
Another RCT in @NEJM of outpatient treatment with Hydroxychloroquine in high risk folks to prevent COVID transmission
No benefit
But about 10X rate of adverse events in HCQ group
Happy to keep studying HCQ
But it really doesn't look like it workshttps://t.co/9nAfir0CMX
— Ashish K. Jha, MD, MPH (@ashishkjha) November 24, 2020
With more data on its COVID-19 vaccine, Russian institute offers new evidence of success
25 Nov, 2020 | 09:13h | UTCWith more data on its COVID-19 vaccine, Russian institute offers new evidence of success – Science
Commentaries: Expert reaction to press release reporting the second interim analysis of the efficacy of the Sputnik V vaccine – Science Media Centre AND Russia says Sputnik V virus vaccine 95% effective – MedicalXpress
Latest COVID-19 guidelines come out against bamlanivimab, remdesivir
25 Nov, 2020 | 09:10h | UTCLatest COVID-19 guidelines come out against bamlanivimab, remdesivir – ACP Internist
Diagnosis, management, and pathophysiology of arterial and venous thrombosis in COVID-19
24 Nov, 2020 | 09:34h | UTCDiagnosis, Management, and Pathophysiology of Arterial and Venous Thrombosis in COVID-19 – JAMA
Commentary on Twitter
Arterial and venous thrombosis are common in #COVID19, especially in critically ill patients. Thromboprophylaxis should be considered for all hospitalized patients with COVID-19 in the absence of contraindications https://t.co/sjqL7MqGLX
— JAMA (@JAMA_current) November 23, 2020
Why does the AstraZeneca-Oxford COVID-19 vaccine’s efficacy vary so much? Here’s what we know
24 Nov, 2020 | 09:30h | UTCWhy Does the AstraZeneca COVID-19 Vaccine’s Efficacy Vary So Much? Here’s What We Know – TIME
Related: Why Oxford’s positive COVID vaccine results are puzzling scientists – Nature
Why the AstraZeneca-Oxford Covid-19 vaccine is different. It does not require extremely cold temperatures for storage, and the price will be “a fraction” of the expense of the other vaccine candidates
24 Nov, 2020 | 09:32h | UTCWhy the AstraZeneca-Oxford Covid-19 vaccine is different – Vox
Emergency COVID-vaccine approvals pose a dilemma for scientists. It could complicate efforts to study long-term outcomes, such as safety, how long protection lasts and whether the jab prevents infection or just the disease
24 Nov, 2020 | 09:28h | UTCWhy emergency COVID-vaccine approvals pose a dilemma for scientists – Nature
Data show hospitalized Covid-19 patients are surviving at higher rates, but surge in cases could roll back gains
24 Nov, 2020 | 09:25h | UTC
Covid-19: Oxford University vaccine shows 70% protection
23 Nov, 2020 | 09:54h | UTCCovid-19: Oxford University vaccine shows 70% protection – BBC
News release: Oxford University breakthrough on global COVID-19 vaccine
Commentary on Twitter
Today marks an important milestone in the fight against #COVID19. Interim data show the #OxfordVaccine is 70.4% effective, & tests on two dose regimens show that it could be 90%, moving us one step closer to supplying it at low cost around the world>> https://t.co/fnHnKSqftT pic.twitter.com/2KYXPxFNz1
— University of Oxford (@UniofOxford) November 23, 2020
Meta-analysis: SARSCoV2 most contagious within the first 5 days of symptom onset
23 Nov, 2020 | 09:53h | UTCCommentaries: COVID-19 most contagious in first 5 days of illness, study finds – CIDRAP AND Infectiousness peaks early in COVID-19 patients, emphasising the need to rapidly isolate cases – The Lancet AND Covid-19 carriers ‘most infectious earlier on’ – BBC
Commentary on Twitter (thread – click for more)
Our systematic review and meta-analysis on #SARSCoV2, #SARSCoV & #MERSCoV viral load dynamics, duration of viral shedding & infectiousness out now in @LancetMicrobe 👇@mugecevik @silverfoxdoc @CVRinfo @UofGlasgow @Infection_StAnd https://t.co/Tac3A2RR3E
— Antonia Ho (@DrToniHo) November 20, 2020
A proposed framework and timeline of the spectrum of disease due to SARS-CoV-2 infection: Illness beyond acute infection and public health implications
23 Nov, 2020 | 09:48h | UTC
Commentary on Twitter
The #COVID19 response focuses on acute illness, but accumulating evidence shows morbidity beyond acute infection, with at least 2 other periods of illness: a rare postacute hyperinflammatory illness, and late inflammatory/viral sequelae https://t.co/mrf8WDxKY4 @jtsylee @CDCgov
— JAMA (@JAMA_current) November 19, 2020
Updated WHO guideline on drugs for Covid-19 rejects Remdesivir and strongly recommends Corticosteroids for patients with severe and critical disease
20 Nov, 2020 | 08:51h | UTCA living WHO guideline on drugs for covid-19 – The BMJ
Commentary: WHO Guideline Development Group advises against use of remdesivir for COVID-19 – British Medical Journal
Commentary on Twitter
Today the @WHO rejects Remdesivir for #COVID19.
The same drug the @US_FDA gave a full approval.
Because the @WHO reviewed all the data and made the right call.https://t.co/u7GKTRlf37@bmj_latest pic.twitter.com/kVwmDnJRCz— Eric Topol (@EricTopol) November 20, 2020
Systematic review: Interventions for breathlessness in patients with advanced cancer
23 Nov, 2020 | 09:43h | UTCFull report: Interventions for breathlessness in patients with advanced cancer
Evidence Summary: Interventions for breathlessness in patients with advanced cancer
Phase 2 trial of Oxford COVID-19 vaccine finds it is safe and provokes immune response in young as well as in older adults
20 Nov, 2020 | 08:50h | UTCCommentaries: Covid: Oxford vaccine shows ‘encouraging’ immune response in older adults – BBC AND Age and frailty in COVID-19 vaccine development – The Lancet AND Expert reaction to phase 2 trial safety and immunogenicity data from the Oxford COVID-19 vaccine trial including in healthy older adults – Science Media Centre AND Phase 2 trial of Oxford COVID-19 vaccine in healthy older adults finds it is safe and provokes immune response – The Lancet
Commentary on Twitter
NEW—UK’s #COVID19 vaccine shows similar safety and immunogenicity results in healthy older adults (aged 56 years & over) to those seen in adults aged 18-55 years: finding from a single-blind, randomised, controlled, phase 2 trial https://t.co/OKDSySPwfK pic.twitter.com/JyXRk5ZzPT
— The Lancet (@TheLancet) November 19, 2020
Randomized trial suggesting mask use does not protect the wearer from Covid-19 sparks controversy
20 Nov, 2020 | 08:48h | UTCEditorials: Of Masks and Methods AND The Role of Masks in Mitigating the SARS-CoV-2 Pandemic: Another Piece of the Puzzle
Commentaries: Expert reaction to paper using an RCT to assess mask use as a public health measure to help control SARS-CoV-2 spread (DANMASK-19) – Science Media Centre AND Here’s How to Think About the Danish Mask Study – MedPage Today AND Lead Researcher Behind Controversial Danish Study Says You Should Still Wear A Mask – Forbes AND Denmark trial measures effectiveness of adding a mask recommendation to other public health measures for preventing SARS-CoV-2 infection – ACP Newsroom
“questioning why a top medical journal would publish a large randomized trial on an important issue is absolutely antithetical to science. Of course they should, so we may all read and debate it” (via @VPrasadMDMPH see Tweet)
Commentaries on Twitter (threads – click for more)
Not perfect, nor confirmatory, but a good enough study to modulate the probability of a large self-efficacy from masks. Study powered to a 50% RRR, correctly concluded that it does not reduce infection by 50%. A negative study is negative only for the effect size it was powered https://t.co/aDPxRoIuqS
— Luis Correia (@LuisCLCorreia) November 19, 2020
So, The Big Mask study has been published, and I thought rather than expound on what the results DID show (everyone's doing that), I might point out a few things that they DIDN'T show 1/n pic.twitter.com/zG4jtXQVVq
— Health Nerd (@GidMK) November 18, 2020
Older adults with COVID-19 commonly present to the ED with delirium
20 Nov, 2020 | 08:46h | UTCDelirium in Older Patients With COVID-19 Presenting to the Emergency Department – JAMA Network Open
Commentaries: Delirium could signal Covid-19 infection in older adults, study finds – STAT AND Delirium fairly common in older COVID-19 patients – CIDRAP AND Delirium is first symptom for many elderly COVID-19 patients – UPI
Commentary on Twitter
In older ED patients w/ COVID-19 only 56% had a fever, 51% SOB & 50% cough. 28% had delirium & one third of delirious pts lacked typical symptoms. In the ED delirium may the only symptom of #COVID19. @sharon_inouye @ACEPNow @GeriatricEDNews @AGEM_SAEM @JAMANetworkOpen pic.twitter.com/MxjSTx3Ffi
— Maura Kennedy (@MauraKennedyMD) November 19, 2020
Systematic review: Routine laboratory tests are not useful for accurately ruling in or ruling out COVID-19 on their own
20 Nov, 2020 | 08:42h | UTCRoutine laboratory testing to determine if a patient has COVID‐19 – Cochrane Library
Summary: Routine laboratory testing to determine if a patient has COVID‐19 – Cochrane Library
Review: How to ventilate obstructive and asthmatic patients
20 Nov, 2020 | 08:39h | UTCHow to ventilate obstructive and asthmatic patients – Intensive Care Medicine
Commentary on Twitter
Ventilation in #COPD & asthma
➡️ respiratory mechanics/gas exchange
➡️ heart–lung interactions
➡️ HFNO & NIV
➡️ managing invasive MV from intubation to (early) weaning limiting hyperinflation
➡️ long‑term outcome & role of tracheostomy
➡️ future strategieshttps://t.co/zBBlwo7EEI pic.twitter.com/4WPeYJZrh4— Intensive Care Medicine (@yourICM) November 9, 2020
Pfizer and BioNTech to submit Covid-19 vaccine data to FDA as full results show 95% efficacy
19 Nov, 2020 | 09:36h | UTCPfizer and BioNTech to submit Covid-19 vaccine data to FDA as full results show 95% efficacy – STAT
News release: Pfizer and Biontech conclude phase 3 study of Covid-19 vaccine candidate, meeting all primary efficacy endpoints
Commentaries: ‘Incredible milestone for science.’ Pfizer and BioNTech update their promising COVID-19 vaccine result – Science AND Pfizer: COVID-19 shot 95% effective, seeking clearance soon – Associated Press AND Expert reaction to announcement by Pfizer that they have concluded the Phase III study of their COVID-19 vaccine candidate after demonstrating 95% efficacy – Science Media Centre AND Covid vaccine: Pfizer says ‘94% effective in over-65s’ – BBC
More people are getting COVID-19 twice, suggesting immunity wanes quickly in some
19 Nov, 2020 | 09:29h | UTCMore people are getting COVID-19 twice, suggesting immunity wanes quickly in some – Science
Review: Fluid administration and monitoring in ARDS. Restrictive vs. liberal strategy of fluid administration, assessment of fluid responsiveness, and other topics are discussed
19 Nov, 2020 | 09:19h | UTCFluid administration and monitoring in ARDS: which management? – Intensive Care Medicine
Commentary on Twitter
Fluid administration & monitoring in #ARDS:
➡️ pathophysiology
➡️ fluid therapy
➡️ fluid balance & outcome
➡️ restrictive vs liberal strategy?
➡️ assessing responsiveness
➡️ origin of positive balance & correction
➡️ approach according to ARDS cause/timinghttps://t.co/wIt305B1Ci pic.twitter.com/54whmo7OmC— Intensive Care Medicine (@yourICM) November 12, 2020
Chinese Covid-19 vaccine candidate (CoronaVac) appears safe and induces an immune response in healthy volunteers in phase 1/2 clinical trial
18 Nov, 2020 | 09:19h | UTCCommentaries: Covid-19: Chinese vaccine ‘successful in mid-stage trials’ – BBC AND Expecting the unexpected with COVID-19 vaccines – The Lancet Infectious Diseases
Commentary on Twitter
NEW—Chinese #COVID19 vaccine candidate (CoronaVac) based on inactivated SARS-CoV-2 virus appears safe & induces an immune response in healthy volunteers: finding from a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial @TheLancetInfDis https://t.co/0AC0fP53dI pic.twitter.com/W3gMdqLzTG
— The Lancet (@TheLancet) November 18, 2020