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Recommendations – Good & Bad (5.27.2022)
Dr. Jack Cush reviews the news, regulatory updates and journal reports from the past week on RheumNow.com. This week gout worries, mortality risks, measuring anti-drug antibodies and a better way in lupus?
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Increasing Corticosteroid Use in Non-Hospitalized COVID-19
JAMA reports that despite NIH recommendations (that corticosteroids only be used in hospitalized COVID-19 patients), nonhospitalized COVID infected patients were oftent prescribed systemic corticosteroids.
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Long COVID Manifestations
MMWR
The acute consequences of a SARS-CoV-2 infection may be bothersome or devastating, but the long-term consequences may lead to so-called "long COVID" syndrome. Long COVID appears to affect up to 20% of those who survive COVID-19 infection.
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The Inflammation Reflex (5.20.2022)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week, neuroimmunology leading to therapy, the cold shoulder approach and Regulatory updates from the FDA.
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The third SARS-CoV-2 vaccine in IMID (RA, SpA, PsA, UC, CD) patients on immunosuppression improves the serologic response follow the first two vaccine doses and allowed them to close the gap compared to the two-dose vaccinated controls #EULAR2022 @RheumNow OP0192 Jyssum et al
Dr. Antoni Chan synovialjoints ( View Tweet)
#EULAR2022 POS0256 by @CaoilfhionnMD, @DrLisaCS, @JuliePaikMD from @HopkinsRheum
10% of pts seronegative for COVID antibodies after vaccination
⭐️Risk factors: Non-white, J&J vaccine, MMF, RTX, GC, combination Rx, not-withholding peri-vaccination immunosuppression
@Rheumnow https://t.co/Izd4QJlOWH
Eric Dein ericdeinmd ( View Tweet)
@Yuz6Yusof on breakthrough infections & severe #COVID in RTX treatment #EULAR2022
🦠Rate of mod/severe COVID infection comparable to pre-pandemic severe infection rate
💉High vaccination rate prevented severe disease
📊Consider #comorbidities & low IgG in risk-benefit assessment https://t.co/PGUVbHD7i2
Mrinalini Dey DrMiniDey ( View Tweet)
#OP0247 #EULAR2022 Prof Mease analysed US Database (>1 million) pre- & post-Omicron using machine learning.Factors assoc with poor #COVID outcomes in IMID:age & comorbidities. Vaccination was protective. JAK-I and RTX increased risk weakly initially but not post-Omicron @RheumNow https://t.co/JCqTZvPgll
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
“Post-exertional fatigue is real (in #LongCovid), not their fault. Validate their symptoms. Pain is secondary.”- Dr. @LCalabreseDO #EULAR2022 @rheumnow https://t.co/hDvxJfb14f
TheDaoIndex KDAO2011 ( View Tweet)
About 50% w/ #LongCOVID has persistent Sx's at 6 mos (fatigue, muscle weakness, insomnia, anxiety, depression, dyspnea). Risks: female, obesity &prior mechan ventilation. Interestingly, the pts have inc CRP levels. DLCO is low. – Prof R Mostard #EULAR2022 @rheumnow https://t.co/8jCEObjf5I
TheDaoIndex KDAO2011 ( View Tweet)
Don’t forget about the benefits of vaccines for diseases other than #COVID19 – Dr. K Hyrich #EULAR2022 @rheumnow https://t.co/86e93ugoBQ
TheDaoIndex KDAO2011 ( View Tweet)
#EULAR2022
"The mRNA vaccines are simple to make." - Saul Faust
The key step is encapsulation in lipid to allow for take up by cell.
💉💉💉
@RheumNow https://t.co/T2ZxF6bLV5
Eric Dein ericdeinmd ( View Tweet)
In people without SLE who have severe COVID19 infection, autoAb against IFN-1 assc w/increased mortality Prof T Dorner #EULAR2022 @rheumnow https://t.co/nt2gACUtkL
TheDaoIndex KDAO2011 ( View Tweet)
#SLE hospitalized pts had worse outcomes than matched controls ? Due to interfonopathy and poor handling of viral infections - worse if #Rituximab or #MMF T Dormer BUT vaccination works if enough B cells responding to #Covid vaccine #EULAR2022 #Lupus scientific session @RheumNow https://t.co/MBb3Dvxmqp
Janet Pope Janetbirdope ( View Tweet)
#POS0263 #EULAR2022 In #rituximab-treated RMD patients with undetectable humoral response to primary #COVID 💉, a study (N=84) found Re-Vaccination with mRNA (2 shots) was better than a Booster (1 shot). Lend support for current approach: 2 + 3rd Primary + Booster @RheumNow https://t.co/AH0wpVKbHc
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Long COVID Manifestations
The acute consequences of a SARS-CoV-2 infection may be bothersome or devastating, but the long-term consequences may lead to so-called "long COVID" syndrome. Long COVID appears to affect up to 20% of those who survive COVID-19.
https://t.co/Oh5R9xPKYD https://t.co/5iRVEjdWZW
Links:
Dr. John Cush RheumNow ( View Tweet)
NSAID use is not associated with increased COVID-19 severity, all-cause mortality, invasive ventilation, AKI, or ECMO in COVID-19 inpatients. 38-center retrospective cohort propensity matched of EHR data from the National COVID Cohort Collaborative. https://t.co/u6Id4WnLPT
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Dr. John Cush RheumNow ( View Tweet)
Israel study of 171 kids w/ MIS-C (med age 8 (5-12): Dx#s - 59 during Alpha , 79 Delta , & 33 Omicron waves. All Rx w/ IVIG + steroids. 6-15% prev recv COVID VAX, none ICU admitted. Worse Dz & higher incidence during alpha wave (54.5/100K) https://t.co/wAby8uKIH4 https://t.co/zc19zeUKpq
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Dr. John Cush RheumNow ( View Tweet)
SARS-CoV-2-infected alveoli (specifically N protein-coding plasmid alone) induces IL-6 production. Also, COVID-19 Sera also induced IL-6, moreso in those w/ severe disease. anti-N Ab promotes IL-6 production & may lead to cytokine storm https://t.co/jfPNwZM0g8 https://t.co/FwIs11i2qc
Dr. John Cush RheumNow ( View Tweet)
FDA has approved baricitinib (Olumiant) for the Treatment of Certain Hospitalized Patients with COVID-19 who require supplemental O2, mechanical ventilation, ECMO. Rec dose: 4-mg once daily for 14 days or until hospital discharge https://t.co/RiEp01tc0v https://t.co/f3RvUAzdRp
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Dr. John Cush RheumNow ( View Tweet)
