Gianfresco et al have published the first peer-reviewed analysis of COVID-19 infected, rheumatic disease patients entered into the Rheumatology Global Alliance registry; showing that a) rheumatic disease patient can be infected with COVID-19, b) that DMARD and biologic use has no apparent effect on outcomes and c) steroid increase and TNF inhibitor decrease the odds of hospitalization.

This week's Tuesday Nite Rheumatology featured Dr Randy Cron from the University of Alabama - Birmingham as he spoke and took questions on the immunology, immunopathogenesis and treatment of Cytokine Storm Syndrome, especially as they relate to COVID-19 and rheumatic disease patients. The program was moderated by Dr. Jack Cush.

Anakinra was studied in 29 COVID(+) patients with respiratory distress and high inflammatory markers (CRP or ferritin) and compared to non-anakinra patients, those on anakinra had better survival (90% vs. 56% ;p=0·009) and greater improvements in CRP and pulmonary function (72% vs 50%) compared to controls at day 21.

As data continue to emerge about a multi-system inflammatory disorder in children apparently connected to COVID-19, evidence is growing that this is not your typical Kawasaki disease.

Last night's Tuesday Nite Rheumatology featured Dr. Joan Merrill (OMRF). In her lecture, "What does COVID-19 have to do with lupus?", she discusses the pathogenesis of lupus, and specifically thrombotic microangiopathy, complementopathies, catastrophic lupus syndrome and the potential overlap with the vascular pathology seen with COVID-19 infection.

It's Nurses Week and time to reaffirm our reverence for nurses. Dr. Jack Cush gives a video testimonial to the dedication, dependability and excellence Nurses bring to patient care. God Bless our Nurses! 

MMWR reports that after attending a 2.5 hr choir practice with one COVID+ symptomatic person, 87% of the choir developed COVID 19; 3 were hospitalized, and two died. 

Modifiable lifestyle choices can impact long term health.  A recent study shows that usual and increased physical activity can results in less hospitalization amongst the the general population.

Hydroxychloroquine has been a dominant news item since the start of the COVID-19 crisis, with a great deal of misconceptions by those who don't know or use or take the drug. HCQ leaped to the headlines on March 19th when President Trump endorsed the drug as being “approved” by FDA. Of course at that time, it was still only approved for SLE, RA and malaria and it wasn't until 2 weeks later (March 31st) that the FDA issued an "emergency use authorization" allowing the use of either chloroquine or HCQ for treatment of severe, hospitalized patients with COVID-19.

To provide clarity and evidence - here are some of the facts you need to know.

On April 26, 2020 the American College of Rheumatology (ACR) published a guidance paper to assist rheumatologists and rheumatology health professionals in assessing the need for urgent or face-to-face medical care versus virtual or telehealth patient care.  The driving principals being

The Annals of Rheumatic Disease has published the preliminary recommendations of the German Society of Rheumatology for the management of Inflammatory rheumatic diseases patients during the SARS-CoV-2/Covid-19 pandemic.

These preliminary recommendations are based on an expert consensus from 17 experienced German rheumatologists.

The world has been turned upside down in the last 6 weeks. Medicine and rheumatology have certainly changed – a frightening experience for Chicken Little, a disaster for the pessimist, a challenge for the pragmatist and an opportunity for the optimists amongst us. Last week I asked our audience to tell me their “upside or downside of COVID-19”. Read on to see how your peers have operating or thinking.

JAMA Open Network reports an interim analysis of the Brazilian CloroCovid-19 trial showing thta higher doses of chloroquine (CQ) in the treatment of severe COVID-19 was associated with QTc interval prolongation and increased mortality.

I need your HELP and INPUT.

The FDA issued a new consumer update on what you need to know about Cannabis or Cannabis-derived Compounds, Including CBD. This is part of the FDA effort to answer questions about the science, safety, and quality of products containing cannabis and cannabis-derived compounds, particularly CBD.

A National Institutes of Health (NIH) expert panel has developed consensus treatment guidelines for the management of coronavirus (COVID-19). To date no drug has been proven to be safe and effective for treating COVID-19. Moreover, they found no evidence to recommended the use of hydroxychloroquine for prophylaxis or treatment of COVID-19 outside of a current clinical trial.

Dr. Alvin Wells gives a primer on Telerheumatology and Telemedicine in the era of COVID-19. This 1 hour Grand Rounds Presentation includes a 30 minute lecture, followed by stimulating 30 minutes of Q&A with a rheumatology attendee audience.

Dr. Jack Cush reviews the appproach to evaluating fever in adults suspected of having a rheumatic disease, Stills disease or autoinflammatory conditions.

Dr. Jack Cush reviews the news, journal articles and new ACR COVID-19 guidelines from the past week on RheumNow.com.