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Clinical Trial Boom or Bust in Severe COVID-19

Jack Cush, MD

A number of recently published clinical trials are further defining the efficacy and outcomes of tocilizumab or remdesivir in treating SARs-CoV-2 infection.



Remdesivir

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Outpatient Visits Return to Pre-COVID Rates

Jack Cush, MD

The COVID-19 pandemic dramatically impacted outpatient care - numbers, scope, quality, etc, but a recent study suggests that while COVID has changed the scope of care, the numbers of outpatient visits have risen to near pre-pandemic numbers.

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RheumNow Podcast – Good Time Charlie…. (10.16.20)

Jack Cush, MD

Dr. Jack Cush sings the news and journal reports from the past week on RheumNow.com.

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COVID Transmission from Young to Old

Jack Cush, MD

The CDC has analyzed temporal trends in percent positivity by age group in COVID-19 hotspot counties before and after their identification as hotspots.

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Hydroxychloroquine Shows No Benefit in Hospitalized COVID-19 Patients

Jack Cush, MD

The NEJM reports on a controlled clinical trial showing patients hospitalized with Covid-19 given hydroxychloroquine (HCQ) do not have a lower incidence of death compared to those receiving routine care.

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RheumNow Podcast – Bad Disease & Bad Outcomes (10.9.20)

Jack Cush, MD

Dr. Jack Cush Reviews the news and journal articles from the past week on RheumNow.com.

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Systemic Steroids Reduce Mortality in COVID-19

Jack Cush, MD

JAMA Internal Medicine reports an analysis of COVID-19 clinical trials showing that critically ill patients with COVID-19 treated with systemic corticosteroids have an overall lower mortality rate.

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RheumNow Podcast – Function Follows Form (10.2.20)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Regulatory approvals, update on global rheumatology alliance, smoking and psoriasis, gabapentin let down and defining difficult RA.

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FDA approved its 1st drug to treat COVID-19 - the antiviral drug Veklury (remdesivir) for for acute care treatment of COVID-19 requiring hospitalization. Approval based on 3 clinical trials showing clinical improvement, but no change in mortality rates. https://t.co/IrA7oKMuGq

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Dr. John Cush RheumNow ( View Tweet)

Study from NY shows that Death rates from COVID-19 have dropped (in hospitalized pts) from a high of 27% down to 3%. Partly because a younger, healthier are now getting infected, arriving @ hospital w/ less-severe Sxs. Also improved COVID medical care https://t.co/8aFuVHUDjY

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Dr. John Cush RheumNow ( View Tweet)

#LTF Listen to Fauci

Dr. John Cush RheumNow ( View Tweet)

Pre Print of UK research suggests biomarkers for Severe COVID-19 includes markers of myeloid or endothelial activation; such as D-dimer, EN-RAGE, CXCL10, GM-CSF, IL-6, TNF-α, IL-2, GDF-15, G-CSF, S100A12, https://t.co/Yv6yM4DYmp

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Dr. John Cush RheumNow ( View Tweet)

There have been many cases of Kawasaki vasculitis in kids ith COVID-19; now Lg vessel vasculitis in 79 yo Japanese man w/ COVID-19 pneumonia, CRP 17.7 mg/dL, spiking fevers and CTA and FDG-PET evid of aortic and LVV, neg ANCA, nl IgG4, but was HLA-DR4+. https://t.co/UpL4Z1qK2p

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Dr. John Cush RheumNow ( View Tweet)

Observational study of 123 Spanish rheumatic dz pts w/ COVID-19, finds 54 hospitalized. Admitted pts were 69.7 yrs, and 22% died. Admission was assoc w/ older age, autoimmune dz (vs inflammatory arthritis; OR: 3.55), but not DMARD Rx. https://t.co/UWNyhOKbvF

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up - Bad Disease & Bad Outcomes. COVID consequences, TNFi Switching in SpA, psychosis in lupus? Watch it here> https://t.co/ced3cKg5eB or listent to podcast on iTunes> https://t.co/FHJv01AAbC or SoundCloud> https://t.co/e4nWr3wECz

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Dr. John Cush RheumNow ( View Tweet)

Another case of COVID-19 Arthritis; 58 yoF w/ non-severe COVID-19, (by qRT-PCR ) had arthralgia, fever, cough, nausea, diarrhoea, dysgeusia, and devloped ankle arthritis CRP 7·36 mg/L, lymphopenia (1·29) persistent arthritis (by US) and +Sars-CoV-2 in SF. https://t.co/4Pg1Vq30EN

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Dr. John Cush RheumNow ( View Tweet)

Comparison of 34,128 COVID and 84,585 influenza pts; COVID-19 patients have been more typically been male, younger, and have fewer comorbidities and lower medication use than flu. (data from USA, South Korea, Spain) https://t.co/VUzVxFdBra

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Dr. John Cush RheumNow ( View Tweet)

To quash the virus, the immune system unleashes an arsenal. Sometimes these weapons turn inward and destroy healthy tissues. Combatting this friendly fire has become as crucial a part of the Covid-19 treatment strategy as subduing the virus itself. https://t.co/FrxVfSleEH

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NYT Health NYTHealth ( View Tweet)

https://t.co/0bh6Mh2pKP
Adam Cifu adamcifu ( View Tweet)
Latest data Global Rheumatology Alliance COVID Registry -2121 pts (40% RA, 17% SLE, 9% PsA), 64% on DMARDs, 33% biologics, 5% JAKi, 34% steroid,27% HCQ, with only 7.6 deaths and 39% hospitalized and 81% resolved infection. https://t.co/g0w4QZHmRl

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Dr. John Cush RheumNow ( View Tweet)

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