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Hydroxychloroquine Fails as Pre-exposure Prophylaxis for COVID-19

Jack Cush, MD

Numerous previous studies have questioned the efficacy or protection afforded by hydroxychloroquine (HCQ) for COVID-19 and studies have show that HCQ has failed when given as post-exposure prophylaxis to health care workers (HCWs).  A new randomized controlled trial has shown that HCQ failed when given as 8 weeks of pre-exposure prophylaxis in hospital-based HCWs exposed to patients with COVID-19 patients. 

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Young Adults are Driving Up COVID-19 Rates

CDC/MMWR

CDC reports that since June 2020 individuals infected with COVID-19 have largely been young adults in the 20-29 year age bracket. Moreover, younger adults appeared to be driving community transmission of COVID-19. 

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purpura

Livedo, Purpura and Coagulopathy in Severe COVID-19

Jack Cush, MD

JAMA Dermatology expands the spectrum of complications seen with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection describing cutaneous purpura and livedo lesions in patients with severe COVID-19.

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CDC Reverses Guidance for Asymptomatic COVID Contacts

Jack Cush, MD

Asymptomatic people who have been exposed to COVID-19 should be tested, the CDC said on Friday, in a reversal of controversial guidance the agency introduced in late August.

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RheumNow Podcast – Lupus Delights (9.18.20)

Jack Cush, MD

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

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COVID-19 Risks in Pregnant Women

Jack Cush, MD

There has been little science or evidence regarding the effects of COVID-19 infection on pregnancy and vice versa; and now the recent MMWR addresses the subject with two new reports

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RheumNow Podcast – To Celiac Test or Not? (9.4.20)

Jack Cush, MD

Dr Jack Cush reviews the news, journal articles and takes a few Back Talk questions this week:

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COVID and the Multisystem Inflammatory Syndrome in Children

Jack Cush, MD

Lancet Infectious Disease has reviewed the epidemiology, causes, clinical features, and current treatment for the multisystem inflammatory syndrome in children (MIS-C) and adolescents associated with COVID-19, noting severe organ damage can occur pediatric COVID-19 patients who are severely ill.&

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Swiss cohort of 666 axSpA, RA & PsA pts seen before, during & after COVID; consults dropped 52%, remote visits increased 129%, & non-compliance slightly increased during COVID (axSpA 20% vs 13% before, p=0.003); but no incr in flares(<15%) or Dz activity https://t.co/lWb7WCwGbN

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up! Cardiovascular Risk in Psoriatic Disease, Higher COVID rates in young adults, Reimbursements for Rheumatologists and more. Watch here>> https://t.co/cBHTeUQhff or liste to podcast here> https://t.co/KBgmsoGRzU or on iTunes> https://t.co/FHJv01AAbC

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Dr. John Cush RheumNow ( View Tweet)

As of 20 Sept, CDC reports total US COVID-19 deaths to be 198,754. In the last 7 days 281,490 new Cases. Trends flat averaging ~40,000 Cases per day and ~600-1100 deaths per day. https://t.co/CPLVhz6qeH

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Dr. John Cush RheumNow ( View Tweet)

Thank you all who participated in the survey. Here are some of our results #Covid_19 #rheumatology https://t.co/55ETf6kK6T

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Bella Mehta bella_mehta ( View Tweet)

The RheumNow podcast is up! Lupus delights - Lupus & Diet, Drug induced lupus & brand new biologics for SLE. Good news on immunosuppressives, colchicine and baricitinib in COVID-19 patients. . Watch it here https://t.co/Ymsd3eXN5d or listen to the podcast https://t.co/20FOr3qu3X

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Dr. John Cush RheumNow ( View Tweet)

Retrospective cohort study of 213 IMID patients, 36.2% tested positive for COVID-19, who had no greater risk of hospitalized or ventilation and immunosuppressive use was not shown to worsened the course of disease (TNFi decreased risk of hospitalization) https://t.co/gmIXDJkLCt

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Dr. John Cush RheumNow ( View Tweet)

Baricitinib in combo with Remdesivir reduces time to recovery in COVID-19 hospitalized pts in NIH-run ACTT-2 Trial w/ >1000 pts randomized to recv 4-mg baricitinib plus remdesivir versus remdesivir alone. Other baricitinib-COVID trials are in progress https://t.co/J87Ypeb4mn

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Dr. John Cush RheumNow ( View Tweet)

Proof-of-concept study colchicine use in the context of COVID-19 infection leads to better survival. 140 consecutive COVID inpatients were Rx w/ standard of care +/- Colchicine. Survival rate @21d was better w/ colchicine (84% vs 64%;p=0.001). https://t.co/OzYd7pZ2ys

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Dr. John Cush RheumNow ( View Tweet)

Danish matched (1:4) cohort study shows COVID-19 pts taking NSAIDs had no greater risk of mortality, hospitalization, ICU admission, mechanical ventilation, or renal replacement therapy; study included 9,236 COVID PCR-positive & 2.7% were on NSAIDs https://t.co/OuUbJ9FxiM

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Dr. John Cush RheumNow ( View Tweet)

Cell phone use and location data during the COVID pandemic shows greater reductions in cell phone activity in the workplace and retail locations, and greater increases in activity at the residence, are associated with lesser growth in COVID-19 cases. https://t.co/3tRAbqqy4i

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Dr. John Cush RheumNow ( View Tweet)

Another metanalysis of Chloroquine, HCQ, or azithromycin in COVID-19 shows HCQ not associated w/ reduced mortality (RR=0.83; 0.65-1.06) in hospitalized COVID-19, but combo of HCQ & azithromycin significantly increased mortality (RR=1.27; 1.04-1.54) https://t.co/xGEGyywxBJ

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Dr. John Cush RheumNow ( View Tweet)

Sanofi suspended Kevzara (sarilumab; 200 or 400 mg) studies in severe hospitalized COVID-19 infx - phase 3 trials didnt meet primary or secondary endpoints vs PBO. 420-Pt multinational trial had similar SAE and death rates in all 3 arms https://t.co/YkuKnVm9B8

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Dr. John Cush RheumNow ( View Tweet)

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