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RheumNow Podcast - The SARS-CoV-2 Update (8-14-20)

Jack Cush, MD

Dr. Jack Cush updates the news and journal articles from the past week on RheumNow.com, with information on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors.

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Rheumatic Diseases, Drugs and COVID-19 Guidelines

Jack Cush, MD

Several recent publications have focused on the risk and outcomes of rheumatic disease (RDD) and autoimmune patients who become infected with SARs-CoV-2.

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Latest COVID-19 Numbers from CDC

Jack Cush, MD

Following are the latest CDC numbers for COVID-19 in the U.S., including total cases and deaths; the states with the highest number of COVID-19 deaths; and COVID-19 healthcare case numbers.

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DMARD Use Does Not Increase COVID Hospitalization

Jack Cush, MD

An observational study of patients with systemic autoimmune inflammatory rheumatic diseases (AIRD) who also had COVID-19 disease shows that AIRD increased the risk of hospitalization, but that the use of disease-modifying antirheumatic drugs (DMARDs) were not associated with hospitalization.

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Fighting Hydroxychloroquine Misinformation

Jack Cush, MD

JAMA Internal Medicine has posted an Editor's note on the use of hydroxychloroquine for COVID-19; noting the sequence of dysfunction since the president promoted its use on March 21, 2020, when he said “What do you have to lose? I’ll say it again: What do you have to lose? Take it.”.

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RheumNow Podcast - Top 13 Rheumatology Centers (7-31-20)

Jack Cush, MD

Dr. Jack Cush reviews the news and TOP 13 list of Best Rheumatology Hospitals.

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Colchicine Benefits COVID-19 Patients

Jack Cush, MD

A proof-of-concept study published in Annals of Rheumatic Disease suggests that colchicine significantly improves COVID-19 outcomes.

Efficacy and safety must be determined in controlled clinical trials.he outbreak of COVID-19 posed the issue of urgently identifying treatment strategies. Colchicine was considered for this purpose based on well-recognised anti-inflammatory effects and potential antiviral properties.

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ACR Advice on Reopening Strategies

The American College of Rheumatology (ACR) has issued a guidance document for rheumatologists and rheumatology health professionals to consider as practices, business and patient care begins to reopen in this next phase of the COVID-19 pandemic.

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Prevalence of SARS-CoV-2 Antibodies in Health Care Personnel in NYC - 46 117 were tested. Overall 13.7% were seropositive. For PCR-positive HCP, 93.5% were also seropositive; PCR-negative HCP 89.7% were also seronegative. https://t.co/ZjzQUK6jmW

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Dr. John Cush RheumNow ( View Tweet)

3 pts w/ myasthenia gravis occurring after the onset of coronavirus disease 2019 (COVID-19), all were AChR antibody–positive. MG Sxs begain within 5 to 7 days after fever onset. They postulate neurologic damage from COVID may have autoimmune mechanisms https://t.co/YSy0SYoSmL

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Dr. John Cush RheumNow ( View Tweet)

Ann Int Med reports that the use of ACE inhbitors or ARB use is not associated with more severe COVID-19 disease (High-certainty evidence), and these meds are not associated w/ pos. SARS-CoV-2 tests- based on observational studies w/ 23565 COVID-19 adults https://t.co/px0rMH1Pjz

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Dr. John Cush RheumNow ( View Tweet)

COVID Testing study of 3046 NY Hospital employees (56% Ab testing, 20% RT-PCR, 12% both); found (9.8%) who tested positive for antibodies; Thus SARS-CoV-2 infection among Hospital workers is lower than that reported for the general public. PPE WORKS!

Dr. John Cush RheumNow ( View Tweet)

Virtual Video Joint Exam Pearl #5: Its easier to see gouty Tophi and rheumatoid nodules than nail changes of PsA or subtle rashes. For Rashes and oral lesions its BEST to have the patient take multiple pix with the cell phone and send them in by EMR or Email.

Dr. John Cush RheumNow ( View Tweet)

Virtual Video Joint Exam Pearl #1: pain elicited by cervical lateral bending (in someone w/ otherwise normal Cx ROM) is highly correlated with Tender trigger points in the neck region (hence #FM)

Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up - Top 13 Rheumatology Centers in the US; anakinra & colchicine in COVID, unload the loading dose, CB2 in Scleroderma. Watch it here>> https://t.co/5LIIi7Pwg1 or listen to the podcast here>> https://t.co/5LIIi7Pwg1

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Dr. John Cush RheumNow ( View Tweet)

The only thing worse than bad covid research is a meta-analysis of bad covid research

Vinay Prasad VPrasadMDMPH ( View Tweet)

Important finding of marked lung fibrosis (scarring) after severe #COVID19 in 8 patients https://t.co/Akp6jVXmB9 @TheLancetInfDis (first complete pathologic description of this finding) https://t.co/QCuri3olgs

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Eric Topol EricTopol ( View Tweet)
Full Read comprehensive overview of Cytokine Storm Syndrome in COVID-19. https://t.co/5hkzHG2zHy

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Dr. John Cush RheumNow ( View Tweet)

Retropective study of 22 French severe COVID-19 pneumonia pts - 10 Rx w/ standard-of-care vs 12 with SOC plus IV anakinra (300 mg⋅d−1 x5 d, tapered over 3 d). All of anakinra pts rapidly improved w/ no deaths, less O2, No mech ventilation (P < 0.01) https://t.co/JhYHDZK0A7 https://t.co/YJASi4eMsR

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Dr. John Cush RheumNow ( View Tweet)
The RheumNow Podcast is up - COVID-19 Responds to Steroids & TCZ, statin myopathy, Lung Dz in AOSD, TNFi & Liver, IL-23 in Psoriasis. Watch it here>> https://t.co/DrrFZSWmZa or listen to Podcast on iTunes>> https://t.co/FHJv01AAbC or on SoundCloud>> https://t.co/nSPI9lcaY9

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Dr. John Cush RheumNow ( View Tweet)

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