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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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CDC: COVID Seroprevalence in Health Care Workers

MMWR

CDC reports that gmong 3,248 healthcare personnel (HCP) observed, 6% had antibody evidence of previous SARS-CoV-2 infection; 29% of personnel with SARS-CoV-2 antibodies were asymptomatic in the preceding months, and 69% had not previously received a diagnosis of SARS-CoV-2 infection.

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RheumNow Podcast – The Bad News That’s Fit to Print (8.21.20)

Jack Cush, MD

Dr Jack Cush reviews the news and journal reports from the past week on RheumNow: filgotinib rejection, delays in diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX.

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Increased Lupus Anticoagulant Activity in COVID-19 Infection

Jack Cush, MD

JAMA Network Open reports that after adjusting for inflammation, lupus anticoagulant (LA) is significantly increased (positive) in COVID-19 patients and that LA positivity was associated with incidence risk of thrombotic events.

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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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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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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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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)

President Trump took HCQ/Azithromycin.... Lancet Rheumatology reports that HCQ in RA has no cardiac risk but long term HCQ increases risk cardiovascular mortality, that may be further augmented by azithromycin. https://t.co/JRtkkAuEeu

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast is Up! Rheum Lives Matter. More about social change, HCQ, JAKs & skin, growing cartilage, FM exercise. Watch it here>https://t.co/LLvADsDJ5O or listen to the Podcast here>https://t.co/pCXzaJUS9s

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast - The Bad News That's Fit to Print (8.21.20) Dr Jack Cush reviews this week highlights filgotinib rejection, delays in Diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX https://t.co/1oZtU14VOB https://t.co/rcWlbYVKYn

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Dr. John Cush RheumNow ( View Tweet)
To date, the FDA has currently authorized 218 tests under EUAs; these include 176 molecular tests, 39 antibody tests, and 3 antigen tests.

U.S. FDA US_FDA ( View Tweet)

Study of 2 Canadian centers finds amongst 2095 patients taking biologics for #Psoriasis, 23 (1.1%) stopped their biologic for "COVID-19 related concerns". 5/23 restarted biologic for PSO flares. This included TNFi, inhibitors of IL17, IL12/23, IL23 https://t.co/gjSX4P0LMK

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Dr. John Cush RheumNow ( View Tweet)

COVID-19 child case count now over 400,000 https://t.co/bRYvZ5AoYt https://t.co/JhEbvncUbr

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Dr. John Cush RheumNow ( View Tweet)
Preprint analyses of RCTs and 11 nonRCTs showed JAK-inhibitor use in COVID-19 reduced mortality (OR 0.12; 0.03-0.39) & ICU admission (OR 0.05; 0.01-0.26). Similarly Type I interferon Rx also significantly reduced mortality (OR, 0.19; 0.04-0.85, p=0.03) https://t.co/NqKCGzcfwF

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Diabetes is a risk factor for COVID mortality; yet Metformin dramatically lowers mortality in a preprint, unreviewed paper - retrospective EHR review of 25,326 subjects COVID tested at UAB; metformin signif reduced mortality risk in DM w/ COVID (OR 0.33) https://t.co/DvZ4b3al1Y

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Dr. John Cush RheumNow ( View Tweet)

NJ study of 764 ICU COVID-19 pts, 210 (27%) received tocilizumab. TCZ treated patients had a lower death rate (49% vs 61%) (HR 0·64, 95% CI 0·47–0·87; p=0·004). Similar results seen in those requiring mechanical vent. or CRP >15 mg/dL https://t.co/idZTDunG1a

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast - The SARS-CoV-2 Update (8-14-20) Dr. Jack Cush highlights the latest numbers on COVID-19 and its impact on Rheumatic Patients. Also, Top 4 best sellers, new take on NR-Ax-SpA & enthesitis https://t.co/IJAHGynSNd

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up: The SARS-CoV-2 Update with info on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors. Watch it here> https://t.co/1WUZQJajgW or podcast listen here>> https://t.co/IJAHGynSNd

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Dr. John Cush RheumNow ( View Tweet)

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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