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Characteristics Underlying Mortal COVID-19 Outcomes
From January 1, 2020–May 18, 2020, approximately 1.3 million cases of coronavirus disease 2019 (COVID-19) and 83,000 COVID-19–associated deaths were reported in the United States.
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RheumNow Podcast – LTF – Listen to Fauci (7.17.20)
Dr. Jack Cush reviews the news, tweets and journal articles from the past week on RheumNow. Let's dig into this week's 14 highlights.
Anti-Rheumatic Therapies for COVID-19 Infection
Since the onset of the COVID-19 pandemic numerous anti-rheumatic therapies have been proposed as being potentially beneficial. The mechanistic effects of these agents, either presumed antiviral, anti-inflammatory and anti-thrombotic effects, may benefit mitigate the damage seen with COVID-19 infection.
This review will examine the potential benefits and existing evidence for treating suspected or proven COVID-19 infection with antimalarials, inhibitors of interleukin-6 (IL-6) or interleukin-1 (IL-1) Janus kinase (JAK) inhibitors, TNF inhibitors or colchicine. There are many other antirheumatic and immunosuppressive therapies that are in clinical trials that will not be reviewed here including IVIG, rituximab, calcineurin inhibitors (sirolimus, etc.), apremilast, emapalumab (anti-IFN gamma), etc.
Growing Risk of COVID Among Adolescents
The risk COVID-19 infection and mortality in the U.S. has been closely correlated with increasing age. However, recent data suggests that young adults (aged 18–25 years) have shown an increasing risk of COVID-19 infection since the pandemic began in March 2020.
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Extrapulmonary Manifestations of COVID-19
A new article in Nature Medicine delineates how our understanding of COVID-19 infection has evolved over time, such that the infection outomes may be worsened by extrapulmonary manifestations; notably thrombotic, cardiac, renal, gastrointestinal hepatic, neurologic, and other complications.
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ICYMI: Protective Benefit of Colchicine in COVID-19 Infection
Colchicine has been advocated as a potential anti-inflammatory intervention in patients with the coronavirus 2 infection and clinical trials have been developed to assess its effect in early COVID-2 infection. JAMA has published a randomized clinical trial showing that low dose colchicine had less clinical deterioration without significant changes in biomarkers, such as high-sensitivity cardiac troponin and C-reactive protein.
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ICYMI: Preventing COVID - Masks, Meters and Eyewear
A Lancet systematic review and meta-analysis provides the basis for physical distancing and the value of making as measures to prevent infection with coronavirus 2 (SARS-CoV-2) or COVID-19.
The analysis included 172 observational studies, no randomised controlled trials and 44 relevant comparative studies involving 25 697 patients.
ICYMI: COVID-19 and Thrombotic Complications
Severe and fatal outcomes with coronavirus infection are often the result of the downstream damage that follows the viral infection. Rising high on the list of complications are the hematologic and vascular complications seen in severely affected patients, so much so that many centers are routinely anticoagulating hospitalized (but not ambulatory) COVID patients.
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