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IL-6 Inhibitors May Benefit COVID-19 Infection

Jack Cush, MD

In the last few days there have been encouraging "preliminary" reports that IL-6 inhibition by either tocilizumab or sarilumab may be efficacious in patients with severe coronavirus infections.

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High Dose Chloroquine Harmful in Severe COVID-19

Jack Cush, MD

JAMA Open Network reports an interim analysis of the Brazilian CloroCovid-19 trial showing thta higher doses of chloroquine (CQ) in the treatment of severe COVID-19 was associated with QTc interval prolongation and increased mortality.

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RheumNow Podcast – In Times of Trouble (4.24.20)

Jack Cush, MD

Dr Jack Cush reviews the news, journal reports, twitter feed and COVID developments from the past week on RheumNow.com

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Potential Role of B Cells in COVID

Jack Cush, MD

A pre-proof letter to the editor in the Journal of Allergy and Clinical Immunology presents a series of patients with immunoglobulin deficiency disorders and how they differentially responded when infected with the coronavirus.

They identified seven Primary Antibody Deficiencies patients with COVID-19 infection; five affected with Common Variable Immune Deficiencies and two affected with Agammaglobulinemia, one with X-linked Agammaglobulinemia and one with Autosomal Recessive Agammaglobulinemia.

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NIH Consensus Guidelines for the Treatment of COVID-19

Jack Cush, MD

A National Institutes of Health (NIH) expert panel has developed consensus treatment guidelines for the management of coronavirus (COVID-19). To date no drug has been proven to be safe and effective for treating COVID-19. Moreover, they found no evidence to recommended the use of hydroxychloroquine for prophylaxis or treatment of COVID-19 outside of a current clinical trial.

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TNR Grand Rounds - Moving Forward with Telemedicine

Jack Cush, MD

Dr. Alvin Wells gives a primer on Telerheumatology and Telemedicine in the era of COVID-19. This 1 hour Grand Rounds Presentation includes a 30 minute lecture, followed by stimulating 30 minutes of Q&A with a rheumatology attendee audience.

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COVID-19 and the Slippery Road of Cytokine Storms

RheumNow

Early reports on the COVID-19 pandemic allude to a cytokine storm or hyper-inflammation, especially in patients who succumbed to the illness.

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A Role for Netosis in COVID-19 Infection?

Jack Cush, MD

Journal of Experimental Medicine has published a paper from a consortium of researchers at Cold Spring Harbor Laboratory, the Feinstein Institutes for Medical Research, and the Research Institute of the McGill University Health Centre (RI-MUHC) on the potential of neutrophil extracellula

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HCQ fails to prevent severe COVID19 in 17 SLE pts (w/ CKD, GN, APL, 12 pred, 7 on immunosuppressants).14 hospitalized, 13 viral pneumonia, 11 respiratory failure, 5 ARDS; 3 ARF. Despite good HCQ levels, 2 died, 5 on ventilator, 36% D/C, 1/2 still hosp. https://t.co/e0qLGtF6Nj

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Dr. John Cush RheumNow ( View Tweet)

Health Canada issued a safety alert noting Chloroquine & hydroxychloroquine can have serious toxicities & should only be used under a physicians supervision. Due o concern that some may be directly buying/using CQ/HCQ to treat/prevent COVID-19 https://t.co/ksxveHADZX

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Dr. John Cush RheumNow ( View Tweet)

Sanofi announced early results of phase 2 trial of IL6 inhibitor, sarilumab, showing benefit only in Critical COVID-19 pts. 457 pts given IV Kevzara 400 mg vs 200 mg vs PBO , high dose had fewer deaths (32 v 46 v 55%) & more D/C (53 v 39 v 41%). https://t.co/6q21qJNj2C

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Dr. John Cush RheumNow ( View Tweet)

On April 24, FDA issued a Drug Safety Communication stating HCQ and CQ have not been shown to be safe and effective in COVID-19 and that HCQ/CQ should not be used outside of hospitalized or pts in clinical trials. https://t.co/l2DNBhhvTR

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up! "In times of Trouble". Watch it here>> https://t.co/gapTwq3REW or listen to the podcast on iTunes or SoundCloud>> https://t.co/dpoCoX8qBR

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up! "In times of Trouble". ABA and DM, Zostavax fails, 3d Doubling rate, population testing, HCQ in COVID; Watch it here>> https://t.co/gapTwq3REW or listen to the podcast on iTunes or SoundCloud>> https://t.co/dpoCoX8qBR

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Dr. John Cush RheumNow ( View Tweet)

There’s a saying that anyone driving faster than you is crazy and anyone driving slower doesn’t know how to drive. Similar with COVID-19: anyone taking more precautions than you has an anxiety issue and anyone taking fewer is an idiot.

Adam Cifu adamcifu ( View Tweet)

Dr C Kershaw @UTSWNews grand rounds on ventilation in #COVID19 Why putting pts in prone position might help with ARDS ⁦@RheumNow⁩ https://t.co/I0AOx72Jwl
k dao KDAO2011 ( View Tweet)
ACR Guidance for Rheumatic Disease during COVID-19 pandemic #Rheumatology @RheumNow https://t.co/vHav6g4p6Q
Maeve Gamble MaeveGamble ( View Tweet)
NICE guidelines on managing rheumatologic conditions during COVID-19 #Rheumatology @RheumNow https://t.co/dQcavsno5N
Maeve Gamble MaeveGamble ( View Tweet)
Dr. Kavanaugh said it well in his blog on the "Upside of Covid" Humanity is really shining thru these days. Im truly touched by all my patients who ask about my health and my safety during COVID-19 == we all have to look out for each other! https://t.co/BYI5LHybeV

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Dr. John Cush RheumNow ( View Tweet)

NY State study shows 13.9% of population to be COVID (+) by Antibody testing; (+) means previously exposed. (+) COVID results were not different between all age groups. Given 15,500 deaths in NY, that means the COVID death rate is 0.5% https://t.co/LCDPeBLy2r

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Dr. John Cush RheumNow ( View Tweet)

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