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COVID 19 Updates from RheumNow

TNR Grand Rounds: IL-6 in Health and Disease

Dr. Len Calabrese from the Cleveland Clinic delivers this week's Tuesday Nite Rheumatology Grand Rounds, entitled "IL-6 in Health and Disease: Where Rheumatology Meets COVID-19".

Hydroxychloroquine's World of Confusion - What you Need to Know

Hydroxychloroquine has been a dominant news item since the start of the COVID-19 crisis, with a great deal of misconceptions by those who don't know or use or take the drug. HCQ leaped to the headlines on March 19th when President Trump endorsed the drug as being “approved” by FDA.

ACR: In-Person Urgent vs. Virtual Non-Urgent Medical Care

On April 26, 2020 the American College of Rheumatology (ACR) published a guidance paper to assist rheumatologists and rheumatology health professionals in assessing the need for urgent or face-to-face medical care versus virtual or telehealth patient care.  The driving principals being the need t

Hydroxychloroquine and QTc Prolongation

JAMA Cardiology reports the risk of QT (QTc) prolongation when hydroxychloroquine (HCQ) was given to hospitalized patients with coronavirus disease 2019 (COVID-19), especially when given with azithromycin. 

German Society of Rheumatology COVID Pandemic Recommendations

The Annals of Rheumatic Disease has published the preliminary recommendations of the German Society of Rheumatology for the management of Inflammatory rheumatic diseases patients during the SARS-CoV-2/Covid-19 pandemic. 

Rheum Views on the Upside and Downside of COVID-19

The world has been turned upside down in the last 6 weeks. Medicine and rheumatology have certainly changed – a frightening experience for Chicken Little, a disaster for the pessimist, a challenge for the pragmatist and an opportunity for the optimists amongst us.

IL-6 Inhibitors May Benefit COVID-19 Infection

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.

Sarilumab (Kevzara)

High Dose Chloroquine Harmful in Severe COVID-19

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.

RheumNow Podcast – In Times of Trouble (4.24.20)

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

Potential Role of B Cells in COVID

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.

NIH Consensus Guidelines for the Treatment of COVID-19

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.

TNR Grand Rounds - Moving Forward with Telemedicine

Dr. Alvin Wells gives a primer on Telerheumatology and Telemedicine in the era of COVID-19.

Social

Check out a great Grand Rounds by Dr. Len Calabrese @LCalabreseDO on "IL-6 in Health & Disease" - great 30 min lecture and great Q&A session - Bravo Lenny! https://t.co/eWTKotQya3

Dr. John Cush RheumNow( View Tweet)

3 weeks 6 days ago
Case report of a stable GPA patient treated with pred and Rituxan on 3/5, developed COVID Sxs next day, progressed to high fever, resp failue, mech ventilaion, Rx with antivirals, HCQ; extubated day 20, negative PCR x2 and discharged day 29. https://t.co/SSSKRbYK2R

Dr. John Cush RheumNow( View Tweet)

3 weeks 6 days ago
World Scleroderma Found Recs on COVID 1) SSc w/ Lung dz may be at risk; 2) Cont Rx & avoid SSc lapse in Rx; 3) SSc pts dont need testing unless Sx+; 4) ACE/ARBs BP meds continued; 5) Initiating preventative Rx w/ HCQ is not recommended https://t.co/8BUE6tLLTi

Dr. John Cush RheumNow( View Tweet)

4 weeks 1 day ago
On May 1st the FDA issued "emergency use authorization" for intravenous use of Remdesivir in patients hospitalised with suspected/confirmed severe COVID-19 infection - defined as SpO2 ≤ 94%, need for O2, mech ventilation, or ECMO. https://t.co/XnBaclhPKm

Dr. John Cush RheumNow( View Tweet)

1 month ago
Pilot study of COVID+ pts treated with antiviral therapy PLUS either Baricitinib or HCQ x2wks shows no changes in clinical/lab outcomes with HCQ/v but better outcomes with Bari for death (0 v 4), CRP *8-->1mg/dl) & discharges (55% v8%) compared to HCQ https://t.co/sTqYHMNOGG

Dr. John Cush RheumNow( View Tweet)

1 month ago
NYC, NYU COVID infected Rheum pts (n 86 RA, PsA, AS, PsO, IBD); 16% Hospitalized. Hosp pts were more likely to be older, w/ HTN, DM, COPD, on Pred, HCQ, MTX, but less likely to be on JAKi, biologic, TNFi (vs ambulatory) https://t.co/UCVndBDc7r https://t.co/ZEk1PFEkXA
Dr. John Cush RheumNow( View Tweet)
1 month ago
ACR has published COVID-19 Recs -American College of Rheumatology Guidance for the Management of Adult Patients with Rheumatic Disease During the COVID‐19 Pandemic by Mikuls Johnson Fraenkel Arasaratnam Baden Bermas Chatham https://t.co/wwpslcLXx2

Dr. John Cush RheumNow( View Tweet)

1 month ago
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

Dr. John Cush RheumNow( View Tweet)

1 month ago
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

Dr. John Cush RheumNow( View Tweet)

1 month ago
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

Dr. John Cush RheumNow( View Tweet)

1 month 1 week ago
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