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COVID 19 Updates from RheumNow

Telemedicine: What's Changed and What Needs to be Addressed?

Along with our patients, we've spent the last several months adapting to telemedicine. Following is an update on legislative changes and uncertainties, a look at the care gap that may still exist, and examining the trajectory of telemedicine after the initial rapid growth spurred by COVID-19.

Rheumatic Diseases, Drugs and COVID-19 Guidelines

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

Latest COVID-19 Numbers from CDC

These are the latest CDC numbers for COVID-19 in the USA:

  • TOTAL CASES  5,119,711  (55,540 New Cases since yesterday)
  • TOTAL DEATHS 163,651   (1,244 New Deaths since yesterday)

States with the highest number of COVID-19 deaths:

DMARD Use Does Not Increase COVID Hospitalization

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.

Rheuma-Yogi-ology

Kathryn Dao, MD and Deedre Morales

Since the start of the pandemic, my emotions have swung like the pendulum of the hydroxychloroquine efficacy/inefficacy for COVID-19 debate. The highs and lows can be extreme.

Fighting Hydroxychloroquine Misinformation

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.”.

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

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

Colchicine Benefits COVID-19 Patients

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

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.

RheumNow Podcast – COVID-19 Responds to Steroids (7.24.20)

Dr. Jack Cush reviews the News and Journal Reports from the past week on RheumNow.com.

Low Risk of COVID in Biologic Treated Rheum Patients

In an Annals of Rheumatic Disease report, Italian investigators performed consecutive testing for SARS-CoV-2 (IgM and IgG) between 25 March to 25 May 2020 and compared test results between rheumatic disease (RMD) patients and the general population. 

Rapid Loss of SARS-CoV-2 Antibodies in Mild Disease

According to a small, observational study out of UCLA published as correspondence in the NEJM on July 21, 2020, those with mild COVID-19 symptoms showed an approximate antibody half-life of 73 days.

Social

#ACR21 L17: Heterologous vs Homologous Booster vax ▶️RTX non-responders to mRNA: Randomized to mRNA 3rd dose vs AZ vax ⭐️Majority of pts develop immune response (humoral and/or cellular) after 3rd dose, no statistical diff b/w groups @Rheumnow https://t.co/cuM9LcEr4u https://t.co/cmNBNSIoOl
2 years 5 months ago
What to do w Rituximab users and #COVID19 vaccine? #Rituximab no seroconversion 30% with 2 #COVIDVaccination. With 3rd vaccine dose up to 94% can have immune response! Pts need their 3rd vaccination @RheumNow #ACR21 #ACRBest abstL17 https://t.co/0GHOuoqPKQ
2 years 5 months ago
👉29% of pts on RTX fail to mount a humoral OR cellular response to #COVIDvaccine & have⬆️hosp,⬆️hosp stay,⬆️severity, persistent viremia,⬆️deaths) 👉study adding booster (AZ or mRNA) overcomes this, enhancing humoral and cellular response #ACR21 @rheumnow Abst#L17 https://t.co/yuX1TT6ZBF
TheDaoIndex @KDAO2011 ( View Tweet )
2 years 5 months ago
Very interesting talk Abst L16 Singh & colleagues found that patients with rheumatic diseases are at increased risk for breakthrough infxn - Recent drug exposure and certain medication type can influence outcomes - Findings support need for 3rd dose in RD pts #ACR21 @RheumNow https://t.co/vU6ZNIEWbc
Akhil Sood MD @AkhilSoodMD ( View Tweet )
2 years 5 months ago
USA EMR (N3C) Data on 577,335 Rheum Pts w/18,164 #COVID19 breakthrough infx (BTI) 👉91% vax'd 👉3.1% w/BTI 👉86% were vax'd May 2021 or earlier 👉More BTI w/Pfizer 👉BTI higher in inflamm myositis, RA 👉Drugs assc w/BTI: biologics, mult DMARDs #ACR21 @rheumnow Abst#L16 #ACRbest https://t.co/Eu77vAAk3N
TheDaoIndex @KDAO2011 ( View Tweet )
2 years 5 months ago
#ACR21 L16 - Breakthrough #COVID19 in rheum pts ⭐️Breakthrough ifn ~4%, compared to 3% wo rheum disease. Statistically signif ⬆️ risk in RA, gout, polymyositis, vasculitis, multiple rheum disease ⭐️bDMARD, multiple AIRD risks @Rheumnow https://t.co/cuM9LcEr4u https://t.co/Los2n7BoIn
2 years 5 months ago
Great case where the #COVIDvaccine was blamed, but he had a diet of doughnuts, steak&cheese sandwiches w/snack cakes, and popsicles. #ThievesMarket #ACR21 @rheumnow https://t.co/J78Nw5NhKs
TheDaoIndex @KDAO2011 ( View Tweet )
2 years 5 months ago
Abst1625 #ACR21 @RheumNow study of kids w/covid induced MIS-C: 91% w/shock & GI ax, conjunctivitis & mucocutaneous involvement. ⬆️CRP,D-Dimer, Troponin, &BNP. On ECHO, 36% had myocardial dysfunction &27% coronary artery abnormalities. 64% required ICU admiss. Rx IVIG& steroids

Olga Petryna @DrPetryna ( View Tweet )

2 years 5 months ago
#SARSCoV2 infections in vaccinated pts w/ #rheumaticdisease @rheum_covid @rheum_cat 👉🏼Most pts with breakthrough infections were on anti-metabolites or B-cell depleting therapies 👉🏼Encourage patients to get their #BoosterShot! Abs#L04 #ACR21 @RheumNow https://t.co/TAB4zrjPN1 https://t.co/z0gpsxN3xc
Mrinalini Dey @DrMiniDey ( View Tweet )
2 years 5 months ago
#ACR21 Ab#L02 - #COVID19 vax in rheumatic pts: ❌No ⬆️ in disease activity scores post-vaccination ❌No serious adverse event ▶️Vax response 88% in RA, 78% in SLE, 87% other rheum diseases after 2 shots vs 100% controls ⭐️RTX and MMF ⬇️ responses @Rheumnow https://t.co/BChhmW0jpy https://t.co/2q8IKRoYqW
2 years 5 months ago