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Faith and Miracle Larry

Mar 17, 2023

This week on the podcast, Dr. Jack Cush recalls what life was like early on during COVID, from March to June of 2020.  During this time, his close friend, Larry, contracted COVID-19 and was hospitalized, intubated and put on mechanical ventilation for nearly 2 months. Larrys recovery from the

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CDC: Nursing home residents not up to date w/COVID-19 vaccines have 30%–50% higher risk for COVID infx vs those up to date. Betw 2022-23 Those vax had COVID rate of 7.2-15.6/1000pts vs 9.5-18.8/1000 pt in those unvaccinated.
UK Database 1,955 breakthrough COVID-19 infxs in 54,576 #gout pts compared to 52,468 w/o gout saw more in gout (adj HR 1.24), also w/ more #COVID hospitalizations (adj HR 1.30) & death (1.36), more so in women. Same for unvaccinated
Autoimmune Dz may be assoc w/ new-onset Atrial Fibrillation, esp in women. Population-based UK Biobank found significant increases for AFib in Rheumatic fever w/o CVD (HR 1.47), Crohn’ (1.23), UC(1.17), RA (1.39), PAN (1.82), SLE (1.82), PSS (2.32)

2022 Rheumatology Year in Review (1-6-2023)

Jan 06, 2023

Dr. Jack Cush reviews the best of 2022 in Rheumatology - highlights on new drug indications, breakthrough lupus therapies, new biosimilars and the multivitamin letdown.

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Should Kids w/ MIS-C get the COVID vaccine? Yes - study of 385 pt > 5 yrs w/ Hx of multisystem inflammatory syndrome showed no serious adverse events after COVID-19 vaccination. The safety profile of COVID-19 vax is same as gen population
On Wednesday 12/21 the FDA approved tocilizumab (Actemra; 8 mg/kg, 60-min IV infusion ) for hospitalized COVID-19 on steroids, supplemental O2 & req ventilation, or ECMO; 1st MAb approved for COVID-19; Prev EUA issued in June 2021
COVID-19 Vaccine Responses in Rheumatic Disease Patients Nature Reviews Rheumatology features a review of three notable papers that address the impact of SARS-CoV-2 vaccination on people with inflammatory rheumatic disease.

COVID-19 Vaccine Responses in Rheumatic Disease Patients

Dec 16, 2022

Nature Reviews Rheumatology features a review of three notable papers that address the impact of SARS-CoV-2 vaccination on people with inflammatory rheumatic disease. 

Studies on the efficacy and safety of the COVID-19 vaccines, have shown rapid and strong development of immunity in

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During 2021–22 FLU season, 6% of hosp pedi-influenza pts had SARS-CoV-2 coinfection; these required more respiratory support. Risk of influenza death augmented by not recv vaccination (flu or covid), no antiviral Rx, comorbidities & coinfx w/COVID
Recent CDC/MMWR report shows Paxlovid x 5days (including those w/ prior COVID or vaccination), had a 51% lower hospitalization rate within 30 days after diagnosis than those not prescribed Paxlovid. Use it irrespective of vaccination status
TIME Mag - "Why Masks Still Matter". 1) COVID is still out there; 2) Influenza on the rise. Authors write "With limited yet mixed data, we would be wise to ...err on the side of masking in high risk, indoor crowded public settings..."
Does Evusheld shield people living with rheumatic diseases? Dr. Yuz Yusof ( @Yuz6Yusof) discusses three key abstracts from #ACR22 on Evusheld findings.
COVID Highlights Dr. Leonard Calabrese and Dr. Cassandra Calabrese share highlights on COVID data being presented at #ACR22
Impact of COVID 19 on Pregnancies in Women with RMD Dr. Cassy Sims ( @DrCassySims) discusses abstract 0950 at #ACR22.
Vaccination +/- prior Covid-19, and with either mRNA or vectored DNA vaccines were not associated with AIRD flares. Negative association 21-days after 1st Covid-19 vaccination and no association after 2nd or 3rd doses. Nakafero G Abs#2194 #ACR22 @RheumNow
Problem w antibodies to prevent #COVID19 infection in rheumatic Pts is that they are not as good in variants that are more prominent ex Omicron strains. But should we use in high risk Pts ex long rituximab users? I do in this group. @RheumNow #ACR22
L08 #ACR22 TIX/CIL (Evusheld) in Rheum Pts 157 pts, f/u 154 days 24 breakthrough COVID ifns (15%) 2 pts required hospitalization, rest had mild-mod symptoms No SAEs (CVD) @RheumNow
In a prospective cohort where MTX was withheld for 1 week post COVID vaccine, antibodies higher than other DMARDs which were continued (mostly RTX/MMF). Good to see more direct data rather than having to extrapolate from flu. @RheumNow ABST0913 #ACR22
Even young SLE patients are still at high risk of severe COVID: - in general pop, age is key factor - in SLE, risk is high across age groups (maybe due to both meds & disease) - vaccination makes a big diff but SLE pts still at high risk ABST1591 @CCalabreseDO #ACR22 @RheumNow

Vaccine Efficacy in Patients with Seronegative Spondyloarthritis

Nov 14, 2022

Vaccine efficacy remains an important and highly discussed topic at this year’s annual meeting given the ongoing COVID-19 global health crisis, current influenza season, and recently published 2022 ACR guidelines for vaccinations in patients with rheumatic and musculoskeletal diseases.

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#ACR22 Abstr#1756 More data on safety of #COVID vaccine to cite when counselling patients with inflammatory arthritis (IA). Data from COVAX registry (over 7000 pts) showed rates of serious adverse event was low 0.3% vs 2.5% in those with non-IA RMD group @RheumNow
The pandemic has brought many challenges to our community. One of them is the lingering effects of COVID-19. #PASC #COVID #ACR22 #RheumTwitter
All monster stories end with an unexpected award: A new order @cuttingforstone at #ACR22 tells the monster story of #covid “How will history review our story?” The science will get an A+, but we failed to learn the lessons of history All was predictable through history @RheumNow
Everyday heroes during #COVID19 Keynote @ACRheum Health care workers who were minorities disproportionately died in the early days of the pandemic. Can’t be all SES as risk but maybe ‘status’ as first line workers. Remember them #ACRBest #ACR22 @RheumNow @AbrahamVerghese 🙏🏻