COVID-19

FDA approved the chikungunya virus vaccine (Ixchiq) in 11/23, but recently announced caution and pause use while it investigates Postmarketing Safety Reports of 17 SAE (cardiac & neurologic) & 2 deaths. 6 SAE in the USA, elderly w/ chronic med conditions. ~80K doses of Ixchiq https://t.co/RED8Xab0Ir
Dr. John Cush @RheumNow( View Tweet )
Soluble CD13 (sCD13) has pro-inflammatory effects & is elevated in severe COVID-19. sCD13 is chemotactic, angiogenic, & arthritogenic. In COVID-19, sCD13 was assoc w/ sCD13 severity, ethnicity, inflammation markers, NETosis, & vascular injury/thrombosis. https://t.co/2bKY9NtnCD
Dr. John Cush @RheumNow( View Tweet )
CDC's Committee on Immunization (ACIP) met and recommended: 1. Expand strains for meningococcal vax 2. Lower age for RSV vax > 50y 3. Rec. chikungunya vax for certain travelers - Flu & Covid Vax to be up next mtg 6/25 https://t.co/jInnR5JSxS https://t.co/PXg0HDLgnL https://t.co/Vro5mbjG9R

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Dr. John Cush @RheumNow( View Tweet )
CDC's Committee on Immunization (ACIP) met and recommended: 1. Expand strains for meningococcal vax 2. Lower age for RSV vax > 50y 3. Rec. chikungunya vax for certain travelers - Flu & Covid Vax to be up next mtg 6/25 https://t.co/jInnR5JSxS https://t.co/PXg0HDLgnL https://t.co/4pfZSRrEzi

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Dr. John Cush @RheumNow( View Tweet )
EPIC EHR data assessed pre- & post-COVID. Pt messaging increased w/ pandemic & remained elevated, w/ no change in pt phone calls. MD EHR time/wk increased for all MDs, post COVID-19: (PCP +6.5%), subspecialists (+9.9%), surgeons (+5.2%). https://t.co/nJZw0Ftjqi https://t.co/ty942TGblu

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Dr. John Cush @RheumNow( View Tweet )
EPIC EHR data assessed pre- & post-COVID. Pt messaging increased w/ pandemic & remained elevated, w/ no change in pt phone calls. MD EHR time/wk increased for all MDs, post COVID-19: (PCP +6.5%), subspecialists (+9.9%), surgeons (+5.2%). https://t.co/j8zwPkdmp9 https://t.co/SyYpZwnMfN

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Dr. John Cush @RheumNow( View Tweet )
If COVID was responsible for causing autoimmune Dz (AD), it is possible that Molecular mimicry was in play. Study shows 10nsequence homology between SARS-CoV-2 & AD epitopes; 2) similar MHC binding; 3) of high empirical immunogenicity. https://t.co/WO3gjxhVBw https://t.co/QdqtQMHcpL

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Dr. John Cush @RheumNow( View Tweet )
With GLP-1 agonists, is there a risk of aspiration during gen. anesthesia. Most advise against elective surgery/anesthesia unless the GLP-1 is held for 1-2 weeks. Based on MOA of delayed gastric emptying - 7/8 studies show Incr residual gastric contents in GLP-1, but none… https://t.co/U690OmeqJm https://t.co/Q6kyv9fyVJ
Dr. John Cush @RheumNow( View Tweet )
13% of the ~22 million people with traditional coverage received a telehealth betw 10-12/2023. Expansion of Medicare telehealth coverage during the COVID-19 pandemic is set to expire on March 31 , 2025. Most telehealth will expire if Congress does not act. https://t.co/mVy7s664OX https://t.co/BVH6Hv5553

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Dr. John Cush @RheumNow( View Tweet )
AI,genes

Diagnoses via Immune ‘Fingerprints’

Jack Cush, MD

Science and researchers at Stanford Medicine have reported the use of Mal-ID (machine learning for immunological diagnosis) to analyze B and T cell receptors sequences from human blood, showing the ability to predict health status (healthy vs diseased) and discriminate between distinct

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At RWCS 2025, Dr. Susan Shenoi aptly noted the prevalence of multisystem inflammatory syndrome in children (MIS-C) has declined significantly. Does this indicated herd immunity or the decline of community SARS-CoV-2 (or both)? @ShenoiSusan https://t.co/vY01VDkNVl… https://t.co/c8Qu4OqBSh https://t.co/yZAoRcG6LN

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Dr. John Cush @RheumNow( View Tweet )
TheDaoIndex @KDAO2011 @drcharitydean on emerging public health threats including H5N1 & communicable dz. We need to be monitoring for human to human disease transmissions. There is a high level of concern by large business as they recognize this will affect the supply chain.… https://t.co/T3TZ7LtHQi https://t.co/Ar85A0EcW4
Dr. John Cush @RheumNow( View Tweet )
"Treat for the most likely, mitigate for the catastrophic" @drcharitydean (my hero!). Read her story in "Premonition" by Michael Lewis. She served an impt role in the COVID19 pandemic as a public health officer for CA. Her lecture is on re-inventing yourself. @rheumnow #RNL2025 https://t.co/3ZWgClzez1

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TheDaoIndex @KDAO2011( View Tweet )
Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C) A nationwide cohort study of patients with MIS-C, a life-threatening complication of COVID-19 infection, showed that many had severe disease during the acute phase, but most recovered quickly and had a reassuring… https://t.co/qbV4Z8SX0x https://t.co/VUD5KHeXZH
Dr. John Cush @RheumNow( View Tweet )
CDC/ACIP 2025 new Immunization recommendations w/ new vaccine recs for COVID-19, influenza, meningococcal serogroup B, pneumococcal, & RSV. Influenza vaccines have been changed from the quadrivalent to trivalent formulations. https://t.co/Kh1NXMuhVU https://t.co/CRq87PZ31j

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Dr. John Cush @RheumNow( View Tweet )
Pan American Health Org announces that in 2024 saw largest dengue epidemic in the Americas, >12.6 million cases reported (3x record in 2023); 21,000 severe w/ 7,700 deaths; 90% from Argentina, Brazil, Colombia, Mexico. Most USA cases (FL, HI, TX, AZ, CA) seen in travelers… https://t.co/nhuJIP9Y8v https://t.co/QLju8uRKZ8
Dr. John Cush @RheumNow( View Tweet )
Dengue fever, a mosquitoborne viral illness, is increasing worldwide; during 2024, approximately 13 million cases have been reported in the Americas. 2010–2024, a total of 15,077 (38.6%) patients were hospitalized But the fatality rate is unchanged. 2023 DENV-3 recent outbreak in… https://t.co/BKrEmN4F6G https://t.co/WIXaPeex8Z
Dr. John Cush @RheumNow( View Tweet )
Small, suspended, post COVID randomized trial, guselkumab failed to show efficacy at reducing proteinuria in 33 SLE pts. Wk24 results, 56% placebo vs. 35% GUS for primary end point., No differences in secondary outcomes or adverse events https://t.co/27imkXkbUn https://t.co/yGdDQlu5v3

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Dr. John Cush @RheumNow( View Tweet )
JAMA Patient Quiz - Joint Pain in a Woman Wearing a Face Mask https://t.co/fbUERrmzW4 https://t.co/KMJZqsSyMG

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Dr. John Cush @RheumNow( View Tweet )
COVID Associated Immune Disease Dr. Len Calabrese reports on a session he participated in discussing if Covid-19 is associated or causal for autoimmune disease. Reporting from #ACR24 https://t.co/vFdlf9XVzf https://t.co/JhpglNVIt7

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Dr. John Cush @RheumNow( View Tweet )
A systematic review & meta-analysis by Dr. JBCorrea et al show that the ff immune-mediated dses are assocd w/⬆️ ocurrence risk after covid19 infection 👇 Behcets SpA SS SLE PMR Pso RA Sjogrens T1DM Vasculitis IBD Ask prior covid infexn in pts history @RheumNow #ACR24 abs2614 https://t.co/TIEglPrmvL

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sheila @RHEUMarampa( View Tweet )
Long COVID outcomes in Autoimmune diseases (AID) Abstract 1897: - Long COVID symptoms higher among AID pts vs controls - vaccinated may have protective benefit @RheumNow #ACR24 https://t.co/2SEcbkxfcU

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Akhil Sood MD @AkhilSoodMD( View Tweet )
To stop tsDMARD / bDMARD To improve #COVIDVACCINE response in those w several previous #COVID19 #vaccinations is NOT necessary This will change my practice! #ACR24 @RheumNow @ACRheum https://t.co/WXeqMOEfuA

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Janet Pope @Janetbirdope( View Tweet )

Is #IL1 inhibition for 4 months a winner in #GCA —NOPE Anakinra daily 100mg sc 4/12 Underpowered but equal relapses and d/c #steroids not different #relapses esp after d/c #anakinra N=30 d/c due to #COVIDpandemic #1699 #ACR24 @RheumNow @ACRheum https://t.co/1TgloS5x8O

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Janet Pope @Janetbirdope( View Tweet )
Study on SLE treatments: Compared adverse events of anifrolumab vs. belimumab Similar risks for mortality, sepsis, herpes zoster, dialysis, MACE, PE/VTE, COVID-19, URI, pneumonia, and mental illness #ACR24 @RheumNow abst#1527

Bella Mehta @bella_mehta( View Tweet )

Recent Blogs

Respiratory Burden of RA

Jeffrey Sparks
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Lung complications in RA remain a major issue, termed the “respiratory burden of RA.” Respiratory mortality is one of the leading causes of death for people with RA, particularly those with seropositive RA. Read Post

Best of 2022: Freeze Tag

Kathryn H. Dao, M.D.
mask,covid,people,risk
A beloved childhood game I enjoyed was Freeze Tag. Players would run to avoid being tagged by the person who was “It”.  If you were tagged, you had to “freeze” in your spot until someone was brave enough to come un-tag you.  The game ends when everyone is frozen or if people quit. For over 2 years, I have been living in a real-life “Freeze Tag” game and able to dodge COVID19, until now. Sitting in my room symptomatic and frozen in isolation, I ruminated about my patients who had COVID19 and their experiences. I wanted to share with you three stories of three variants. Read Post
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