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COVID-19

Singapore study of Autoimmune (AIRD) risk w/ COVID infx compared 104 179 DELTA + pts vs 666 575 PCR neg controls (~80+% Vax) & 375 903 Omicron+ vs 619 379 controls (~75% boosted). Found no signif incr risk of AIRD w/ COVID infx. https://t.co/gXzWdotzvL https://t.co/UsQpwgsyTD
Dr. John Cush @RheumNow( View Tweet )
The new Covid KP.2 booster vaccines are becoming available throughout the US. Besides high-risk (e.g. age 65+, immunocompromised, comorbidities), one of the most important reasons to get boosted, often overlooked, is to reduce #LongCovid risk by ~50%. Agree with Marks at FDA… https://t.co/SgX7JiPRzH https://t.co/i0W4xadxjW
Eric Topol @EricTopol( View Tweet )
Anti-Inflammatory Diet yields a lower risk of Dementia. UK Biobank study shows patients w/ type 2 diabetes, heart disease, or stroke who were on an anti-inflammatory diet had a 31% lower risk for dementia vs. a pro-inflammatory diet https://t.co/OjHq3BBOfd https://t.co/tG9vO59IEc
Dr. John Cush @RheumNow( View Tweet )
3+ million persons died in USA in 2023. Overall age-adjusted death rate in 2023 was 6.1% lower than 2022. Overall death rate highest among non-Hispanic Blacks or African Americans. The number of COVID-19 deaths was 68.9% lower than in 2022 https://t.co/Oqgxcs4yUz https://t.co/lDn1PuEQ5Z
Dr. John Cush @RheumNow( View Tweet )
Study of 4378 pts COVID tested betw 2020-22, found low risk (3-4%)of myalgic encephalomyelitis/chronic fatigue syndr (ME/CFS) subsequent to SARS-CoV-2 infx, w/ no difference betw COVID test pos & neg. (OR 0.84; 0.42-1.67) Not supporting long COVID as FM? https://t.co/M0NWvuxT2n https://t.co/hoW5sVOYcN
Dr. John Cush @RheumNow( View Tweet )
Decline in Physician Trust During the COVID-19 Pandemic AMA reports that following the COVID-19 pandemic US adults trust in physicians and hospitals decreased, and was associated with lower odds of COVID vaccination. https://t.co/3XcMYcnzD3 https://t.co/yiIvOp1o5a
Dr. John Cush @RheumNow( View Tweet )
Arthritis drugs may relieve long COVID lung symptoms University of Virginia SOM researchers have identified a potential treatment for the respiratory symptoms of long COVID after discovering an unknown cause of the condition inside the lungs. https://t.co/4gqVhzOEMg https://t.co/NEysSjRE8c
Dr. John Cush @RheumNow( View Tweet )

Decline in Physician Trust During the COVID-19 Pandemic

JAMA reports that following the COVID-19 pandemic US adults trust in physicians and hospitals decreased, and was associated with lower odds of COVID vaccination.

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Arthritis drugs may relieve long COVID lung symptoms

EurekAlert!

University of Virginia School of Medicine researchers have identified a potential treatment for the respiratory symptoms of long COVID after discovering an unknown cause of the condition inside the lungs.

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@RheumNow The always erudite @LCalabreseDO is no slouch of a debating opponent, however. He acknowledges that the science has been imperfect, too much is wrapped up in it, and that fibromyalgia can teach a lot to long COVID. #EULAR2024 @RheumNow https://t.co/TzR4SMZh9f
David Liew @drdavidliew( View Tweet )
@RheumNow @LCalabreseDO @NIH and Len gives us some key recommendations for better practice for long COVID - for me, equally as applicable to fibromyalgia as to long COVID. Fantastic discussion #EULAR2024 @RheumNow https://t.co/8PnjPEKcOu
David Liew @drdavidliew( View Tweet )
Fantastic long COVID debate: close friends Xavier Mariette & @LCalabreseDO head-to-head, debating whether long COVID is a specific disease or part of fibromyalgia. Xavier argues it looks like any post-viral syndrome, & the immunological signal isn’t there. #EULAR2024 @RheumNow https://t.co/ajKjBSRo2n
David Liew @drdavidliew( View Tweet )
My friend the late, great @philipcrobinson and I wrote @TheLancetRheum about what we could learn from COVID about preventative medicine. https://t.co/55j8rduvyn It's worth us thinking how we can do better by our patients. 18/ #EULAR2024 https://t.co/zlDKYngsu0
David Liew @drdavidliew( View Tweet )
Anakinra in COVID showed mixed (often negative) results. But this Turkish retrospective observational study comparing standard of care to IV anakinra in severe COVID pts. IV ANAK had less thromboembolic event (5% vs 12.3%, p = 0.038), better survival https://t.co/4webWJKEfB https://t.co/85GnCd6N8O
Dr. John Cush @RheumNow( View Tweet )

ACR’s Run at Goliath (PCPs) (5.31.2024)

Dr. Jack Cush reviews the journal reports and articles from this past week on RheumNow.com. The ACR (and Cush) address their new website designed to educate PCPs and APPs - what do you think?

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National French study finds post COVID Vaccine the IR of PMR (179 cases; RR 7.1/mill) & GCA (54 cases; RR 2.1 /million) were reported 7-10d post vax. These #s are below population incidence rates (1-20/mill for GCA) https://t.co/XvaoWhqs2g https://t.co/BFDy2WKcLx
Dr. John Cush @RheumNow( View Tweet )
Machine learning analysis of retrosp EHR data (3/20-9/22) on 2+ million showed COVID (5.3%) outcomes in #IMID pts not linked to DMARD or IMID Dx; but rather to age, unvaccinated, & comorbidities (Afib, CAD, CHF, CKD, COPD, CA, liver Dz) https://t.co/aMmJD5P9cc https://t.co/Yy9FuCvol4
Dr. John Cush @RheumNow( View Tweet )
September 2023, CDC’s recommended the updated 2023–2024 booster COVID Vaccine (monovalent XBB.1.5). MMWR study shows only 18% of high risk (immunocompromised) recv'd it. Vax was 38% effective at preventing COVID hospitalization https://t.co/vf5jkMkPwj https://t.co/c55SuIuaDb
Dr. John Cush @RheumNow( View Tweet )
Post-COVID POTS? Neurology cohort study of 16 pts - 81%F, mean age 36. Common Sxs: - Palpitations & Fatuge in 2/3 - in <1/3: migraines, IBS, Raynaud’s - Variable tilt test but High autonomic Sxs No insights on Rx... https://t.co/I7MLjHAUDb https://t.co/hWnfJ9WWPX
Dr. John Cush @RheumNow( View Tweet )
MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children MIS-C is a rare but serious condition typically occurring 2–6 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. https://t.co/PN2MPQxqSR https://t.co/eIzB4pjner
Dr. John Cush @RheumNow( View Tweet )

Ides of March (3.15.2024)

Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.





  1. Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory

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MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children

CDC

Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 2–6 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement.  The current MMWR report shows that MIS-C case numbers have decreased by 98% since 2021.

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COVIDs Extended Risk for Rheumatic Disease Annals of Internal Medicine reports a large, binational study finding SARS-CoV-2 infection was associated with an increased risk for AIRDs that extends up to 12 months after infection. https://t.co/HjQ56hiiny https://t.co/vvC3iVqNyF
Dr. John Cush @RheumNow( View Tweet )

COVIDs Extended Risk for Rheumatic Disease

EurekAlert!

Annals of Internal Medicine reports a large, binational study finding SARS-CoV-2 infection was associated with an increased risk for autoimmune inflammatory rheumatic diseases (AIRDs) that extends up to 12 months after

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False positive COVID tests (+Rapid Ag; neg PCR) are rare, 1.7% of 11,297 tests; Persistent false positives seen in 13/191 and usually in women, with autoimmune dz (6/13; RA, SLE etc) & using the Quidel QuickVue rapid antigen test https://t.co/Pqkk7uBVcO https://t.co/m6ylQz00Ih
Dr. John Cush @RheumNow( View Tweet )