COVID-19: Dexamethasone [RECOVERY trial]

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We are bringing you near-daily updates on COVID-19. There is a firehose of information and most of us are too busy to read and digest it all. Note: If you are listening to these more than a few days in the future, please beware that information may have changed and check subsequent episodes. This episode was recorded June 22, 2020

We’ve been looking at a treatment for severe COVID-19 and this massive trial from the United Kingdom, the RECOVERY trial [protocol], published a pre-print of the results of the dexamethasone portion of the trial. Note: these results are preliminary and have not been peer reviewed

Hornby et al [pre-print]

COVID-19: Mask Fit and Filtration with Re-use and Sterilization

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We are bringing you near-daily updates on COVID-19. There is a firehose of information and most of us are too busy to read and digest it all. Note: If you are listening to these more than a few days in the future, please beware that information may have changed and check subsequent episodes. This episode was recorded June 19, 2020

Throughout the COVID-19 pandemic in the United States, personal protective equipment (PPE) shortages have plagued health care workers and institutions, leading the extended use and reuse of N95 respirators and the use of KN95s from China. These studies provide some insight into the effectiveness and potential problems associated with some of these protocols

Cai et al. JAMA Network Open 2020
Degesys et al JAMA 2020

COVID-19: How early was SARS-CoV-2 in the community in the US?

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We are bringing you near-daily updates on COVID-19. There is a firehose of information and most of us are too busy to read and digest it all. Note: If you are listening to these more than a few days in the future, please beware that information may have changed and check subsequent episodes. This episode was recorded June 11, 2020

Many have wondered whether SARS-CoV-2 was coursing through our communities prior to the outset of the pandemic – perhaps lurking, undetected in flu season? Post-mortem testing revealed 2 deaths in WA and CA from 2/6 and 2/17 that tested positive, adding to this worry.  Jorden et al in CDC MMWR triangulate data from several sources to investigate this.

COVID-19: Mental Health

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We are bringing you near-daily updates on COVID-19. There is a firehose of information and most of us are too busy to read and digest it all. Note: If you are listening to these more than a few days in the future, please beware that information may have changed and check subsequent episodes. This episode was recorded June 9, 2020

Smalley et al Am J Emerg Med 2020
Castro et al. JAMA Network Open 2020
Xie et al JAMA pediatrics
McGinty et al JAMA 2020

COVID-19: Convalescent Plasma RCT Update

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We are bringing you near-daily updates on COVID-19. There is a firehose of information and most of us are too busy to read and digest it all. Note: If you are listening to these more than a few days in the future, please beware that information may have changed and check subsequent episodes. This episode was recorded June 4, 2020

Check out our primer on an intro to convalescent plasma in COVID-19

Li et al JAMA 2020

COVID-19: Inconsistencies in hydroxychloroquine data in the Lancet

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We are bringing you updates on COVID-19.  Note: If you are listening to these more than a few days in the future, please beware that information may have changed and check subsequent episodes. This episode was recorded May 30, 2020

On May 22, the Lancet published a study by Mehra et al that reported an analysis of an enormous international registry of 96,032 patients with COVID-19 that reported patients who received hydroxychloroquine, chloroquine, or these drugs combined with a macrolide had higher risk of mortality. This led to the WHO halting trials. At the same time, remdesivir’s popularity rose and the future for HCQ became bleak. However, some of the numbers just didn’t add up…and, it turns out, it is possible that the data was fabricated or some other serious wrongdoing occurred. More than 100 scientists from around the world have authored an open letter (Watson et al) regarding this concern.

There is one other published paper using the Surgical Outcomes Collaboration, unfortunately, this was the large NEJM study on ACE-I/ARBs in COVID-19, which suffers from similarly improbable data …see this thread

https://twitter.com/mikejohansenmd/status/1267132835871305731?s=20

*UPDATE 6/4/20* The authors have issued notices of retraction for both the hydroxychloroquine article as well as the ACE-I/ARB study , citing that they did not have access to the raw data. This is interesting because the NEJM letter is also signed by the author who is the CEO of Surgisphere, who curates the database used in the study, and the corresponding author reported in the original manuscript having full access to the data.