Coronavirus thread

[45dotACP]

peeps or PEEPS?
Sorry, couldn't resist!

Haven't seen any pleurisy associated with it at this point. But continue to see people who just aren't bouncing back like we'd normally expect. Had one last week who keeps getting odd fevers for some reason, despite x-ray looking a lot better.

Trach patient?

We get a lot of patients who had a tracheostomy inserted and ever since just can't keep a normal temp. Can't say we've seen a lot of pleurisy though.

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[YVK]

peeps or PEEPS?
Sorry, couldn't resist!

.

That was good. Both, I guess.

[ccmdfd]

Trach patient?

We get a lot of patients who had a tracheostomy inserted and ever since just can't keep a normal temp. Can't say we've seen a lot of pleurisy though.

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No, not even intubated when she was admitted.

Her fevers are like 102-104, according to her. She had no temp at her OV with me.

[TheRoland]

First UK variation found in CO, and was apparently a community-acquired case. So it's loose there. Not great news.

[DrkBlue]

First UK variation found in CO, and was apparently a community-acquired case. So it's loose there. Not great news.

I am not in the UK, but follow COVID developments there closely.

UK had a new case rate roughly twice (2x) the worst US states (North and South Dakota) during September-October. They have had slightly worse fatalities rate than the US (1.5 to 2%). Their second wave commenced in August, well ahead of the US.

That said, the UK had COVID mostly licked on December 1, after a month-long national lockdown that was roughly middle of the road by US terms (limited businesses open but 100% for schools). The R factor dropped well below 1, into the .8 range. They reopened nationally and the new COVID case numbers stayed low, except in Kent.

Kent blew up, then spreading into London and the rest of the Southeast. In 20 days, the R factor was at 1.3 nationally but still declining where the B.1.1.1 variant is not circulating (North and West). Even after the government put the London and East in the maximal Tier 4 restrictions, the new variant is spreading fast. The 70% more infectious statement seem entirely likely.

No reason to panic, but the new variant is concerning. If the UK activity is replicated in the US, the variant has a strong possibility of becoming the predominant strain by spring for North America. Official statements:
https://www.gov.uk/government/news/c...-virus-variant
https://www.cdc.gov/coronavirus/2019...n/variant.html

[Crusader8207]

I am on day 7 since my positive COVID test. The ONLY symptoms I had was loss of taste and smell. Other than that zero issues. Prior to getting it, I have been on a high dose of Vitamin D3 because of a broken foot (Orthopedic Surgeons orders), magnesium, and zinc. The Oklahoma Health Department Called me yesterday to review my symptoms and try to find out how or where I contracted it. The gal was shocked as to my lack of symptoms. She said from all of the people that she has interviewed, mine appeared to be the least sever case she had heard of. I will tell you the worst part of this has been the psychological aspects, I feel like a damn prisoner. I can't go anywhere. I have been walking my dog 3 miles a day in the woods and working out every night. I am so ready to get this behind me. December 31 is my day of freedom.

[MGW]

I am on day 7 since my positive COVID test. The ONLY symptoms I had was loss of taste and smell. Other than that zero issues. Prior to getting it, I have been on a high dose of Vitamin D3 because of a broken foot (Orthopedic Surgeons orders), magnesium, and zinc. The Oklahoma Health Department Called me yesterday to review my symptoms and try to find out how or where I contracted it. The gal was shocked as to my lack of symptoms. She said from all of the people that she has interviewed, mine appeared to be the least sever case she had heard of. I will tell you the worst part of this has been the psychological aspects, I feel like a damn prisoner. I can't go anywhere. I have been walking my dog 3 miles a day in the woods and working out every night. I am so ready to get this behind me. December 31 is my day of freedom.

I’m on day 7 also. Symptoms are what I would describe as mild but I still feel like shit. Never ran a fever but have experienced pretty much everything else. Wife got sick about the same time. She had almost zero symptoms but lost smell and taste before I did. Right now it feels like a bad sinus infection and I wish it would go away. I hate head colds. Lost my sense of smell and taste yesterday. That depressed me and I’m not really sure why. Have I mentioned I feel like shit?

[Sensei]

peeps or PEEPS?
Sorry, couldn't resist!

Haven't seen any pleurisy associated with it at this point. But continue to see people who just aren't bouncing back like we'd normally expect. Had one last week who keeps getting odd fevers for some reason, despite x-ray looking a lot better.

We have one SICU attending who rules the roost and insists on loooong courses of IV methylpred - basically the ARDSnet taper over 28 days, but keeps them going until “improving.” Well, these people ain’t improving, and we have insane rates of bacteremia and fungemia likely because of the steroids. Literally, all of them eventually grow fungus, VRE, or gram negatives from their CABSI. Then, there is the GI bleed because everyone is on a heparin drip...forever. We’ve managed to de-cannulate ONE (just one damn person) from VV-ECMO this latest wave - the rest are either dead after weeks on pump or still circling the drain.

[Crusader8207]

I’m on day 7 also. Symptoms are what I would describe as mild but I still feel like shit. Never ran a fever but have experienced pretty much everything else. Wife got sick about the same time. She had almost zero symptoms but lost smell and taste before I did. Right now it feels like a bad sinus infection and I wish it would go away. I hate head colds. Lost my sense of smell and taste yesterday. That depressed me and I’m not really sure why. Have I mentioned I feel like shit?

Yes the loss of taste and smell is completely depressing for sure. I have been making some really good dinners for the family and can't enjoy them. Definitely takes the fun out of cooking.

It's so weird how this affects everyone differently.

I pray for a speedy recovery for you my friend.

[Nephrology]

We have one SICU attending who rules the roost and insists on loooong courses of IV methylpred - basically the ARDSnet taper over 28 days, but keeps them going until “improving.” Well, these people ain’t improving, and we have insane rates of bacteremia and fungemia likely because of the steroids. Literally, all of them eventually grow fungus, VRE, or gram negatives from their CABSI. Then, there is the GI bleed because everyone is on a heparin drip...forever. We’ve managed to de-cannulate ONE (just one damn person) from VV-ECMO this latest wave - the rest are either dead after weeks on pump or still circling the drain.

I remember when early reports were still coming out of China that they experienced very high rates of VAPs that most attributed to their use of IV steroids, not surprised it's happening if he's blasting them with steroids to effect.

Is the IV UFH drip particular to your institution? I haven't heard of any guidelines re: anticoagulation for COVID patients, but I haven't been paying very close attention either.