Coronavirus thread

[Nephrology]

Did you give it in the very early stages of the disease?

This study looked specifically at plaquenil in early COVID-19 and found no benefit. I posted it with the other 1/2 dozen a while back, along with this study that looked at people with just mild/moderate disease. Neither showed any benefit. I've posted these a few times by now.

Seriously, read the articles I linked. I know they're kind of dry and may be hard to understand if you don't read papers like this often, but they are the pure, 100% unfiltered (by a media outlet) results of two well designed clinical trials. You don't get any closer to the source than that. They will give you far more accurate information than any news media outlet, and they will tell you with explicit detail exaclty how they arrived at the conclusions they did.

You can always post here or shoot me a PM if you need help interpreting parts of them, but it really would be worth the effort for you to try to read the papers. If they aren't publicly accessible I can download them via the university library and host them somewhere.

[TheNewbie]

Could you expand? I thought Sweden was leading the US in per capita deaths, in spite of a less dense population and access to healthcare better than a lot of us.

Not arguing, I'm curious.

I think it depends on what concerns you more. The lockdown or the virus. For me the lockdown, and the attempted silencing of dissension, is more concerning and damaging than the virus.

If you believe the virus is the greatest threat, then the Swedish model might be the best.

[TheNewbie]

This study looked specifically at plaquenil in early COVID-19 and found no benefit. I posted it with the other 1/2 dozen a while back, along with this study that looked at people with just mild/moderate disease. Neither showed any benefit. I've posted these a few times by now.

Seriously, read the articles I linked. I know they're kind of dry and may be hard to understand if you don't read papers like this often, but they are the pure, 100% unfiltered (by a media outlet) results of two well designed clinical trials. You don't get any closer to the source than that. They will give you far more accurate information than any news media outlet, and they will tell you with explicit detail exaclty how they arrived at the conclusions they did.

You can always post here or shoot me a PM if you need help interpreting parts of them, but it really would be worth the effort for you to try to read the papers. If they aren't publicly accessible I can download them via the university library and host them somewhere.

I’ll PM you in a bit.

[45dotACP]

@45dotACP have you seen any patients who recovered from the ARDS/pneumonia but continued to have coagulation problems?


For any of the docs/nurses are there any ideas on the mechanism of the clotting? Do ya’ll think it’s related to organ failure caused by lack of oxygen due to ARDS or is there something else going on with the virus replicating in blood cells or something crazy?

I haven't heard of a lot of patients who had major coagulopathy after a full recovery. The problem IMO is the modern medical approach is to discharge patients "quicker and sicker" and not everyone discharged is fully recovered.

As for mechanism, I'd be interested to see it myself. I don't think it's related to end organ damage, as we tend to see D dimers elevate well before the patients need to be intubated, and other signs of organ damage (elevated LA, BUN/Creatinine, LFT elevation) aren't present. I suspect but can't prove it has some bizarre relationship with how pro-inflammatory this virus is.

What's the angle you proned them at? I am pretty much decided that if I get rona and my vitals and insp volume stay OK, and I can keep my Is/Os in balance, I am proning myself at home with compression stockings on. I believe our institutional policy for remdesivir is 4L flow requirement so I intend to stay home till that time.



Re zinc: I did a self-case control study, sample of 1. When this started, I took some zinc supplements on advice of my Chicago colleagues who were/are in the middle of this. Then, like all unsupervised males my age, I forgot to keep taking it, just as rona cases tripled in my state.
I found no difference in the outcomes. The skeptic will say it made no difference. The optimist may say we failed to detect an additive effect of zinc to my compulsive masking and hand sanitizing. I agree with both.

I'm set if I get the 'Rona. I'm a belly sleeper anyways!

The angle of proning seemed less important than being able to prone them in a way that didn't put their heads in an uncomfortable hyperextension. I found that sort of "ramping" the patients chest with pillows helped them be fairly comfortable.

For the tubed patients or those with NG or OG tubes I was more insistent on trying to get them as close to 30 degrees as I could.

I would be surprised if proning non intubated patients is a practice we don't carry over for the standard ARDS patients well after the pandemic is over.

RE: Zinc supplements, we still do it. Same with vitamin C.

Sent from my moto g(6) using Tapatalk

[GyroF-16]

I think it depends on what concerns you more. The lockdown or the virus. For me the lockdown, and the attempted silencing of dissension, is more concerning and damaging than the virus.

If you believe the virus is the greatest threat, then the Swedish model might be the best.

So, just to be clear - you would choose a 17.5% higher death rate over periodic lockdown.
Ok.

I would not.

[TheNewbie]

So, just to be clear - you would choose a 17.5% higher death rate over periodic lockdown.
Ok.

I would not.

I would chose what I think does the least damage for the greatest number of people. We disagree about what's best for society.

[Jakus]

I’ve seem this same article at multiple new sites.

https://www.dailywire.com/news/healt...l-tuberculosis

Is the world ignoring TB to focus on COVID? Concerning if true. Crazy if India has diagnosed 75% less TB cases year to date.

[LittleLebowski]

I’ve seem this same article at multiple new sites.

https://www.dailywire.com/news/healt...l-tuberculosis

Is the world ignoring TB to focus on COVID? Concerning if true. Crazy if India has diagnosed 75% less TB cases year to date.

I’m never surprised at anything coming out of India.

[Nephrology]

TB is a lot less contagious than SARS Cov2 at least, but it's a super shitty disease.

The healthcare system is definitely not functioning as normal during this pandemic - this is just one of many predictable consequences of the challenges we're facing now.

[Glenn E. Meyer]

My grandmother had TB and was sent to a sanitarium. My grandfather was dead, do to probably some kind of heavy metal inducing cancer from the industry where he was working. All the kids (my aunts and uncles, mom) were put in an orphanage. I used to check on medical forms that I had contact with someone that had TB. I recall the tuberculin skin tests when I was a kid for several years. Do they do them anymore?