The Novel Coronavirus 2019, was first reported on in Wuhan, China in late December 2019.  The outbreak was declared a public health emergency of international concern in January 2020 and on March 11th, 2020, the outbreak was declared a global pandemic.  The spread of this virus is now global with lots of media attention.  The virus has been named SARS-CoV-2 and the disease it causes has become known as coronavirus disease 2019 (COVID-19).  This new outbreak has been producing lots of hysteria and false truths being spread, however the data surrounding the biology, epidemiology, and clinical characteristics are growing daily, making this a moving target.

REBEL COVID-19

will serve as a summary of what is currently known, how to screen, when to test, and how to prevent spread, and any new data/information on COVID-19.

May 13, 2021

Background Information: Over one year into the pandemic many therapies to treat COVID-19 have targeted innumerable aspects of the virus. Most recently, the use of corticosteroids to treat the virus’ excessive inflammatory effects has become the front and center of therapy in patients requiring oxygen therapy.1 The RECOVERY trial showed a mortality benefit when using Dexamethasone in severe cases where oxygen therapy or mechanical ventilation was required.2 Interestingly, compared to other corticosteroids, high doses of Methylprednisolone are actually the preferred agent for anti-inflammation in pulmonary diseases as it achieves a more direct effect on cell membrane associated proteins.3 The authors of the following paper sought to investigate the effectiveness of methylprednisolone compared to Dexamethasone in hypoxemic ICU patients with COVID-19.

April 5, 2021

Background Information:

The use of corticosteroids in patients with pneumonia secondary to COVID-19 has been a controversially hot topic, particularly early on in the pandemic. Prior evidence seen in Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome have led some to argue against their use due to delayed viral clearance.1 More recent evidence related to SARS-Cov-2 has specifically shown reduced mortality and reduced need for mechanical ventilation with corticosteroids.2-4 More recently, the RECOVERY Trial showed an improvement in 28-day mortality among patients on oxygen therapy who received Dexamethasone.5 Little information exists in the literature about patients with moderate to severe disease who do not warrant ICU level of care but require hospital admission due to the extent of their illness. The authors of this study designed and conducted a pragmatic, partially randomized control trial to evaluate the possible benefit of methylprednisolone in hospitalized patients with moderate to severe COVID-19 pneumonia.

March 30, 2021

Background: COVID-19 vaccination is ramping up both in the US as well as throughout the world. Randomized clinical trials looking at the efficacy of the mRNA vaccines demonstrated 94% to 95% reductions in symptomatic cases (Polack 2020). Randomized clinical trials are considered the gold standard when evaluating therapies. However, they are not without limitations. Mass vaccination rollouts do not mirror the settings we see in the highly controlled environments of a randomized clinical trial. It will be important to note if suboptimal adherence to vaccination scheduling and handling logistics will affect the vaccines’ effectiveness. As we continue to vaccinate, we need to further assess the real-world effectiveness of the vaccines.

March 28, 2021

Background: Israel has succeeded in ramping up its vaccination program faster than any nation in the world. In December 2020, Israel began a national immunization campaign prioritizing health-care workers. In the original clinical trial data, the Pfizer vaccine was estimated to prevent 52.4% of COVID-19 before dose two and 90.5% on days 2 – 7 after dose two. However, it is important to study the effectiveness of the vaccines in a real world setting.

March 20, 2021

Background: A major challenge during the COVID pandemic is balancing personal protection and communication. Being heard while wearing a surgical mask or N95 isn't too much of a challenge, communication can be significantly impaired while wearing a respirator mask. There are a number of fixes to this problem. Here, we share one simple, inexpensive option via Whit Fisher, MD (https://www.procedurettes.com/)
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