December 7, 2020

Background: SARS-CoV-2 infection has resulted in a high mortality rate, with the majority of deaths resulting from respiratory failure. As waves of the pandemic continue to overwhelm healthcare systems throughout the world, a pragmatic risk stratification tool that would allow for the early identification of patients with COVID-19 infection who are at the highest risk of death could help guide the management of individual patients as well as resource utilization.  In a systematic review from April 2020, Wynants et al found that prediction models have rapidly entered the literature since the start of the covid-19 pandemic, but that they are of questionable quality and at high risk of bias, and as such are not ready for general use.  A prediction model based on a large cohort with high quality methods would be of great value to the medical community.  

December 5, 2020

Background: Despite limited high-quality evidence, many institutions are currently using convalescent plasma therapy (CPT) in the treatment of COVID-19.  The majority of the evidence for CPT comes from observational studies lacking placebo arms (US Expanded Access Program). Convalescent plasma therapy isn’t a novel treatment modality and has been used in the treatment of other infectious diseases (SARS, MERS, H1N1, Ebola, etc…) with mixed results. The theory behind CPT is it can supplement the patient’s immune response by administering plasma rich in antibodies from someone previously infected who has recovered.  Thus far the US Expanded Access Program, showed that giving convalescent plasma earlier (i.e. ≤3 days) and with higher titers (>18.45 S/Co) was associated with improved mortality in COVID-19 (This data cannot show causality as there was no randomization and no control arm) [3].

December 4, 2020

Background: Throughout the COVID19 pandemic, massive efforts have been invested on the research of effective therapeutics.  Much of the research looks at repurposing older treatments (i.e. antimalarial drugs, antiviral agents, interleukin blockers and convalescent plasma therapy).  There have been no large randomized, controlled trials of targeted treatments specific to SARS-CoV-2. LY-CoV555 is an anti-spike protein neutralizing monoclonal antibody that binds with high affinity to the receptor-binding domain of SARS-CoV-2. Its role in treatment of COVID19 is unclear.

December 1, 2020

It is no secret we are in the middle of a pandemic, the likes of which our generation has never seen. Every day, clinicians care for thousands of patients infected with SARS-CoV2. One sick person can infect many more without proper precautions. Though we are making strides, progress is slow, and our efforts thus far have fallen short. The SARS-CoV-2 virus has proven to be quite a formidable and destructive opponent. However, a pandemic of misinformation can potentially be even more devastating.

November 29, 2020

Background: We have tried to decrease the number of updates on COVID-19, as I am sure everyone is getting tired of all the trials coming out on this.  I know I am exhausted just reading through everything.  However, every so often I will try to bring updates that are relevant.  In this post we will cover an interesting trial that should be on your radar as more evidence arises on this treatment option.
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