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.
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.
Background: Hydroxychloroquine (HCQ) is an antimalarial and immunomodulatory drug that is postulated to exert an antiviral effect by increasing intracellular pH resulting in decreased viral binding at the ACE2 receptor. Azithromycin is a macrolide antibiotic that also has anti-inflammatory and ...
Background: We have been in need of a sign of hope in the fight against SARS-CoV-2 as it runs from city to city overwhelming health systems. The majority of patients will be either asymptomatic or have only mild disease. These ...
Background: Despite the initial excitement around the use of chloroquine (CQ) and hydroxychloroquine (HCQ), there is mounting evidence that neither drug is effective in COVID-19 treatment. Laboratory studies have shown antiviral and immunomodulatory properties in vitro but these have not ...
Background: Convalescent plasma therapy is not a new or novel therapeutic option. It involves taking the plasma from patients who have recovered from an illness and using it to treat patients who currently have the same illness. This approach has ...
Background: We have covered the two previous RCTs on remdesivir on REBEL EM (RCT #1 and RCT #2). In the first trial by Wang et al , there was no statically significant improvement in clinical outcomes, but, there were trends ...
I am fortunate to work in a hospital system that is very forward thinking. We have a phenomenal relationship with our intensivists, and I have been fortunate enough to have several discussions with them about how we are managing COVID-19 ...
Background: One of the hot topics in COVID-19 care is the mortality rate associated with invasive mechanical ventilation (IMV). There have been early reports of IMV having mortality rates ranging from 50 to 90%. These high rates are concerning but, ...
Background: The saga of Remdesivir for treatment of COVID-19 continues. We previously covered two studies of this drug on REBEL EM (Link is HERE & Link is HERE). One trial (≈200pts) showed no difference in the primary outcome of median ...
This publication has now been retracted by Lancet (June 4, 2020) Background: There is no conclusive evidence that chloroquine, or its derivative hydroxychloroquine, with or without a second-generation macrolide is effective in COVID-19 treatment or prophylaxis. Laboratory studies have shown ...
Disclaimer: This post explores some of the pathophysiologic findings in severe SARS-CoV-2 infection. It explores possible mechanisms-based and posits theories BUT, this is not a clinical post. The hypothesis and findings here are not confirmed and extrapolation to management is ...
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