Discover and read the best of Twitter Threads about #covid19foam
Most recents (24)
Fully Vaccinated is ≥2weeks after 2nd dose of Moderna/Pfizer
Fully Vaccinated is ≥2weeks after 1 dose of J&J
Fully Vaccinated is ≥2weeks after 1 dose of J&J
Fully vaccinated ppl can:
-Visit w/other fully vaccinated ppl w/o wearing masks/physical distancing
-Visit w/unvaccinated ppl from single household who are low risk for severe COVID19 dz w/o wearing masks/physical distancing
-No need for quarantine & testing if asymptomatic
-Visit w/other fully vaccinated ppl w/o wearing masks/physical distancing
-Visit w/unvaccinated ppl from single household who are low risk for severe COVID19 dz w/o wearing masks/physical distancing
-No need for quarantine & testing if asymptomatic
1/After a March choir practice in Washington, 1 symptomatic singer led to 53 members showing symptoms
Thx @EmoryMedicine creators @krobharrington & @abhatch_, editors @an_xiao_ & @cg_coleman, & reviewer @bcmhouston ID fellow @AxellHouse
#EducationInTheTimeOfCOVID #COVID19FOAM
Thx @EmoryMedicine creators @krobharrington & @abhatch_, editors @an_xiao_ & @cg_coleman, & reviewer @bcmhouston ID fellow @AxellHouse
#EducationInTheTimeOfCOVID #COVID19FOAM
3/
& link to Baylor's COVID-19 literature review (our new partner)
bcmfamily.bcm.edu/2020/04/09/cov…
& link to our webpage with the visual abstracts from
@EmoryMedicine students
med.emory.edu/departments/me…
& link to Baylor's COVID-19 literature review (our new partner)
bcmfamily.bcm.edu/2020/04/09/cov…
& link to our webpage with the visual abstracts from
@EmoryMedicine students
med.emory.edu/departments/me…
1/ As a career researcher of coronaviruses, Susan Weiss, PhD offers insight from 40 years of research.
Thx @EmoryMedicine MS3s creators Anjali Om & Namita Mathew, editors @an_xiao_& @cg_coleman, & Baylor ID fellow @AxellHouse (reviewer)!
#EducationInTheTimeOfCOVID #COVID19FOAM
Thx @EmoryMedicine MS3s creators Anjali Om & Namita Mathew, editors @an_xiao_& @cg_coleman, & Baylor ID fellow @AxellHouse (reviewer)!
#EducationInTheTimeOfCOVID #COVID19FOAM
2/Here's a link to the article:
rupress.org/jem/article/21…
& link to our webpage with the visual abstracts from @EmoryMedicine students
med.emory.edu/departments/me…
& link to Baylor's COVID-19 literature review - one of our new partners for this initiative! bcmfamily.bcm.edu/2020/04/09/cov…
rupress.org/jem/article/21…
& link to our webpage with the visual abstracts from @EmoryMedicine students
med.emory.edu/departments/me…
& link to Baylor's COVID-19 literature review - one of our new partners for this initiative! bcmfamily.bcm.edu/2020/04/09/cov…
3/Sorry @nemathew & @anjali_om - sorry for not tagging you before! For some reason your account didn't come up when I tried to put your names into the initial tweet.
Tagging you now!
Tagging you now!
1/ Can antibody testing help predict true case fatality rate for #COVID19?
Thx @EmoryMedicine M3s Timothy Arleo & @mlmargol (creators), M4s @tylerdau &@cg_coleman (editors) & Emory ID fellow Aaron Kofman (review)
#EducationInTheTimeOfCOVID #COVID19FOAM
Thx @EmoryMedicine M3s Timothy Arleo & @mlmargol (creators), M4s @tylerdau &@cg_coleman (editors) & Emory ID fellow Aaron Kofman (review)
#EducationInTheTimeOfCOVID #COVID19FOAM
2/ This study has multiple limitations making it difficult to know the accuracy of the results.
It will be interesting to see the results after the peer review process.
It will be interesting to see the results after the peer review process.
3/ Here's a link to the pre-print (i.e. not peer-reviewed yet)
doi.org/10.1101/2020.0…
Link to our #EmoryID fellows' scholar blog w/ other lit summaries by our ID fellows; plus visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
doi.org/10.1101/2020.0…
Link to our #EmoryID fellows' scholar blog w/ other lit summaries by our ID fellows; plus visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
How well do alcohol-based hand rub formulations inactivate SARS-CoV-2?
Thx @EmoryMedicine students @emilyslovern & @sims_hershey (creators), @an_xiao_& @cg_coleman (editors) & @EmoryDeptofMed ID fellow @DanielSGraciaa (reviewer)
#EducationInTheTimeOfCOVID #COVID19FOAM #COVID19
Thx @EmoryMedicine students @emilyslovern & @sims_hershey (creators), @an_xiao_& @cg_coleman (editors) & @EmoryDeptofMed ID fellow @DanielSGraciaa (reviewer)
#EducationInTheTimeOfCOVID #COVID19FOAM #COVID19
A link to the article @CDC_EIDjournal by @AnnikaKratzel & @StephaniePfaen1
doi.org/10.3201/eid260…
Link to our #EmoryID fellows' scholar blog w/ other lit summaries by our ID fellows; plus visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
doi.org/10.3201/eid260…
Link to our #EmoryID fellows' scholar blog w/ other lit summaries by our ID fellows; plus visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
Please tag additional authors of this work!
The ISTH recommends prophylactic anticoagulation for #COVID19 inpatients
Thx @EmoryMedicine students @andre_kerri & @justalisongrace (creators), @tylerdau @cg_coleman (editors) & @EmoryDeptofMed ID fellow @alfherrom (review)
#EducationInTheTimeOfCOVID #COVID19FOAM
Thx @EmoryMedicine students @andre_kerri & @justalisongrace (creators), @tylerdau @cg_coleman (editors) & @EmoryDeptofMed ID fellow @alfherrom (review)
#EducationInTheTimeOfCOVID #COVID19FOAM
Here's the link to the article
doi.org/10.1111/jth.14…
And the link to our #EmoryID fellows' scholar blog w/ other lit summaries by our ID fellows; plus visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
doi.org/10.1111/jth.14…
And the link to our #EmoryID fellows' scholar blog w/ other lit summaries by our ID fellows; plus visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
@RoyKhalife89 - would love to hear your thoughts on this!
1/Recent article on remdesivir for #COVID19. More summaries to come soon on more recent data.
Thx @EmoryMedicine MS3s @an_xiao_ & @chung_yg (creators), MS4s @tylerdau & @cg_coleman (editors) & #ID fellow @Dr_AmyKacin (review)!
#EducationInTheTimeOfCOVID #COVID19FOAM
Thx @EmoryMedicine MS3s @an_xiao_ & @chung_yg (creators), MS4s @tylerdau & @cg_coleman (editors) & #ID fellow @Dr_AmyKacin (review)!
#EducationInTheTimeOfCOVID #COVID19FOAM
2/This is not a randomized controlled trial, which is the data that we really need. Trials ongoing with results soon.
3/Here's the link to this article in @NEJM
doi.org/10.1056/NEJMoa…
And the link to our #EmoryID fellows' scholar blog w/ other lit summaries, visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
doi.org/10.1056/NEJMoa…
And the link to our #EmoryID fellows' scholar blog w/ other lit summaries, visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
What was the impact of various public health interventions on #COVID19 in Wuhan, China?
Thx @EmoryMedicine M3s @SimonCohen617 & @blokolog9 (creators), @tylerdau & @cg_coleman (editors) & @EmoryDeptofMed #ID fellow JessH_A (review)!
#EducationInTheTimeOfCOVID #COVID19FOAM
Thx @EmoryMedicine M3s @SimonCohen617 & @blokolog9 (creators), @tylerdau & @cg_coleman (editors) & @EmoryDeptofMed #ID fellow JessH_A (review)!
#EducationInTheTimeOfCOVID #COVID19FOAM
Here's a link to the article in @JAMANetworkOpen
jamanetwork.com/journals/jama/…
And the link to our #EmoryID fellows' scholar blog w/ other lit summaries, visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
jamanetwork.com/journals/jama/…
And the link to our #EmoryID fellows' scholar blog w/ other lit summaries, visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
Here's the actual link - sorry, that prior link was to the commentary on the article:
jamanetwork.com/journals/jama/…
jamanetwork.com/journals/jama/…
[THREAD]
We just published the largest, most detailed case series of mechanically ventilated #COVID19 patients with ARDS in a western country and with the longest follow-up.
Read our infographic & the article on @CCRJournal bit.ly/2SiXYgD
#COVIDFOAM #FOAMed #FOAMcc
We just published the largest, most detailed case series of mechanically ventilated #COVID19 patients with ARDS in a western country and with the longest follow-up.
Read our infographic & the article on @CCRJournal bit.ly/2SiXYgD
#COVIDFOAM #FOAMed #FOAMcc
2/7
Mortality of ICU mechanically ventilated patients with #COVID19 ARDS is as high as 23% at the 20 days follow-up.
#COVIDFOAM #FOAMed #FOAMcc
Mortality of ICU mechanically ventilated patients with #COVID19 ARDS is as high as 23% at the 20 days follow-up.
#COVIDFOAM #FOAMed #FOAMcc
3/7
Acute kidney injury (75%) and secondary bacteremia (37%) are the most frequent complications of #COVID19 ARDS.
Also, pneumothorax, pneumomediastinum, and thromboembolic complications were relatively common.
#COVIDFOAM #FOAMed #FOAMcc
Acute kidney injury (75%) and secondary bacteremia (37%) are the most frequent complications of #COVID19 ARDS.
Also, pneumothorax, pneumomediastinum, and thromboembolic complications were relatively common.
#COVIDFOAM #FOAMed #FOAMcc
1/This retrospective study did not show any benefit of hydroxychloroquine in patients w/ #COVID19
Thx @EmoryMedicine M3s @AGangavelli & @sverma46 (creators), @chung_yg & @cg_coleman(editors) & Emory ID fellow @Dr_AmyKacin (peer review)
#EducationInTheTimeOfCOVID #COVID19FOAM
Thx @EmoryMedicine M3s @AGangavelli & @sverma46 (creators), @chung_yg & @cg_coleman(editors) & Emory ID fellow @Dr_AmyKacin (peer review)
#EducationInTheTimeOfCOVID #COVID19FOAM
2/We are still waiting results of the randomized controlled trials for definitive evidence, but this additional data continues to suggest that HCQ is not helpful for #COVID19
3/And here's a link to the pre-print (i.e. not peer-reviewed yet): doi.org/10.1101/2020.0……
And the link to our #EmoryID fellows' scholar blog w/ other lit summaries, visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
And the link to our #EmoryID fellows' scholar blog w/ other lit summaries, visual abstracts & infographics created by our medical students. scholarblogs.emory.edu/covid19roundup/
Thank you to @ICNARC who have published data on the first 5578 critically ill patients in the NHS. I've summarised some of their publication in this thread below: #covid19 #covid19foam #foamed #FOAMcc Original here: icnarc.org/Our-Audit/Audi…
The data does not include Scottish ICUs - but does for Eng, Wales and NI. To date (yday) there have been 6664 ICU admissions due to COVID19. The largest cohort being in London. There is also cumulative data of numbers by date. #covid19 #covid19foam #foamed #FOAMcc
You can see the *current* distributions of cases across England, Wales and NI #covid19 #covid19foam #foamed #FOAMcc
Fascinating discussion from the @ICS_updates webinar
Differing opinions on HFNC, CPAP and intubation
The risk of P-SILI described by @bjoern_weiss
Versus the benefits of avoiding intubation
Again: NO ONE can predict who will successfully manage with noninvasive therapies.
Differing opinions on HFNC, CPAP and intubation
The risk of P-SILI described by @bjoern_weiss
Versus the benefits of avoiding intubation
Again: NO ONE can predict who will successfully manage with noninvasive therapies.
Up to 50% of patients will manage with noninvasive therapies alone (CPAP/HFNC)
But which 50%? Does everyone warrant a trial? And where should this trial take place?
#icswebinar #covid19foam
But which 50%? Does everyone warrant a trial? And where should this trial take place?
#icswebinar #covid19foam
The discussion around PEEP is ongoing
SuperPEEP is out. A modest level of PEEP (8-10) is suggested by @deoxyexplorer
Superdry for fluid balance is also out- euvolaemia is current target.
#icswebinar #covid19foam
SuperPEEP is out. A modest level of PEEP (8-10) is suggested by @deoxyexplorer
Superdry for fluid balance is also out- euvolaemia is current target.
#icswebinar #covid19foam
Lung compliance can often be normal/high (L type) but can progress to low compliance (H type)
Berlin Criteria:
Timing: w/i 7d
Imaging: Bilateral infiltrates
Origin: Not explained by cardiac failure/fluid overload
Mild: P/F <200mmHg (≤300 with PEEP/CPAP ≥5cmH20)
Mod: P/F <100mmHg (≤200 with PEEP/CPAP ≥5cmH20)
Severe: P/F ≤100mmHg with PEEP ≥5cmH20
Timing: w/i 7d
Imaging: Bilateral infiltrates
Origin: Not explained by cardiac failure/fluid overload
Mild: P/F <200mmHg (≤300 with PEEP/CPAP ≥5cmH20)
Mod: P/F <100mmHg (≤200 with PEEP/CPAP ≥5cmH20)
Severe: P/F ≤100mmHg with PEEP ≥5cmH20
Welcome to the @esicm webinar on renal issues in #COVID19 including AKI & CRRT esicm-tv.org #COVID19foam #foamed #FOAMcc
Low rates of AKI and CRRT initially thought. Does this marry up with the current picture?
1/9
#COVID19FOAM
#StopTheSpread
#ProtectHealthCareWorkers
Joint effort from @American_Heart @ACEPNow @SOCCA_CritCare @AmerAcadPeds @aarc_tweets @ASALifeline guiding #resuscitation efforts in #cardiacarrest in suspected/confirmed #COVID19
bit.ly/3e8QplH
@CircAHA
#COVID19FOAM
#StopTheSpread
#ProtectHealthCareWorkers
Joint effort from @American_Heart @ACEPNow @SOCCA_CritCare @AmerAcadPeds @aarc_tweets @ASALifeline guiding #resuscitation efforts in #cardiacarrest in suspected/confirmed #COVID19
bit.ly/3e8QplH
@CircAHA
2/9
General Principles of #ProtectHealthCareWorkers have always applied to first responders in prior #resuscitation guidelines. Remember, first things first:
👉Assess the safety of the scene, make sure that victim, yourself and bystanders are safe
#GetMePPE
General Principles of #ProtectHealthCareWorkers have always applied to first responders in prior #resuscitation guidelines. Remember, first things first:
👉Assess the safety of the scene, make sure that victim, yourself and bystanders are safe
#GetMePPE
3/9
Minimize the number of people in the room
👉 Whenever able, mechanical CPR devices can reduce the number of rescuers required & provide consistent high-quality compressions
Minimize the number of people in the room
👉 Whenever able, mechanical CPR devices can reduce the number of rescuers required & provide consistent high-quality compressions
new section on the mixology of analgo-sedation for intubated COVID patients. there are lots of approaches analgo-sedation, this is my favorite mix...(1/6)
#COVID19foam
IBCC section: bit.ly/3aTDlyL
#COVID19foam
IBCC section: bit.ly/3aTDlyL
if possible, achieving an awake & comfortable patient on the ventilator is enormously beneficial:
- easier to extubate
- can communicate, determine sources of pain
- might help avoid lung-injurious tidal volumes
- less delirium, faster rehab (2/6)
- easier to extubate
- can communicate, determine sources of pain
- might help avoid lung-injurious tidal volumes
- less delirium, faster rehab (2/6)
the fundamental principle is multi-modal analgo-sedation. using *low* doses of *several* medications maximizes synergistic efficacy, while avoiding the toxicity of any specific agent (#3/6)
continuing to see crazy pro-coagulable states in COVID-19, for example patients breaking straight through therapeutic dosing of heparin 👇 (#1/3)
#COVID19foam
#COVID19foam
the role of anticoagulation remains largely unknown. here are my current thoughts on this, recognizing the complete absence of high-level evidence (#2/3).
(IBCC section: bit.ly/2x6EjZK)
(IBCC section: bit.ly/2x6EjZK)
please post any thoughts, comments, new evidence etc. at this page which was developed specifically to discuss COVID-DIC. (#3/3).
emcrit.org/squirt/covid-d…
emcrit.org/squirt/covid-d…
Fascinating paper shared with me via @DFarcy Preliminary Observations on the Vent Management of ICU #COVID19
sfar.org/preliminary-ob…
COVID-19 ICU pts are NOT similar to ARDS pts. They have profound hypoxia with pulmonary compliance that is generally high
#COVID19FOAM
sfar.org/preliminary-ob…
COVID-19 ICU pts are NOT similar to ARDS pts. They have profound hypoxia with pulmonary compliance that is generally high
#COVID19FOAM
High-Pulmonary Compliance: Hypoxic vasoconstriction. Major issue is lung perfusion. Increasing PEEP and prone positioning are of minimal help with recruitment of collapsed lungs. In these patients high PEEP (>15cmH20) may compromise right cardiac filling
Oxygen Alone vs Ventilation: High FiO2 more important in the short run, other interventions (i.e. intubation) may be more harmful than buying time
IBCC correction: Procalcitonin in COVID-19 😬. Initially the IBCC stated that COVID-19 didn't generally increase procalcitonin, based on several studies👇... but intubated COVID patients in my unit are routinely showing procalcitonin elevations in the range of 1-10 🤔 #MeaCulpa
if we dig deeper into the Guan study, we see that some patients with more severe disease *do* have procalcitonin elevation 👇. so procalcitonin elevation might be a reflection of more severe infection, vis a vis cytokine storm 🌩️.
(study: bit.ly/2vPTyWq)
(study: bit.ly/2vPTyWq)
🔎 recent meta-analysis of procalcitonin in COVID-19 also found this: elevated procalcitonin may be a marker of more severe disease. (although can't prove with 100% certainty that these patients don't have bacterial co-infection)
(article: bit.ly/2QLk8Y2)
(article: bit.ly/2QLk8Y2)
Echter Verlauf eines COVID-19 Falls
Frau Mitte Vierzig. Befindet sich seit So in unserer Klinik
Vorgeschichte
Seit Di vorletzter Woche fühlt sich Frau Xx sehr schlapp. Sie beschließt zum Arzt zu gehen Klagt über Fieber ,Kopfschmerzen und trockenen Husten.
#COVID19FOAM #COVID19
Frau Mitte Vierzig. Befindet sich seit So in unserer Klinik
Vorgeschichte
Seit Di vorletzter Woche fühlt sich Frau Xx sehr schlapp. Sie beschließt zum Arzt zu gehen Klagt über Fieber ,Kopfschmerzen und trockenen Husten.
#COVID19FOAM #COVID19
Die Hausärztin fragt nach Reisen in ein Coronarisikogebiet. Frau Xx verneint. Auch Kontakte zu Coronakranken habe sich nicht gehabt. Letztlich erhält Sie symptomlindernde Medikamente und wird wieder nach Hause geschickt.
#COVID19 #COVID19FOAM
#COVID19 #COVID19FOAM
In den folgenden Tagen kommt es zu vermehrten Husten und progredienter Dyspnoe. In der Zwischenzeit erkrankt auch der Ehemann, wenn auch nicht so schwer.
#COVID19de #covid19foam
#COVID19de #covid19foam
Going thru the Surviving Sepsis Campaign guidelines on COVID. There's some good stuff here, if you can skip thru the usual SSC boiler-plate nonsense (lactate as a perfusion endpoint 🤣).
(guidelines: bit.ly/2QvTm5x)
#COVID19foam
(guidelines: bit.ly/2QvTm5x)
#COVID19foam
Air quality:
- SSC rec's negative pressure rooms for aerosol-generating procedures. Sure, but we are rapidly running out of them.
- When negative pressure isn't available, HEPA filters should be used whenever possible (they asked: how many? GIVE ME ALL THE HEPA FILTERS).
- SSC rec's negative pressure rooms for aerosol-generating procedures. Sure, but we are rapidly running out of them.
- When negative pressure isn't available, HEPA filters should be used whenever possible (they asked: how many? GIVE ME ALL THE HEPA FILTERS).
Masks
- SSC rec's surgical masks for non-vented patients who aren't undergoing aerosol-generating procedures
- Try to conserve N95s for when they are absolutely needed
- Sensible advice if N95 supply limited (risk of burning through the supply of N95s on COVID rule-outs)
- SSC rec's surgical masks for non-vented patients who aren't undergoing aerosol-generating procedures
- Try to conserve N95s for when they are absolutely needed
- Sensible advice if N95 supply limited (risk of burning through the supply of N95s on COVID rule-outs)
Thread on some ED Doc's thoughts on dealing with #COVID19US on frontlines
1/ First PPE: At this point, everyone should be wearing a surgical mask at your desk and in ED. No eating or drinking unless in Staff lounge, away from patient care
2/ When going into a potential #Covid19 room, wear a N-95 if you have it. Put a surgical (eg. regular) mask over it to protect it, then wear a face shield over that. Googles not as good, but we'll take what we can get.
I've been dreading this, but I think we need to reconsider the issue of steroid in COVID-19. This is extremely complicated, especially for two reasons...(1/7)
#COVID19foam
#COVID19foam
1st level of complication = patients vary a lot!
- Most require minimal care
- Many just need low flow oxygen
- Few develop cytokine storm and multiorgan failure
- Many are somewhere in-between
It may be *impossible* to render any blanket statement for all patients. (2/7)
- Most require minimal care
- Many just need low flow oxygen
- Few develop cytokine storm and multiorgan failure
- Many are somewhere in-between
It may be *impossible* to render any blanket statement for all patients. (2/7)
2nd level of complication = disease goes thru phases in any patient
Initially: viral replication phase w/ weak immune response. Immunosuppression *dangerous* here?
Rarely: later surge of adaptive immunity causes cytokine storm. Immunosuppression potentially good here?? (3/7)
Initially: viral replication phase w/ weak immune response. Immunosuppression *dangerous* here?
Rarely: later surge of adaptive immunity causes cytokine storm. Immunosuppression potentially good here?? (3/7)
Australian Safe Airway Society Consensus Statement of Airway Management and Tracheal Intubation in COVID19 Adult Patients – Preprint Only
bit.ly/3d4Ud77
#COVID19FOAM
bit.ly/3d4Ud77
#COVID19FOAM
Aerosol Generating Procedures
Suggested Contents of COVID-19 Intubation Tray
