Discover and read the best of Twitter Threads about #hydrocortisone
Most recents (3)
IMPORTANT THREAD on #COVIDTreatments - What Works & What Does not. Will be an ongoing threat.
Start with Dr Zarir Udwadia of Mumbai.
Start with Dr Zarir Udwadia of Mumbai.
Link to Dr Udwadia's Video
1st Point: 90000+ Medical papers on Covid. UNFORTUNATELY, big divergence in Observational Studies impact and Real World impact of a rigorous RCT
1st Point: 90000+ Medical papers on Covid. UNFORTUNATELY, big divergence in Observational Studies impact and Real World impact of a rigorous RCT
RCT is Randomized controlled trial.
A Good website is Covid19Primer.com
2) What Works ?
(A) Steroids are essential. #DEXAMETHASONE 6mg/day for Critically ill Covid Patients. Reduces Death by 33/20% for Patients on Ventilators & Oxygen.
A Good website is Covid19Primer.com
2) What Works ?
(A) Steroids are essential. #DEXAMETHASONE 6mg/day for Critically ill Covid Patients. Reduces Death by 33/20% for Patients on Ventilators & Oxygen.
It’s been a busy couple of nights in the ICU. Normally I’d be asleep right now, but I’m pumped to talk about #steroids in #COVID19.
A Brief Thread on #steroids in #COVID19.
(Spoiler alert: more compelling RCTs show that steroids work!)
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A Brief Thread on #steroids in #COVID19.
(Spoiler alert: more compelling RCTs show that steroids work!)
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Early in the pandemic it was unclear if steroids would be beneficial or harmful.
There were studies that steroids could reduce mortality in ARDS (DEXA-ARDS), but also studies showing that they could prolong viral shedding in related viruses (MERS).
Clear equipoise for RCTs.
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There were studies that steroids could reduce mortality in ARDS (DEXA-ARDS), but also studies showing that they could prolong viral shedding in related viruses (MERS).
Clear equipoise for RCTs.
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This changed in June, when the #RECOVERY trial (bit.ly/2QKCSGJ) found an impressive mortality decrease in patients treated with #dexamethasone.
This large, well designed study almost immediately changed practice. But a few questions lingered..
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This large, well designed study almost immediately changed practice. But a few questions lingered..
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Tabulated the topline results released by the #recoverytrial team on #hydroxychloroquine & #dexamethasone, and went over their protocol (recoverytrial.net/results) to better digest them.
Basic stuff:
- hospitalized patients @ 175 NHS centres
- open label, 5 initial arms
- thread—
Basic stuff:
- hospitalized patients @ 175 NHS centres
- open label, 5 initial arms
- thread—
Important point from #RECOVERYTrial protocol
- if a patient had a #contraindication to one of the intervention arms, according to the clinical care team at the site, that particular arm was not available to that patient at the time of #randomization
- if a patient had a #contraindication to one of the intervention arms, according to the clinical care team at the site, that particular arm was not available to that patient at the time of #randomization
So if a patient enrolled in #recoverytrial had a contraindication to #dexamethasone, that patient was not allowed to be randomized to that arm. So the results need to be interpreted in the context of no contraindication to steroids: already on steroids, #immunosuppression, etc.
