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A new @jclinicalinvest commentary suggesting the use of serum from people who have recovered from #COVID19 as a potential prevention/treatment jci.org/articles/view/…
by @ACasadevall1 @JohnsHopkinsSPH and Liise-Anne Pirofski @EinsteinMed
They make a very strong case and review all the prior experience, ending w/:
"Hence, as we are in the midst of a worldwide pandemic, we recommend that institutions consider the emergency use of convalescent sera and begin preparations as soon as possible. Time is of the essence."
The #COVID19 convalescent transfusion concept was also advanced @TheLancet 2 weeks ago
thelancet.com/action/showPdf… via @tmprowell @matthewherper
@TheLancetInfDis
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More from @EricTopol see all

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Eric Topol
@EricTopol
It's time to clear up the issues about testing. So I've put together a #COVID19 thread on spread.
Addressing the Super-spreaders, Spreaders, and the essentiality of testing
Let's start in China where the 1st cases were manifest.
A @ScienceMagazine yesterday provided elegant modeling from real data to show that 79% of the spread was from people without #COVID19 detection.
Now Singapore, which dealt with 3 clusters by having tight surveillance of pneumonia, testing immediately and tracing all the contacts
thelancet.com/journals/lance… @TheLancet
Read 9 tweets
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Eric Topol
@EricTopol
What will go down as the biggest breakdown in the US response to #COVID19 is the lack of test kits. South Korea and the US had their 1st patients on Jan 20 and Jan 21, respectively. Look at the difference in daily testing. By March 4th, SK was ~18,000 per day.
On March 14, Dr. Barbara Birx did, "When you are tested, and our results look very similar to South Korea now, with South Korea with 96% plus of people with symptoms are negative." That's 4% positive by CDC tests.
Fully transparent: @COVID19Tracking w/ a 9.7% positive rate today
Similar plot of South Korea vs US #COVID19 test data today @nytimes; it includes more recent CDC data, the cumulative N of tests 55 days after each country's 1st patient was diagnosed, confirmed cases, and has a different Y-axis display from mine
nytimes.com/interactive/20…
Read 6 tweets
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Eric Topol
@EricTopol
A new @ScienceMagazine paper is the best evidence yet for the people without symptoms ("undocumented," i.e. with no or mild Sx, not tested) driving the spread #COVID19
science.sciencemag.org/content/early/… brilliant modeling of synthetic outbreak
via @hholdenthorp
If anyone questioned the value of social and physical distancing, this ought to help squelch it.
#StayHomeSaveLives stayhomesavelives.us
I'm taking the liberty of changing the headline of this very good @CNN piece
by @elizcohencnn cnn.com/2020/03/14/hea…
Read 5 tweets

Related threads

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Guðmundur Jóhannsson
@gfj1979
Thread:
Insulin, insulin resistance, the immune system & COVID-19

First observation is that individual w diseases/conditions that track with insulin resistance are at risk for worse outcomes: older age, CVD, DM, HTN + DM may ↑ risk for infection by 2-3x medscape.org/viewarticle/92…
Furthermore it seems that IR & hyperinsulinemia are the normal metabolic response of the body to viral infections sciencedirect.com/science/articl…
Recent evidence suggest that the T-cells of the immune system are reliant on insulin signaling to boost them when dealing with infections. If they are IR it interferes with their ability to drive protective immunity agains viruses such as influenza cell.com/cell-metabolis…
Read 9 tweets
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Anirban Maitra
@Aiims1742
As the decade draws to a close, here’s a compendium of the major advances in #PancraticCancer over the past ten years. Rather than focus on individual papers, I am highlighting a few big themes.
Please add as needed. Hoping for lots more progress in the coming decade!! #PDAC2020
The top 5 most cited #PancreaticCancer original research papers of the decade are:
1: @NEJM: nejm.org/doi/10.1056/NE…
2: @NEJM: nejm.org/doi/10.1056/NE…
3: @CR_AACR: cancerres.aacrjournals.org/content/74/11/… @PanCAN
4: @nature: nature.com/articles/natur… @ciacobu
5: @nature: nature.com/articles/natur…
While #PancreaticCancer remains a challenging disease to Rx, this decade saw the approval of two 1st line therapies for advanced PDAC:
FOLFIRINOX:
nejm.org/doi/pdf/10.105…
Gemcitabine + Abraxane:
nejm.org/doi/10.1056/NE…
And in 2nd line, Onivyde:
thelancet.com/journals/lance…
Read 16 tweets
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AZ
@azfaust
Let's talk a bit about graphical abstracts.
What is a graphical abstract? I call it a visual hypothesis or in essence, the model that will be tested in a grant. It can also represent the workflow or how smaller components fit into the big picture.
Elsevier defines it as: "a single, concise, pictorial and visual summary of the main findings of the article. ...captures the content of the article for readers at a single glance."

Now for grants, turn the finding to what it would look like if your hypothesis was correct.
Read 17 tweets
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Gabor Erdosi /erdoke
@gerdosi
What renders your HDL pro-atherogenic? The acute phase response, or more precisely, serum amyloid A (SAA), that displaces ApoA-I in HDL. Beautiful ‘design’ to deal with infection/infiltration, but a huge problem if the trigger remains unresolved.
ahajournals.org/doi/full/10.11…
The same underlying cause of high CVD mortality in late- and end-stage renal disease.
jasn.asnjournals.org/content/23/5/9…
Serum amyloid A impairs the antiinflammatory properties of HDL jci.org/articles/view/…
Read 6 tweets
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Alexis Verger
@Alexis_Verger
#365papers Let's try this for 2019, highlighting 365 papers (does not necessarily mean 1 paper per day) - A thread
#365papers 1⃣ The thread started with a bang - A must read opinion by @MarcHalfon on the fundamental question of how to define an enhancer cell.com/trends/genetic…
#365papers 2⃣ citrullination by PADI2 of RNA Pol II CTD R1810 regulates the transcription of highly expressed genes by mediating the interaction with P-TEFb cell.com/molecular-cell…
Read 367 tweets
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Tony Breu
@tony_breu
1/
 Why does acute tubular necrosis decrease GFR?

There is clearly “acute kidney injury” (the tubules are damaged), but the glomerulus is intact. Why should glomerular filtration decrease if the filtering apparatus is unaffected?

Follow this thread to find out!
2/
 Patients with ATN experience a profound decrease in GFR (as evidenced by an increase in creatinine +/- a decrease in urine output).

Which of the following is a major contributor?
3/
 Distal sodium delivery is a key factor in ATN. As part of tubular injury, the Na/K-ATPase moves from the basolateral to apical membrane (so cool!). Without the ATPase, sodium reabsorption is limited.

The unabsorbed sodium remains in the lumen.

link.springer.com/article/10.100…
Read 18 tweets

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