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Here are some additional slides from my presentation I gave to the @MDAndersonNews #Oncology healthcare providers. While I covered a lot, here is further information on #therapeutics for #COVID19

Not enough time to discuss everything so I highlighted a few.
- For further information regarding lopinavir/r please check out the recent article published from China
- This was the study that has led to all the "hype" about the potential for HCQ.
- Please note the limitations of the study
- Also note potential side effects of HCQ and Azithromycin
-Graph depicting viral clearance for HCQ vs HCQ/Azithromycin vs No therapy
- All 5 patients received a range of antivirals
- All 5 patients were within a range of age groups
- By day 12 after infusion all 5 had clearance of VL, improved P/F ratio, and improved SOFA score
- By day 12 after infusion 4/5 had improved temperature
Final Thoughts
- There are a lot of potential therapies
- This thread highlights only a few potential therapies
- If you have a patient with #COVID-19 please try to enrolled in a clinical trial rather than giving them a medication off label as we really need science to lead
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Related hashtags

#Oncology #therapeutics #COVID19 #COVID

More from @KrutikaKuppalli see all

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Dr. Krutika Kuppalli
@KrutikaKuppalli
Interesting info from Wuhan. From 2/4/20-2/28/20 62 pts with #COVID19 randomized to receive SOC vs SOC+HCQ medrxiv.org/content/10.110…

1. Inclusion:
- >18
- RT-PCR positive #SARSCoV2
- Chest CT w/ PNA
- SaO2/SPO2 ratio >93% or P/F ratio >300
- Willing to be randomized
2. Exclusion:
- Severe/critical illness not deemed to meet benefit
- Retinopathy/Retinal dz
- Conduction block or arrhythmia
- Liver Dz (Child-Pugh >C or AST >2x ULN)
-Pregnant/Breastfeeding
-GFR <30 or CRRT
-Received other tx for COVID w/in 30d
-Transfer to OSH in 72h
3. Patients:
- 62 patients randomized to SOC vs SOC + HCQ 200 mg bid x 5 d
4. Endpoints:
- Time to clinical recovery (TTCR) normalization of temp and cough relief
- Change in CT lung findings
Read 7 tweets
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Dr. Krutika Kuppalli
@KrutikaKuppalli
Ppl ask, why not try #Hydroxychlorquine and #Azithromycin for #SARSCov2 #COVID19. Here is some important info to know about the study sciencedirect.com/science/articl…

1. 20 HCQ pts (200 mg TID) & 16 controls with SARSCoV2
2. Pts w/ URTI, LRTI, or asx
3. 6 HCQ pts received Azithro x 5 d
4. Pts received Azithro to prevent bacterial superinfxn
5. At day 6 post-inclusion 70% of HCQ pts were virologically cured vs 12.5% in control
6. At day 6 100% (6 pts ) with HCQ+Azithro were virologically cured vs 57.1% of HCQ only (14 pts) vs 12.5% in control (16 pts)
Although this data is potentially promising there are a few things to consider
1. This study is not powered for efficacy
2. Small sample size
3. No long term follow-up (although virologically cured unknown if it returned)
4. Unclear info on pt co-morbidities who received drugs
Read 5 tweets
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Dr. Krutika Kuppalli
@KrutikaKuppalli
Since #California is #shelteringinplace for #COVID19 here tips for how to survive based on my 21 day quarantine after returning from W. Africa

1. Develop a daily routine/schedule
2. Limit time on TV/Internet dedicated to COVID-19
- Check news 1-2x/day
- Follow a few sources
3. Exercise
- Go for a walk/run, try an online yoga class or video
4. Schedule FaceTime or Skype calls with friends/loved ones (particularly the elderly)
5. Pick up a new hobby
-Cooking, painting, take an online course in something you always wanted to learn (@coursera)
6. If nervous/anxious try to meditate.
- You can use apps like @Headspace or @calm
7. Have virtual "dates" via @Zoom or @Skype
- coffee, drinks, dinner, movie nights
8. Organize that room/closet you have always wanted to
9. Play online games with friends (i.e. @wordsproblems)
Read 4 tweets

Related threads

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Shyam Sundar
@shyamsundark
Here's the consolidated helpful links, phone numbers & details.

ℹ️ #CHENNAI COVID-19 HELP LINKS
🔗 many.link/tn-covid19 [single link to access all information]

#covid19 #TNAgainstCorona #21daylockdown #covid #CoronaAlert #CoronaUpdate
Sources: Official Twitter handles of TN Chief Minister @CMOTamilNadu, Greater Chennai Corporation @chennaicorp , Dr. Alby John IAS @albyjohnV, Chennai Police @chennaipolice_ & others. Note: Call helpline numbers only when needed. Stay Home & Stay Safe.
🆘 Helpline - Chennai Zone Wise 🏙️

Link -

Any issues or have any important queries, please call your respective Z.Os or RDCs and get it resolved.
Read 29 tweets
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Omar Kassim 🏡
@okassim
⚡️ In a communication to staff earlier today, @MediclinicME's CEO, @Hadleyd outlined their take on #COVIDー19's trajectory in the UAE

For reference, @MediclinicME is one of the largest private healthcare providers in the UAE, operating 7 hospitals, 21 clinics and 920+ beds
🦠 40% of the UAE population will contract the virus at some point

📈 If the current trajectory continues, 100K cases in one month

☠️ Age adjusted for the UAE, death rate = 0.2%

🏥 1% of infected will require hospitalisation, but 25% will require ICU treatment
Bottom line: Assuming a UAE population of 9.5m people, 3.8m estimated to be infected, resulting in 36,500 hospital admissions, 9,000 ICU admissions and over 6,500 deaths
Read 3 tweets
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Yolonda (with an “O” in the middle) Wilson
@ProfYolonda
A brief thread about how the #COVIDー19 crisis in my small hometown of Albany, GA (Dougherty County) exposes some of the challenges unique to healthcare in rural places, but also serves as a harbinger of things to come in larger places. 1/14
Albany is a hot spot. Two and a half weeks ago there were zero cases. Now Albany has the largest number of cases per capita in the state of Georgia. Eleven people are dead. The ICU is FULL (more on that later). Let that sink in. 2.5 weeks from zero to devastation. 2/14
Here is a helpful interactive map of COVID-19 cases in Georgia. You see the dark mass of counties comprising the Atlanta metro area. Then you see one lone dark county in south GA. That's Albany. Someone came into town for a funeral. Now here we are.
albanyherald.com/local/georgia-… 3/14
Read 14 tweets
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Nathan Stall 🇨🇦
@NathanStall
1/7 What is the max daily number of incident #COVIDー19 cases a healthcare system could manage?

@vasilepi @BreslowDay @mattwrkntn @BogochIsaac and I made an interactive tool modelling the capacity of acute and critical care resources during the pandemic: caic-rt.shinyapps.io/CAIC-RT/?utm_s…
2/7 The tool determines the max daily number of incident #COVIDー19 cases where the rate of #COVIDー19 patients being admitted to acute care, critical care or requiring mechanical ventilation ("patients in") equals the max daily turnover rate of those resources ("patients out").
3/7 Data from the @CDCgov @CDCMMWR on age-based case distribution and severity (cdc.gov/mmwr/volumes/6…) are used to estimate the population-weighted proportion of #COVIDー19 patients requiring acute and critical care resources ("patients in").
Read 7 tweets
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Maya FLATTEN THE CURVE Hammoud, MD,MBA
@Maya_Michigan
How to reduce healthcare worker exposure and flatten our #COVID curve
This is what we’re doing w/ OBGYN faculty and residents
1. Separate providers: Inpatient & Outpatient
2. Divide in 2 teams: Active Duty (in person care) and Reserve Duty (Virtual), rotate on 2 wk basis (1/4)
3. Cluster L&D shifts: Same day team and same night team over several consecutive days
4. If pairing or teams, always pair/team the same people together and replace them as a team if one becomes ill (2/4)
5. Mandate each person wipe down the work station/keybboard before each shift and sanitize hands regularly – multiple users at computer stations is unavoidable across a day
6. Enforce social distancing by removing/re-arranging furniture in common areas (3/4)
Read 5 tweets
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Hassan Ahmad 🇺🇸
@HMAesq
#Healthcare is a fundamental human right. In 2018, our legislature helped to ensure that right by expanding Medicaid. As of today, nearly 250K Virginians have enrolled in the program and now have access to quality healthcare.
This is what happens when we elect Democrats who are tenacious and unwilling to accept the status quo. But we still have work to do. We still have an opioid epidemic that is devastating communities and major improvements that need to be made to our mental health care system.
Last week, I was happy to visit one of our local facilities and have a great discussion with physicians and staff about these issues; we even tackled the benefits of community health.
Read 5 tweets

Trending hashtags

#TaskForce #Soliga #TransformationalLeadership #WHO #Ooty #backache #AYUSH #Revolutionary #RNA #TraditionalMedicalPractices #Hydroxychloroquine #Chicagohospitals #DriveThru #China #COVIDー19 #TIF #COVID #SafetyFirst #OutOfAfrica #EpiPen #Teva #Karnataka #Pediatricians #Brainstorming #Uptown

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