Thread by @ChrisCarrollMD

Very excited for this @CHESTCritCare session! From Zero to Sixty: The Fast Changing Science of #COVID19 Care at the Bedside. Coming up at 8:45 CT at #CHEST2020

@ThinkMD: Moderating this great session! #CHEST2020

First up: Dr. Tatjana Calvano: The State of #COVID19 Diagnostics #CHEST2020

Dr Calvano: Testing is our way out #CHEST2020

Dr Calvano: An abundance of testing out there. So many factors that influence performance. Currently 186 molecular, 56 antibody and 6 antigen tests available. #CHEST2020

Dr Calvano: Significant testing limitations. #CHEST2020

Great table on Molecular vs. Antigen vs. Serology tests. #CHEST2020

Dr Calvano: Much controversy of testing site. Data controversial in literature and not a clear answer yet #CHEST2020

Dr Calvano: PCR testing. High false negative rate on day 1 of illness (false negative rate declines with time). Diagnostic accuracy depends on specimen collection. #CHEST2020

Dr Calvano: Antibodies cannot diagnose current infection. Asymptomatic patients may seroconvert later or not at all. #CHEST2020

Dr Calvano: Antigen testing can have quick turnaround but best earliest in illness. Good for POC testing. #CHEST2020

Next up: @RMavesMd: Antiviral and Immunologic Therapies for #COVID19. #CHEST2020. Great summary slide from @iamyourgasman!

@RMavesMd: Haven't found the silver bullet for COVID19. As of today, >1300 trials ongoing. So what is the BLUF? Stick to the basics! #CHEST2020

@RMavesMd Remdesivir. ACCT Trial showed decreased time to recovery (10 days vs 15 days). Especially in patients on supplemental oxygen. Analogous to other antivirals for meds for things like flu. #CHEST2020

@RMavesMd. SOLIDARITY Trial release on pre-print (not peer-reviewed). A WHO trial that should not effect or improved mortality. #CHEST2020

@RMavesMd But there are some issues with the SOLIDARITY Trial that will hopefully come out in peer-review. Not blinded, limited data monitoring. For now SOLIDARITY Trial remains a big question mark. #CHEST2020

@RMavesMd Other anti-virals agents studied but not been shown to be effective. #CHEST2020

@RMavesMd Early in the pandemic, some immunomodulating agents studied. But these medications have not been shown to be effective. #CHEST2020

@RMavesMd Convalescent Plasma. Much of the data is retrospective and still awaiting randomized controlled trials. #CHEST2020

@RMavesMd: "The ID doc in me thinks the idea of using glucocorticoids for a viral infection is like fighting a forest fire with kerosene" #CHEST2020

@RMavesMd: However, the RECOVERY Trial showed a benefit to steroids, and a stronger benefit to those more severely ill and on supplemental oxygen #CHEST2020

@RMavesMd And steroid benefit for #COVID19 is consistent among multiple studies. #CHEST2020

@RMavesMd: Lots of other therapies under investigation. #CHEST2020

@RMavesMd: So what's the answer? Master the basics of critical care first. Dexamethasone and Remdesivir for hypoxemic patients. #CHEST2020

Dr David Ferraro: Preventing the spread of #COVID19. Some primary considerations. #CHEST2020

Dr Ferraro: Basic Tenets of Infection Control and Prevention. #CHEST2020

Dr Ferraro: Unfortunately, we are still operating at the bottom of the hierarchy of infection control. #CHEST2020

Dr Ferraro: Be like Darth Vader to prevent #COVID19! #CHEST2020

Dr Ferraro: And remember what happened when Darth Vader took off his mask! #CHEST2020

Dr Ferraro: Although HFNC was thought to increase spread of virus, recent studies have shown that HFNC has less spread than venturi masks. #CHEST2020 @rrtnpscnpt

Dr Ferraro: Basic principles of infection control. #CHEST2020