1/ *tweetorial* on how to participate in #ATSchats

Helloooo #Medtwitter , #PCCSM people, and everyone else interested in participating in the #ATSchat s: this 🧡 is for you!

If it's your first time and you don't know how to do it, follow me ;-) @atsearlycareer @atscommunity
2/ At the scheduled date/time:
1.Type #ATSchat in the search bar at the top right of your window.
2.Ensure you click on the β€œlatest” tab: This allows the chronologically most recent tweets to show up allowing you to easily follow the chat!

(see screenshot below)
@SushmaCribbs
3/ @ATSearlycareer will post the questions starting with Q1, Q2, Q3, and so on.

You can answer the question in one of two ways:

a. Below is one way (see screenshot): type in #ATSchat and A1, A2 respectively and answer it ;-)
4/
b. The other way to answer the #ATSchat is to hit the retweet button (RT) button, and then do it with a comment.
You type in your answer, again starting with A1, A2, A3 … followed by #ATSchat.
5/ To follow the chat (as others are also answering it), you can refresh your screen by hitting the β€œLatest” tab regularly.

You will likely find responses from other experts/participants that pique your interest. Responding to such tweets is encouraged!
6/ When interacting in the chat, remember to type the hashtag #ATSchat and the "answer number" to which it refers to (A1, A2 etc) before you hit the send button.

This is important ;-)
7/ Last but not least, please have fun & connect!

#ATSchats are meant to be educational βœ…, to offer network opportunities βœ… but also to create an environment for connection in a true way. And that all depends on us, so, come aboard!
8/ Optional: if you really wanna fancy it up: try using tweetdeck on your computer/laptop.

Tweetdeck is Twitter’s own offering and does not need any new sign up. It allows you to break your screen into different windows that allow one to follow conversations easily!
9/ A big thanks to @virenkaul who have compiled all of it!

By the way, if you are not following him already, you are missing out on great PCCSM content ;-)

β€’ β€’ β€’

Missing some Tweet in this thread? You can try to force a refresh
γ€€

Keep Current with Leticia Kawano-Dourado πŸ‡§πŸ‡·

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More from @leticiakawano

5 Sep
1/ Another result of the collaborative effort, Coalition Covid-19 Brazil, is out!
Kudos at this time to HIAE trial coordination: Otavio Berwanger & Remo Furtado, not on twitter πŸ˜• @JuliaMachline #COVIDγƒΌ19 @TheLancet @f_g_zampieri @a_serpaneto @FlaviaSepsis @azevedo_lcp
2/ Here the population included in the trial, note that about half of pts were on IMV, ~1/4 shocked. Steroids were being administered to only 15-20% (at that time, early on in the pandemic, steroids were not known to benefit severe covid-19 pts)
3/ At day 15, the use of azythromycin 500mg/d for 19 days did not change health status, look at death (6) and IMV (5) or discharged pts (1)
Read 6 tweets
2 Sep
1/ It's out! The Codex trial.
This is the 2nd RCT result published as a result of an unprecedented collaborative research effort, the Coalition Covid19 Brazil πŸ‡§πŸ‡·.
Deserve special recognition: @azevedo_lcp @ICURevisited and all HSL team!

jamanetwork.com/journals/jama/… @JAMA_current
2/ In the Codex trial, mod-severe Covid-19 ARDS cases were randomized to Dexa 20mg/d for 5 days followed by 10mg/d for more 5 days.

*Dexa increased the number of days alive & free of mechanical ventilation in 28 days*

PS: for MV-free days, death was penalized as 0 free days
3/ When you breakdown the composite 1ary outcome in its components, note that mortality was the major driver of difference between groups. No short-term difference in AE was noted:
Read 8 tweets
24 Jul
1/ Some more information on our study Coalizao 1, on HCQ/Azithro for #Covid19 that explains some issues:

@f_g_zampieri @damiani_petri @tlisboa79 @azevedo_lcp @FlaviaSepsis @a_serpaneto
Before I start, the first thread on the study is here:
2/ Back in March, we knew much less than we know today on Covid19 (and as a consequence v. little information to inform RCT design)
Regulatory agencies & WHO have defined the ordinal scale as an important outcome.

As @f_g_zampieri commented (in Portuguese) elsewhere
3/ We realized, after the trial started, that a clinical status ordinal scale would be potentially problematic given that the level of support offered could differ between countries and local practices not reflecting necessarily dz severity
Read 7 tweets
23 Jul
1/ Our study (Coalition I) on HCQ and azithromycin for #Covid19 is out!
This study is the effort of an unprecedented collaboration (Coalition Covid19 Brasil) established between major Brazilian hospitals and research networks/Institutes.

nejm.org/doi/full/10.10…
2/ Coalition I is one of nine RCTs on drug repurposing and long-term consequences of Covid19 being conducted by this research team.
I am honored and humbled to be part of this research effort in Brazil in such daring times.
3/ 667 hospitalized pts w mild to moderate Covid19 (pts on NIV/HF or MV were non-eligible) were randomized 1:1:1 to:
-HCQ + Azithromycin + Standard of care* (SoC)
-HCQ + SoC
-SoC
*SoC: antibiotics (~60%), oseltamivir (~25%), and steroids (~20%) w/o difference between groups.
Read 8 tweets
29 May
1/ How is it, on a personal level, to be a Respiratory physician & #Covid_19 researcher in the epicenter of the #coronavirus pandemic, in Sao Paulo, πŸ‡§πŸ‡·:

I receive phone calls and whatsapp messages almost every day from colleagues & friends all over πŸ‡§πŸ‡· asking for advice/help
2/ Delicate/tender situations happen all the time, as for ex, when a physician friend from another State called me telling me he/she had covid19... he/she was deteriorating & he/she wanted me to help him/her decide on steroids yes/no #ThisIsTough πŸ’” ...
3/ Or when another friend called me to advise him/her on how to properly remove both elderly parents w ARF due to #covid19 through an Air ICU to another State to make sure his/her parents got the life support they needed.
Read 6 tweets
24 May
1/ ACTT-1 preliminary results
πŸ”΄1:1 randomization stratified by dz severity & center - Remdesivir vs placebo (total sample: 1,063)
πŸ”΄1ary outcome: *time* to recovery (time frame: 28d)

nejm.org/doi/full/10.10… @NEJM
2/
πŸ”΄By the time the DSMB recommended for the end of the study, recruitment had finished. Only 391/340 pts in the Remdesivir/placebo group had 28d complete data.
πŸ”΄But the analysis of the population included 1,059 for whom researchers had at least some postbaseline data
3/ Pts were not too old (mean age 58), median time PSO ~9 days, with moderate to severe #covid19
Read 7 tweets

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