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Priya Sampathkumar

@PSampathkumarMD

21 Apr

I am getting calls from friends/ family in India about COVID. From neurosurgeons to urologists, doctors are being roped in to handle the crisis.

1/ Having managed pts with COVID for the last year & having the luxury of time, here are my thoughts for those new to this battle.

2/ Diagnosed COVID? What next ?

Check oxygen sats.
If sats > 90%, reassure
-Paracetamol as needed for fever
-Inhaled steroids (budesonide)
-Continue to follow sats
-No need for hospitalization
-No need for chest CT

3/ if O2 Sats < 90%

-Supplemental oxygen
-Dexamethasone 6 mg/day or equivalent steroid (prednisone 40 mg, methylprednisolone 30 mg; hydrocortisone 150 mg
Steroid preparation/route does not make a difference
-Prone positioning ( sleeping on stomach)

Read 7 tweets

Priya Sampathkumar

@PSampathkumarMD

17 Mar

Astra Zeneca vaccine has been paused in many European countries due to concerns about blood clots. What do we know. What does this mean?

1/ 17 million doses in UK and EU - To date 15 cases of deep vein thrombosis & 22 cases of pulmonary embolism. Rate is not higher than expected

2/However cases of blood clots veins in the brain, called central venous sinus thrombosis have been reported. These are very rare occurrences and this is concerning

3/ So far Denmark, Norway, Bulgaria, Iceland, France, Germany, Italy, Spain, Portugal, Slovenia, and Cyprus have suspended all use of the vaccine. Five other countries (Austria, Estonia, Latvia, Lithuania, and Luxembourg) have paused the use of a single batch of the vaccine.

Read 10 tweets

Priya Sampathkumar

@PSampathkumarMD

15 Mar

@MayoProceedings

COVID outcomes at Mayo Clinic.

1/ Outcomes in 7217 adults and 674 children published in @MayoProceedings

2/ In adults:
897 of 7217 (12%) needed hospitalization

354 of 7217 (5%) needed ICU

94 of 7217 (1.3%) died

@MayoClinic @MayoClinicINFD mayoclinicproceedings.org/article/S0025-…

3/ Risk of hospitalization by age:

<18: 2%
18-34: 3.5%
35-49: 10%
50-64: 18%
65-74: 30%
>=75: 46%

4/ Risk of needing ICU admission by age:

<18: 0.3%
18-34: 1%
35-49: 4%
50-64: 8%
65-74: 13%
>=75: 16%

Read 8 tweets

Priya Sampathkumar

@PSampathkumarMD

1 Mar

50 million people in the US have received a COVID vaccine.
What changes after vaccination?

FAQ Thread
1. Do vaccinated people still need to wear masks around others?

Yes. For the time being, until enough people in the population are vaccinated.

There is concern that vaccinated people can still get asymptomatic COVID and then transmit it to others. Until a large proportion of the population is vaccinated please wear a mask to protect others.

2. But what if everyone in a small family or social group is vaccinated?

In a small group in which everyone has been vaccinated its OK to meet without masks. Risk is low

In work settings masks are still recommended as verifying vaccination & health status of coworkers is tricky

Read 8 tweets

Priya Sampathkumar

@PSampathkumarMD

15 Dec 20

FAQs on Pfizer COVID vaccine.
Thread

1.Which COVID vaccine should I get? Is one better than others?

You should get the vaccine you are offered. Getting a large number of people vaccinated is more important than differences in vaccine efficacy

2.Who cannot get the Pfizer COVID Vaccine?

Under the current EUA - those younger than 16 years cannot get the vaccine.

3. What about people with allergies? Can they get vaccinated?

Two nurses in the UK had a serious allergic reaction to the vaccine. Both had history of serious allergic reactions in the past that were severe enough to require that they carry epi pens.

Read 17 tweets

Priya Sampathkumar

@PSampathkumarMD

11 Dec 20

@US_FDA

Pfizer-BioNTech COVID-19 VACCINE UPDATE

Thread
Pfizer-BioNTech and Moderna, have applied for @US_FDA Emergency Use Authorization for their mRNA based vaccines.

Here is what we know about the Pfizer vaccine and what it means. @MayoClinic @MayoClinicINFD

1/

The Pfizer vaccine has received Emergency Use Authorization in the UK and Canada and the vaccination campaign in the UK has commenced. An FDA expert panel has recommended approval of the Pfizer vaccine.

2/

44,000 patients were enrolled in the Pfizer-BioNTech trial. Half received two doses of the COVID-19 vaccine separated by 21 days, the other half received a placebo. Data from the first 36,621 patients was analyzed in mid-November

3/

Read 15 tweets

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