Major caveat is that most autopsies included were from first wave, pre-#RECOVERYtrial and use of steroids and other immunomodulation likely increase risk of #CAPA.
Big congratulations to Dr Brittany Kula (@ScrofKula), ID fellow extraordinaire @UofA_ID and soon @UAlberta_ICU fellow, for doing a wonderful job leading this study. Brittany is pictured in the first tweet, and here is her cat Gladys
Many thanks also to collaborators @ClancyNeil and Hong Nguyen @mhn5pittedu1. This was a companion / complementary study to one Neil led on bacterial superinfections detected on autopsy (which is much more difficult to determine conclusively) academic.oup.com/ofid/article/8…
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My conclusion: clearly there is a clinically meaningful benefit in patients who require supplemental oxygen but not higher levels of respiratory support.
Personally I would also use it in critically severe disease *if supply was not a constraint*. But unfortunately it is.
Thanks to the US “me-first” approach to hoarding remdesivir, minuscule supplies are available in Canada.
We were allocated 30 courses for the *entire province* (4.5 million people) outside of a clinical trial (which is not an option at most hospitals)
A reminder of how the 🇺🇸🇨🇦 HCQ PEP trial came to be through #IDTwitter.
We didn’t have any details of how or if this would work... Todd just decided to get it done, adapting David’s protocol to Canada with support from colleagues in Manitoba & Alberta.