What have we learned during COVID? Prof Tony Gordon takes us through a whirlwind tour of COVID-19 research.... #SOA21 Image
Scientists AND politicians in the spotlight during COVID. Very different approaches between the two groups.#SOA21 Image
First reports and articles with hundreds of patients.... moving on to thousands of patients. #SOA21 ImageImage
There was a paucity of evidence at the start. We've even seen some retractions. #SOA21 ImageImageImage
But then we learned that RCTs were possible in a pandemic and that ICU treatments can show benefit! #SOA21 Image
IL6 Antagonists in COVID-19 was a new discovery. Immunotherapies can work in some critically ill patients. #SOA21 Image
And things moved very fast.... the next day = announcement. Decades to change clinical practice? Not here. #SOA21 Image
Data sharing worked well across academics and industries. The treatment would become a WHO standard. #SOA21 ImageImage
IL-6 inhibitors alongside Steroids - another section of research entirely too!
Critically ill, or ward-based? The data showed different things in different groups (different times of admin). Proving we should always test an RCT. #SOA21 These were actually a collab from REMAP-CAP platform and beyond. Image
Convalescent Plasma? No. But maybe there are subgroups who would.... (see immunodef section in middle here...?) #SOA21 Image
We have a panel to expedite useful studies. This helped us prioritise and deliver results as quick as possible. Image
ICU recruitment was really excellent. What used to take 2-3 years, took a Christmas period.... #SOA21 Image
Remdesevir.... We didn't compare against placebo - so who knows? Still a bit of a shame we didn't get more info about this drug #SOA21 ImageImage
Who benefitted from MAbs? - Different if you've started making your own antibodies or not. #SOA21 Image
Not all about trials. We need to understand more about the disease itself. What about anti GM-CSF strategies? Also - what about Baricitinib for example? #SOA21 Image
CPAP! Led to less mortality/intubations. Avoiding intubation is the key mechanism here. But for how long do we keep on with CPAP? More to come in this area.... #SOA21 Image
We've seen some of the best and the worst in research across the world.... but overall UK research has been excellent. We've had a lot of useful outcomes in our research... and this has obviously helped a lot of people. Plenty more to be done. #SOA21 Image
"How much time and science must be wasted on backing up people's pet theories?" Is a HUGE question for medicine/science.... @docpgb #SOA21
Is there a 'vanity' in biomedical research that displaces some very important research on social factors that looks at vaccine uptake/lockdowns etc? @docpgb #SOA21
New favourite phrase, "epistemic trespassing" #SOA21 academic.oup.com/mind/article-a…

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More from @Gas_Craic

8 Dec
What were the most impactful non-COVID papers over the past 2 years? Let's delve in and take a look. #SOA21 Image
Finally an opportunity to not talk about COVID! #SOA21 ImageImageImage
TOMAHAWK - immediate vs delayed/selective angio. 3 years to conduct the trial in 31 ICUs. 554 patients. 'Worse' survival in immediate angiograph? Not SS, but close... #SOA21 ImageImageImageImage
Read 27 tweets
8 Dec
We've looked at bats for a long time.... #SOA21 They have strong interferon responses, but not strong inflammation.... Image
So what happens instead? #SOA21 They will tolerate high levels of viraemia with little symptoms. Bats are old... 65million years ago - they appeared at the end of the dinosaurs! They are far longer lived that other mammals. Senescence is late - more towards end of life. Image
Read 14 tweets
7 Dec
Organophosphate poisoning, toxicology, dengue, snake bites and malaria.... sure what could go wrong? #SOA21 @ICS_updates Drs. Chacko, Yacoub, Bhaumik and Dondorp tell us more.... 🧵👇😘 Image
Let's go to India - Tamil Nadu. ImageImage
I'd advise anyone not overly family with Organophosphates to start here: ncbi.nlm.nih.gov/books/NBK49986… #SOA21
Read 43 tweets
7 Dec
Biomarker guided abx treatments in sepsis. We catch up with Drs/Profs: Paul Dark, Stacy Todd, Enitan Carrol, Jonathan Sandoe and Matthew Stevenson on this large area of research @ICS_updates #SOA21 Image
So, do biomarkers have any utility in guiding abx use in sepsis? We can measure, usually, these ones fairly easily: #SOA21 Image
In around 2014, commissioned review in PCT. Seemed to suggest a shorter duration in abx use when PCT used.... tenuous data though. #SOA21 Low quality. Little evidence from UK... how does this fit into NHS practice in the realms of stewardship? ImageImage
Read 13 tweets
7 Dec
@iceman_ex, myself and @dr_mattmorgan talk about how to keep yourself intellectually safe on Social Media at #SOA21 (full talk at soa.ics.ac.uk)

A thread 🧵👇 Image
There's been a lot that's gone on over the past few years that's exposed the well known 'darker' side of social media. Traditional paradigms of knowledge dissemination have changed (if not disappeared). Much higher tech-savy population. #SOA21
This has democratised the discussion space to an extent. It allows for *anybody* (lit. anybody) to get involved. #SOA21
Read 17 tweets
6 Dec
Is COVID-19 hyperinflammation, or a cytokine storm in a teacup? @DrPujaMehta1 's fab talk from #SOA21 today! Image
Main Q = "Hyperinflation contributing to worse outcomes for some patients with COVID-19" - clinical similarities to sHLH seen. Viruses are the most common trigger of sHLH. Early reports from China suggested cytokine profile was similar to sHLH in terms of COVID severity. #SOA21 Image
We now know some things work and some things don't.... in certain populations. #SOA21 Image
Read 28 tweets

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