🦘Cacatman's Personal Coronavirus COVID-19 Update Thread

[cacatman]

Testing During Initial Hospital Presentation
Baseline tests - CBP, elu, lft, CXR, ECG,
Check for influenza, community acquired pneumonia
If PCR negative, can do a stool PCR
Watch for arrhythmias, cardiac impairment, sepsis, multi organ dysfunction
corticosteroids only in those who become O2 dependent - Dex 6 mg daily for 10 days (or hydrocortisone IV 50 mg 6 hourly) or prednisolone 50 mg for 10 days
Consider Remdesivir

ICU if:-
haemodynamically unstable
worsening tachypnoea/hypoxaemia
require > 40% FiO2 to maintain O2 sats > 92% ie. 4 L/min unable to maintain 92%.

If they get out of hospital, need to stay home for at least 14 days from onset of symptoms

https://covid19evidence.net.au/wp-content/uploads/FLOWCHART-3-MODERATE-SEVERE.pdf?=200924-84344

https://covid19evidence.net.au/wp-content/uploads/FLOWCHART-2-MANAGEMENT-OF-MILD.pdf?=200924-84343

 

[cacatman]

Phone Assessment of Breathing
Assessment of breathing:-
Patient's description of breathing

“Are you so breathless that you are unable to speak more than a few words?”

“Are you breathing harder or faster than usual when doing nothing at all?”

“Are you so ill that you’ve stopped doing all of your usual daily activities?”

Any changes to breathing?
“Is your breathing faster, slower or the same as normal?”

“What could you do yesterday that you can’t do today?”

“What makes you breathless now that didn’t make you breathless yesterday?”

Physical signs - Blue lips, an audible wheeze, or needing to lean forwards and support yourself to breathe are red flags you can ask a patient about.

P.S. Roth Score has been used, but is not considered a validated test for assessing breathlessness after false reassurances.
Count out loud from 1 to 30 in their native language. Count the number of seconds before they take another breath. If the “counting time” is 8 seconds or less, this has a sensitivity of 78% and specificity of 71% for identifying a pulse oximeter reading of <95%. If the counting time is 5 seconds or less, sensitivity is 91%

 

[cacatman]

Vaccine Trials 2/10/20
As of 2/10/20 coronavirus vaccines being trialled
142 preclinical trials (animals)
Phase 1 - 35 (small scale safety trials - 10s of people)
Phase 2 - 19 (expanded safety trials - 100s of people)
Phase 3 - 11 (large scale efficacy trials)
Approval - 0

Oxford, Pfizer, Novovax, uni of melbourne in phase 3 trials

 

[cacatman]

8 Strains of Coronavirus
There are 8 strains of coronavirus altogether that infect humans

Eight strains of coronavirus afflicting the world

Scientists around the world are racing to study the novel coronavirus strain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Now, it appears that there are eight strains of SARS-CoV-2 circulating the globe. The good news is that according to infectious disease physician and...

www.news-medical.net

 

[Tom.]

cacatman going ham

 

[flyer]

Thank you.

 

[Tom.]

8 Strains of Coronavirus
There are 8 strains of coronavirus altogether that infect humans

Eight strains of coronavirus afflicting the world

Scientists around the world are racing to study the novel coronavirus strain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Now, it appears that there are eight strains of SARS-CoV-2 circulating the globe. The good news is that according to infectious disease physician and...

www.news-medical.net

Have you included the new mink related strain?

 

[cacatman]

Have you included the new mink related strain?

There were 7 before that for several months, until the last week, so I guess they included it.

 

[cacatman]

Poor Long Lasting Immunity Post Infection
While 60% of people in the study had "potent" antibodies when they were battling COVID-19, only 17% had the same level of potency three months later, the researchers found.

Longitudinal evaluation and decline of antibody responses in SARS-CoV-2 infection

Antibody (Ab) responses to SARS-CoV-2 can be detected in most infected individuals 10-15 days following the onset of COVID-19 symptoms. However, due to the recent emergence of this virus in the human population it is not yet known how long these Ab responses will be maintained or whether they...

www.medrxiv.org

Overall, 194 participants had detectable antibodies at the beginning of the study. Among the 156 employees who repeated testing, 93.6 percent saw antibody levels decline within 60 days. Twenty-eight percent of healthcare workers saw antibody levels drop to below the threshold for positivity.

Decline in SARS-CoV-2 Antibodies After Mild Infection Among...

This report describes a decline in antibody levels among frontline health care workers who had previously received a positive COVID-19 antibody test and were retested 60 days later.

www.cdc.gov

 

[cacatman]

The 20% of Asymptomatic MAY not be as Infectious as Symptomatic Carriers
Asymptomatic COVID infected people have just as much virus in their noses and throats as symptomatic people. But it doesn't mean they are as infectious.

Upper respiratory viral load in asymptomatic individuals and mildly symptomatic patients with SARS-CoV-2 infection | Thorax

thorax.bmj.com

20% of infected people can be asymptomatic

Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: A living systematic review and meta-analysis

Diana Buitrago-Garcia and co-workers present a systematic review and meta-analysis on asymptomatic SARS-CoV-2 infections.

journals.plos.org