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🦘Cacatman's Personal Coronavirus COVID-19 Update Thread

Complications - Neurological issues Post COVID-19
- Loss of gray matter in survivors (study from 782 volunteers)


- serious infections of COVID-19 may damage the brain leading to long-term complications such as stroke or dementia-like symptoms. The authors noted that more data is needed to adequately assess the effects of COVID-19 on brain health, though.
 
Testing - PCR False Negative/False Positives
Our findings come mainly from 38 studies that provided results based on the time since people first noticed symptoms.

Antibody tests one week after first symptoms only detected 30% of people who had COVID-19. Accuracy increased in week 2 with 70% detected, and was highest in week 3 (more than 90% detected). Little evidence was available after week 3. Tests gave false positive results in 2% of those without COVID-19.

Results from IgG/IgM tests three weeks after symptoms started suggested that if 1000 people had antibody tests, and 50 (5%) of them really had COVID-19 (as we might expect in a national screening survey):

- 58 people would test positive for COVID-19. Of these, 12 people (21%) would not have COVID-19 (false positive result).

- 942 people would test negative for COVID-19. Of these, 4 people (0.4%) would actually have COVID-19 (false negative result).

If we tested 1000 healthcare workers (in a high-risk setting) who had had symptoms, and 500 (50%) of them really had COVID-19:

- 464 people would test positive for COVID-19. Of these, 7 people (2%) would not have COVID-19 (false positive result).

- 537 people would test negative for COVID-19. Of these, 43 (8%) would actually have COVID-19 (false negative result).

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Treatment - Remdesivir, Dexamethasone Studies
Remdesivir (IV only) reduced hospital stay, but no proven improvement in mortality rate.

Dexamethasone was the first drug proven to save lives 6 mg orally/IV. But only patients on O2 (RECOVERY Trial) - given for 10 days. CRP and ferritin improves. LDH decreases. D-dimer decreases. Not necessary to taper off Dex at 10 days. Could make case to continue dexamethasone.

Acid base status/na/k/cl/hco3/BUN/Cr/Glucose - Check carefully

Hyperventilating in ICU may cause hypernatraemia due to dehydration

Plasma has been used but no controlled trials.

Dexamethasone, a corticosteroid, is the only drug found to have a mortality benefit in SARS-CoV-2 infection in a controlled trial. However, several forms of corticosteroids have shown some degree of clinical benefit in COVID. In some patients who progress to severe COVID-19 disease, it appears that the host immune response may lead to lung injury and multisystem organ dysfunction (Huang, January 2020; Moore, May 2020). Multiple studies on the use of corticosteroids in severe COVID-19 are underway to determine how they may mitigate pathology resulting from hyper-inflammation.

Corticosteroids have been studied via many routes of dosing, most recently the inhaled route, with a study of inhaled budesonide that has shown reduction in hospitalization among patients on inhaled budesonide.
 
J & J (Johnson & Johnson) Vaccine Paused
Six cases of cerebral venous sinus thrombosis (CVST) combined with thrombocytopenia were reported in the U.S., all among women ages 18-48, and all within 6-13 days, with a median of 9 days following vaccination with the Johnson & Johnson vaccine, the agencies reported in a statement.


With approximately 6.8 million doses administered in the U.S., it suggests a one-in-a-million risk. Johnson & Johnson said it was halting the product's distribution in Europe, reportedly taking officials there by surprise.

Out of the over 12 million people who have received the vaccine, there are roughly 100 cases that may be associated with the syndrome. Guillain-Barré syndrome (GBS) is a rare neurological disorder in which the body’s immune system attacks the network of nerves located outside of the brain and spinal cord. Cases can range from mild, with a person experiencing brief periods of weakness, to serious cases that result in paralysis that leaves the person unable to breathe independently, sometimes resulting in death.


Data now published in a major journal show that the Johnson & Johnson COVID-19 vaccine generated strong activity against SARS-CoV-2 for at least 8 months, including against variants of concern.
 
J & J (Johnson & Johnson) Vaccine Paused
Six cases of cerebral venous sinus thrombosis (CVST) combined with thrombocytopenia were reported in the U.S., all among women ages 18-48, and all within 6-13 days, with a median of 9 days following vaccination with the Johnson & Johnson vaccine, the agencies reported in a statement.


With approximately 6.8 million doses administered in the U.S., it suggests a one-in-a-million risk. Johnson & Johnson said it was halting the product's distribution in Europe, reportedly taking officials there by surprise.

Out of the over 12 million people who have received the vaccine, there are roughly 100 cases that may be associated with the syndrome. Guillain-Barré syndrome (GBS) is a rare neurological disorder in which the body’s immune system attacks the network of nerves located outside of the brain and spinal cord. Cases can range from mild, with a person experiencing brief periods of weakness, to serious cases that result in paralysis that leaves the person unable to breathe independently, sometimes resulting in death.


Data now published in a major journal show that the Johnson & Johnson COVID-19 vaccine generated strong activity against SARS-CoV-2 for at least 8 months, including against variants of concern.

EMA’s safety committee (PRAC) has recommended that people who have previously had capillary leak syndrome must not be vaccinated with COVID-19 Vaccine Janssen.
 

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