Covid-19

[Lloyd Braun]

For anyone with a child in the 12-17 year range in Cincinnati, Moderna is looking for participants in clinical trials.

https://connect.trialscope.com/studi...-9b4cda3c0e36/

Based on what I see here, we are a long ways off from having covid immunization available for children. Next year at earliest.

[Muskie in dayton]

This is the one I still wonder about. Have we decided HCQ is effective in treating Covid or not? It went back and forth so many times confused with bumbling Trump's ramblings that I don't know if I ever saw a definitive answer from the medical community.

I recently read a CRT meta-analysis preprint that found some effectiveness of HCQ: https://www.medrxiv.org/content/10.1...#disqus_thread

HCQ was associated with a 24% reduction in COVID-19 infection, hospitalization or death, P=.025 (RR, 0.76 [95% CI, 0.59 to 0.97]). No serious adverse cardiac events were reported. The most common side effects were gastrointestinal. Conclusion--Hydroxychloroquine use in outpatients reduces the incidence of the composite outcome of COVID-19 infection, hospitalization, and death. Serious adverse events were not reported and cardiac arrhythmia was rare.

When searching for it, I also found another meta-analysis with similar results: https://www.medrxiv.org/content/10.1....01.20223958v1

A total of 26 articles were found (N=44,521 COVID-19 patients, including N=7,324 from 4 randomized clinical trials (RCTs)); 10 studies were valuable for analysing the association of HCQ+AZM. Overall, the use of HCQ was associated with 21% lower mortality risk (pooled risk ratio: 0.79, 95%CI: 0.67 to 0.93; high level of heterogeneity: I2=82%, random effects). This association vanished (1.10, 95%CI: 0.99 to 1.23 and 1.10, 95%CI: 0.99 to 1.23) when daily dose >400 mg or total dose >4,400 mg were used, respectively). HCQ+AZM was also associated with 25% lower mortality risk, but uncertainty was large (95%CI: 0.50 to 1.13; P=0.17).

[Muskie in dayton]

The WHO just issued new guidance identifying the issue with PCR tests and false positives generated at high cycle thresholds (Ct). This includes a requirement to report the Ct. WHO Information Notice for IVD Users 2020/05

Ultimately this transparency will result in reduced (more realistic) case numbers. Interesting timing, eh?

[Lloyd Braun]

I recently read a CRT meta-analysis preprint that found some effectiveness of HCQ: https://www.medrxiv.org/content/10.1...#disqus_thread[FONT="][FONT="]

When searching for it, I also found another meta-analysis with similar results: [/FONT]https://www.medrxiv.org/content/10.1....01.20223958v1[/FONT]

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Lots of observational data in both of these studies/meta-analyses with lack of placebo. Not saying HCQ is bad, just that this is not exactly a convincing argument for using it.

The WHO just issued new guidance identifying the issue with PCR tests and false positives generated at high cycle thresholds (Ct). This includes a requirement to report the Ct. WHO Information Notice for IVD Users 2020/05

Ultimately this transparency will result in reduced (more realistic) case numbers. Interesting timing, eh?

The number of people that have had covid and never tested far will outweigh and false positives seen. I could argue that this transparency may even increase the number of people tested/number of tests ran and positive cases. Clinical judgement is key and why I continue to uphold the notion of not testing asymptomatic individuals. At this point keeping track of cases is negligible. Establishing an accurate diagnosis to treat though is certainly important however.

Also, i found it interesting to read the first few weeks and months of this thread. There’s lots of Old Takes Exposed which is funny to read (myself too). We just passed 400,000 deaths nationwide and there are some posts referencing this number and how crazy/impossible it would be to approach this number.

[D-West & PO-Z]

Lots of observational data in both of these studies/meta-analyses with lack of placebo. Not saying HCQ is bad, just that this is not exactly a convincing argument for using it.




The number of people that have had covid and never tested far will outweigh and false positives seen. I could argue that this transparency may even increase the number of people tested/number of tests ran and positive cases. Clinical judgement is key and why I continue to uphold the notion of not testing asymptomatic individuals. At this point keeping track of cases is negligible. Establishing an accurate diagnosis to treat though is certainly important however.

Also, i found it interesting to read the first few weeks and months of this thread. There’s lots of Old Takes Exposed which is funny to read (myself too). We just passed 400,000 deaths nationwide and there are some posts referencing this number and how crazy/impossible it would be to approach this number.

Yeah yikes. Some definite cold takes early in the thread.

"Doctors predicting 400,00 deaths are more irresponsible than calling this no big deal"
"They wont cancel the ncaa tournament"
"When this is over in a few weeks or couple months"

etc.

Obviously we couldn't predict what we were in for but man, the beginning pages are interesting to look at.

[xu82]

Hmm, really? That's interesting, I thought a lot of the literature said to try to avoid it if possible, but then again no idea if the patients she's prescribing it to have benefits of HCQ for other conditions even if still prescribed for COVID. I'd be interested to hear the logic behind it.



I got my first dose recently, but my sister got her second dose (Internal Medicine, just turned 30) and the second dose has been the one that's been the most brutal for her and other people she/I know who took it. Absolutely knocked people on their ass for about 48 hours, headaches, fatigue, the whole nine yards. I'll however take a couple days of feeling like crap over possibly transmitting it to my parents or loved ones.

My wife’s niece (a 30-ish doctor) got her second shot and it kicked her butt. A bunch of other people missed work, but she suffered thru it. They think it hurt younger people worse, but who knows? It was a day or two of rough times, but she’s glad she did it and glad it’s behind her.

[muskiefan82]

My wife’s niece (a 30-ish doctor) got her second shot and it kicked her butt. A bunch of other people missed work, but she suffered thru it. They think it hurt younger people worse, but who knows? It was a day or two of rough times, but she’s glad she did it and glad it’s behind her.

I get my second shot in a week. I have heard the same types of things, but I am still going to get it.

[paulxu]

Just some general questions for you guys who work with this stuff, as I'm getting ready to get the first shot.

1 - Why is there a need for a second shot. I think the vaccine is different than the regular flu in its creation process with the RNA stuff, but why a second shot?

2 - Can you go a little longer between doses than the 21/28 day recommendations, and still be OK?

[noteggs]

Just some general questions for you guys who work with this stuff, as I'm getting ready to get the first shot.

1 - Why is there a need for a second shot. I think the vaccine is different than the regular flu in its creation process with the RNA stuff, but why a second shot?

2 - Can you go a little longer between doses than the 21/28 day recommendations, and still be OK?

1 - As you know, the second shot will give you the 95% efficacy and from what I’ve read, the first shot is about 50% effective. Yes it’s because of mRNA technology and pharmacokinetics of the drug.

2 - The CDC states there is no maximum interval between the first and second shot. Keep in mind, Moderna measured its maximum efficacy of its vaccine starting 14 days after the second dose, while Pfizer measured it starting seven days after the second dose. In nutshell, the longer you wait will determine maximum coverage.

[paulxu]

1 - As you know, the second shot will give you the 95% efficacy and from what I’ve read, the first shot is about 50% effective. Yes it’s because of mRNA technology and pharmacokinetics of the drug.

2 - The CDC states there is no maximum interval between the first and second shot. Keep in mind, Moderna measured its maximum efficacy of its vaccine starting 14 days after the second dose, while Pfizer measured it starting seven days after the second dose. In nutshell, the longer you wait will determine maximum coverage.

Thanks!