geoffrey modest medical blogs

  I will do a few blogs on potential long-term consequences of Covid-19 infection, the 1 st   one on cardiac involvement documented in a German study  (see  covid cardiac probs common jamacardiol2020  in dropbox, or doi:10.1001/jamacardio.2020.3557)   Details:  -- a prospective observational cohort study of 100  unselected   patients who recovered from Covid-19 (all with positive PCR), identified at the University Hospital in Frankfurt Germany between April and June -- 53% male, median age 49, BMI 25, systolic blood pressure 129/80, heart rate 67 -- pre-existing symptoms in those developing Covid-19 included hypertension in 22, diabetes 18, hyperlipidemia 22, known CAD 13, smoking 22, COPD or asthma 21     --No difference in pre-existing symptoms between those who recovered at home or were hospitalized -- severity of illness: 18 asymptomatic, 49 minor-to-moderate symptoms, 33 severe symptoms (2 underwent mechanical ventila...

  A new trial of remdesivir for treatment of patients with moderate Covid-19 pneumonia found a statistically significant difference in clinical status with the medication, though the difference was of uncertain clinical importance ( see  covid remdesivir review jama2020  in dropbox, or doi:10.1001/jama.2020.16349 )    Details: -- 580 for patients with confirmed SARS-CoV-2 infection by PCR and moderate Covid-19 pneumonia (pulmonary infiltrates and room air oxygen saturation >94%) were randomized to receive a 10-day course of remdesivir, a 5-day course of remdesivir, or standard care. Remdesivir was dosed at 200 mg on day one followed by 100 mg per day IV, in an open label trial in 105 hospitals in the US, Europe, and Asia between March 15 and April 18 -- median age 57, 39% women, 58% white/18% black/18% Asian/18% Hispanic, BMI 27, 84% were at clinical status 5 (see below) -- 56% had cardiovascular disease at baseline, 42% hypertension, 40% diabetes, and 1...

  A recent Korean study found a high rate of people with asymptomatic SARS-CoV-2 (36%), long-term PCR positivity (many over 3 weeks), and similar viral loads to those who were symptomatic (see  covid asx korea jamintmed2020  in dropbox, or doi:10.1001/jamainternmed.2020.3862) .    Details: -- 303 symptomatic and asymptomatic patients with SARS-CoV-2 infection between March 6-March 26 who had been isolated in a community treatment center in Korea because they were SARS-CoV-2 positive -- median age 25, 66% women, 4% had comorbidities (ten had hypertension, one cancer, one asthma)      -- though not statistically significant (especially given the small numbers), it may be notable that only 2 of the patients who were asymptomatic had comorbidities (whereas 10 of the symptomatic ones did) -- median time from diagnosis to isolation was 6 days -- most common symptoms in the symptomatic group were cough (56%), rhinorrhea (46%) and sputum product...