geoffrey modest medical blogs

recent evidence suggests that the seroprevalence of SARS-CoV-2 is >10 times higher than reported (see the CDC summary at  https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/commercial-lab-surveys.html  , and the article preprint at  https://www.medrxiv.org/content/10.1101/2020.06.25.20140384v1.full.pdf Details: --the CDC partnered with 2 commercial labs to assess SARS-CoV-2 antibodies from 6 areas: Connecticut, South Florida, New YorkCity metro area, Missouri, Utah, and Western Washington State. they will expand to 4 other states as well: California, Louisiana, Minnesota, and Pennsylvania --they tested 11,933 blood samples collected for other reasons (sick or routine visits unrelated to Covid-19, such as lipid screening) --goal:1,800 samples from each area, approximately every 3-4 weeks --they balanced the sampling by age (0-18yo, 19-49, 50-64, >65) and sex --this was compared to the positivity rate of PCR of SARS-CoV-2 in those areas --sera were tested at the CDC, having &q

This study augments the initial IMPACT study on triple therapy for COPD previously reported, by collecting and reporting additional data ( see  copd triple therapy dec mortality amjrespcritcare2020  in dropbox,  https://www.atsjournals.org/doi/10.1164/rccm.201911-2207OC   or  https://www.atsjournals.org/doi/pdf/10.1164/rccm.201911-2207OC   Details  (elaborated further in blog of 2018 publication ( http://gmodestmedblogs.blogspot.com/2018/05/copd-improvement-with-triple-inhaler.html ) : --10 ,355 symptomatic COPD patients were randomized to fluticasone/umeclidinium/vilanterol (FF/UMEC/VI) vs UMEC/VI vs FF/VI in patients with COPD at risk of future exacerbations [fluticasone is an inhaled corticosteroid (ICS), umeclidinium is a long-acting muscarinic antagonist (LAMA), and vilanterol is a long-acting   b 2 -agonist (LABA)]. these combos were also referred to in the studies as ICS/LAMA/LABA vs LAMA/LABA vs ICS/LABA, respectively)     --of note, they randomized only 20% to the LAMA/LABA gr

it is pretty clear that many people have residual symptoms after Covid-19 that can last for at least 1+ months (sometimes much longer), and in my limited anecdotal experience, the most common one is fatigue (though anosmia/dysgeusia can also last a long time). there are some ongoing studies to look at these longer term symptoms (eg CORAL: see  https://www.nhlbi.nih.gov/news/2020/looking-forward-understanding-long-term-effects-covid-19  or  https://www.omf.ngo/2020/04/26/tracking-covid-19-patients/  ).  A recent article in The Atlantic focused on 9 people considered "long-termers" or "long-haulers": see  https://www.theatlantic.com/health/archive/2020/06/covid-19-coronavirus-longterm-symptoms-months/612679/ , brought to my attention by Hannah Webb and  Emily Lowenberg .  These nine people were relatively young and had what was considered mild Covid-19 infections. but, so far, they have had months of subsequent prolonged disabling symptoms, that may wax and wane, or b