geoffrey modest medical blogs

  A randomized controlled trial in India found that convalescent plasma did not help adults with moderate Covid-19 infections, the PLACID Trial (see   covid convales plasma not help bmj2020   in dropbox, or   dx.doi.org/10.1136/bmj.m3939)    Details: --464 adults admitted to one of 39 public and private hospitals across India from April till July, all with PCR=confirmed moderate Covid-19 infection (PaO 2 /FiO 2  of 200-300 mmHg or respiratory rate of > 24 per minute with oxygen saturation 93% or less on room air) -- all received the standard of care, though 235 of them also received convalescent plasma      -- those receiving convalescent plasma received 200 mL transfused 24 hours apart, for total of 2 doses      -- the presence and levels of neutralizing antibodies were not measured beforehand, but were at the end of the study -- 94% of the donors were men, mean age 34, median disease duration was 6 days, and most had mild disease. Recovered patients who had moderate or severe dise

  A recent multi-state study looked at the asymptomatic/presymptomatic SARS-CoV-2 infection rates in nursing homes, finding that 60% were in these categories (see  covid asymptomatic nursing homes jamaintmed2020  in dropbox, or doi:10.1001/jamainternmed.2020.5664) Details: --data from Genesis HealthCare, a multi-state long-term care provider with 350 skilled nursing facilities (SNFs), accessing their electronic medical data logs of infection dates and results, from March 16 til July 15.      --given the variability of testing in SNFs by region/state, they assessed only SNFs with at least 1 point-prevalence survey, which included 182 SNFs --all patients had nursing assessments at least twice a day, recording symptoms --patients were considered symptomatic if they had new suggestive Covid-19 symptoms within 5 days of first positive test; presymptomatic if no suggestive symptoms in those 5 days before testing but then developed suggestive symptoms within 14 days; and asymptomatic if no sy