geoffrey modest medical blogs

blog from 4/1/20 A recent study from China raised the potential continued infectivity of SARS-CoV-2 from stool and sputum up to 39 days after pharyngeal samples were negative (see  covid pos sputum feces longterm AIM2020  in dropbox, or doi:10.7326/M20-0991 )   Details: -- 133 patients who were admitted to the hospital with documented Covid-19 infection, over a 5 week period -- 22 of these patients had an initial or follow-up positive sputum or fecal sample for  SARS-CoV-2 while having  negative follow-up pharyngeal samples, per protocol below     -- 545 specimens were collected from these 22 patients: 209 pharyngeal swabs, 262 sputum samples, and 74 feces samples     -- 18 of these patients were 15-65 years old, 14 male, 11 had a history of the travel or exposure to an individual from Hubei province in the past month.     -- 17 had no coexisting condition (of the other 5, 4 had hypertension, 2 diabetes, 1 COPD: ie, none had signfic...

blog done 4/8/20 for those interested in the pharmacology of chloroquine in the context of SARS-CoV-2, see  https://reader.elsevier.com/reader/sd/pii/S0924857920300881?token=B8320F2D7609180B3203A21CD0B1DC787CBE966357763D4CBB12AEEAD8F7E0BFC9E9508DFE1C4D07455BE25148893E08  , sent to me by julita mir.   this review indicates that chloroquine/hydroxychloroquine might have several different mechanisms of antiviral action that could impede SARS-CoV-2  -- chloroquine has widespread antiviral effects (including SARS-CoV-1, hiv, zika, dengue, hepatitis B, hsv...)  found in in-vitro tests.     --for SARS-CoV-2, there are suggestive data that chloroquine:     --can inhibit a pre-entry step of the viral cycle: interfering with viral particles binding to ACE2 receptors     --can impair another early step in viral replication: interfering with pH-dependent endosome-mediated viral entry: prevention of endocytosis and/or elevating endosomal pH...

for those interested in the pharmacology of chloroquine in the context of SARS-CoV-2, see  https://reader.elsevier.com/reader/sd/pii/S0924857920300881?token=B8320F2D7609180B3203A21CD0B1DC787CBE966357763D4CBB12AEEAD8F7E0BFC9E9508DFE1C4D07455BE25148893E08  , sent to me by julita mir. this review indicates that chloroquine/hydroxychloroquine might have several different mechanisms of antiviral action that could impede SARS-CoV-2  -- chloroquine has widespread antiviral effects (including SARS-CoV-1, hiv, zika, dengue, hepatitis B, hsv...)  found in in-vitro tests.   --for SARS-CoV-2, there are suggestive data that chloroquine:     --can inhibit a pre-entry step of the viral cycle: interfering with viral particles binding to ACE2 receptors     --can impair another early step in viral replication: interfering with pH-dependent endosome-mediated viral entry: prevention of endocytosis and/or elevating endosomal pH (a pH-...

A recent study from China raised the potential continued infectivity of SARS-CoV-2 from stool and sputum up to 39 days after pharyngeal samples were negative (see  covid pos sputum feces longterm AIM2020  in dropbox, or doi:10.7326/M20-0991 ) Details: -- 133 patients who were admitted to the hospital with documented Covid-19 infection, over a 5 week period -- 22 of these patients had an initial or follow-up positive sputum or fecal sample for  SARS-CoV-2 while having  negative follow-up pharyngeal samples, per protocol below     -- 545 specimens were collected from these 22 patients: 209 pharyngeal swabs, 262 sputum samples, and 74 feces samples     -- 18 of these patients were 15-65 years old, 14 male, 11 had a history of the travel or exposure to an individual from Hubei province in the past month.     -- 17 had no coexisting condition (of the other 5, 4 had hypertension, 2 diabetes, 1 COPD: ie, none had signficant immu...