COVID-19 Clinical Study Update and Other Critical Information | Orthopedics This Week

COVID-19 Clinical Study Update and Other Critical Information

Source: Wikimedia Commons and Martin2035

Lynn Peterson, who, in our opinion, is one of the best reporters in medicine today, continues to come up with the best, most authoritative information about the rapidly accelerating SARS-CoV-2 virus and the disease it causes, COVID-19 (aka: coronavirus).

We won’t tell you everything Lynn wrote. It is available from her publication, Trends-in-Medicine[1]. But here are some highlights from her latest update.

Highlights From Peterson’s Report

  • If you get COVID-19, How Long will it last? – Based on data from China and the U.S. COVID-19 lasts a few days to weeks or months. Patients who die, die from acute respiratory distress syndrome (ARDS), for which there is no treatment. In the most critical cases, respirators are the last line of defense.
  • How Long Does COVID-19 Live on Hard Surfaces? – According to Peterson, an unpublished study by National Institutes of Health (NIH) says that the virus can live on hard surface for as long as 3 days, on cardboard for a day. It dies faster in direct sunlight. Food contamination is not believed to be an issue, but utensils can be infected. According to Peterson, “The virus also can survive in the air for several hours.”
  • New Tests Are in the Works – The FDA has granted emergency authorization for new rapid tests:
    • Roche’s cobas SARS-CoV-2 Test, an RT-PCR test for COVID-19 that is 10 time faster than the CDC’s test. The test was also given a CE-IVD Mark, so it can be used in Europe as well.
    • Thermo Fisher Scientific’s TaqPath COVID-19 Combo Kit.
    • The CDC is working on two blood tests.
    • Chembio Diagnostics and LumiraDx are collaborating on a point-of-care diagnostic assays for SARS-CoV-2.
    • GenMark Diagnostics’ ePlex test – An emergency use authorization was submitted to the FDA.
    • Hologic is working on a molecular diagnostic test for SARS-CoV-2 that can process ~ 1,000 tests in 24 hours using the Panther Fusion system
    • CT scans – a new study in the journal Radiology found that CT scans can distinguish COVID-19 from usual pneumonia.
  • How Long Does SARS-CoV-2 Viral Shedding Last? – A new study published in The Lancet written by Chinese researchers provided data showing that viral shedding can occur for 8-37 days in virus survivors.
  • What’s the Latest Vaccine Update? – there are more than a dozen vaccines in development including:
    • Gilead Sciences’ remdesivir – This is an antiviral drug originally developed to treat Ebola and failed. Gilead is running two trials, the NIH one and there are two trials in China. It is available for use in patient in the U.S. under compassionate use rules. Gilead is providing the drug to the U.S. military for free.
      • How effective is remdesivir? – According to CDC Commissioner Robert Redfield, M.D., Chinese trial data will be available by April 2020. Peterson, however, was able to get the summary data from a pre-print of a paper to be published, but has NOT been reviewed yet, on the first 12 U.S. patients, 3 of whom were treated with remdesivir. Bottom line, so far, according to Peterson is side effects but no “wow” response.
      • What are the side effects? – Transient gastrointestinal symptoms, including nausea, vomiting, gastroparesis, or rectal bleeding.” In one case these side effects were likely related to prior travel to Mexico. Three patients developed elevated aminotransferase elevation.
      • The researchers concluded – “Because remdesivir use was not given as part of a randomized controlled trial, we are unable to assess its effectiveness or safety.”
      • Median symptom duration was 14 days (range 6-20 days).
      • All patients recovered or are recovering and hospitalized patients worsened in week 2
    • Chloroquine – This is an old anti-malarial for which there is no reliable, detailed information but, according to Peterson’s reporting is flying off the shelves in South Korea and China’s Ministry of Science and Technology is saying that chloroquine should be included in the standard regimen for treating COVID-19.
  • Peterson’s Unanswered Questions – One of Peterson’s superpowers is her ability to ask the right questions. Here is her list of unanswered questions. For the rest of her report, please go to:
    • “How does the outbreak end? Will it end or will it become a regularly circulating virus, infecting people like the common cold – until there is a reliable vaccine?”
    • “What percent of severe patients who survive get or will get pulmonary fibrosis ? Would Boehringer Ingelheim's Ofev (nintedanib) help these patients?”
    • “If a vaccine is developed, will it work like a measles vaccine – once and done – or will it be more like a flu vaccine that has to be modified each year? And could the virus mutate between now and when the vaccine is ready so the vaccine doesn’t work?”
    • “Officials continue to say that they don’t know if there is a SARS-CoV-2 reservoir in the body that persists as with HIV or Ebola, so this remains an open question.”

“Is the U.S. blood supply safe? How is it being tested?”

[1] Stephen Snyder, Publisher
2731 N.E. Pinecrest Lakes Blvd.
Jensen Beach, FL 34957
Fax 772-334-0856


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