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Brad Goldberg, MD @BradGoldbergMD
· 10h
The list keeps growing… to my friends in healthcare, best of luck. To everyone else, if you feel sick it’s probably #COVID19, skip the holiday plans. Yes, testing is limited but pls don’t come to the ED just purely for testing, we are swamped.
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Brad Goldberg, MD
@BradGoldbergMD
· 13h
Working Christmas Eve in the ED right now. Everyone has #COVID19. Currently have a positive 4 month old, 4 year old, and a 8 year old. Some will be admitted to the hospital. Be safe this holiday, get vaccinated.
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305 Brad Goldberg, MD @BradGoldbergMD
· 13h
SARS-CoV-2 continues to have devastating consequences worldwide. Though vaccinations have helped reduce spread, new strains still pose a threat. Therefore, it is imperative to identify treatments that prevent severe COVID-19 infection. Recently, acute use of SSRI antidepressants in COVID+ patients was shown to reduce symptom severity. The aim of this retrospective observational study was to determine whether COVID+ patients already on SSRIs upon hospital admission had reduced mortality compared to COVID+ patients not on chronic SSRI treatment. Electronic medical records of 9044 patients with laboratory-confirmed COVID-19 from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure. In this sample, no patients admitted on SSRIs had them discontinued. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs. those not taking SSRIs, after controlling for age category, gender, and race. This study shows the utility of large clinical databases in determining what commonly prescribed drugs might be useful in treating COVID-19. During pandemics due to novel infectious agents, it is critical to evaluate safety and efficacy of drugs that might be repurposed for treatment.
Another important clinical issue is whether SSRIs are continued or discontinued when a COVID-19 patient is hospitalized or admitted to an ICU. SSRIs are frequently discontinued in the ICU patient [42,43]. There is literature showing that discontinuation results in adverse ICU outcomes [42,43]. SSRIs are often inadvertently discontinued because they are not considered important in acute disease. This can cause increased agitation among these patients and need for additional sedation, which may in turn depress respiration.
"...there’s an obvious contest that’s happening between different sectors of the colonial ruling class in this country. And they would, if they could, lump us into their beef, their struggle." ---- Omali Yeshitela, African People’s Socialist Party
(My posts are not intended as advice or professional assessments of any kind.) Never forget Excalibur.
The COVID-19 outbreak is a global health concern. Understanding the transmission modes of the SARS-CoV-2 virus is key to limit the spread of the pandemic. A lack of knowledge about the possibility of SARS-CoV-2 transmission and infection through contaminated surfaces is noticeable and recent studies have stated conflicting findings. This scoping review aims to understand the risks of contaminations via fomites better. Relevant publications were selected through Google Scholar, Web of Science, PubMed, Embase, Medline, and Cochrane Library, with related keywords. PRISMA-ScR guidelines were followed. Out of the 565 articles found, exclusion criteria were applied, duplicates removed, and a total of 25 articles were finally included in the study. The included documents were assessed by the contamination risk: “low” (37.5%), “high” (16.7%), “plausible” (8.3%), “unlikely” (8.3%) risk, and “insufficient evidence” (29.2%). Research in hospital settings was found as the main setting in the reviewed papers, which precisely indicated the risk of contaminated surfaces. This scoping review underscores the risk of SARS-CoV-2 infection via contaminated surfaces assessed as low in the majority of the reviewed articles. Further evaluation of the risk of the virus transmission by fomites and providing adequate information on its infectivity via contaminated surfaces in real-life conditions is essential.
> the risk of SARS-CoV-2 infection via contaminated surfaces was assessed
> as low in the majority of the reviewed articles {before summer 2021}
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reminds me to the old revere saying at effectmeasure : little evidence
that flu spreads by hands, touching.
Then we heard that the common cold often does. Cold viruses are infective on hands for hours
(flu only 5min)
But there are many different common cold viruses. Hand hygiene seems to be less important for
coronaviruses or at least sarbecoviruses or at least SARS2
Despite WHO's handwashing campaign.
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