tpa COVID

tPA for Critically Ill ICU Patients with COVID-19: Does Alteplase Help?

How do you define a last-ditch effort to save someone's life from COVID-19? Perhaps giving tPA to a severe COVID patient? At this point, I am certain many of us have attempted, with informed consent of course, therapies for our patients that may make theoretical sense but have no evidence to support its use. At …

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atorvastatin covid

Atorvastatin for ICU COVID Patients: Not Ready for Prime Time

It bears repeating that I am quite the fan of inexpensive, readily available therapies to help save the lives of our patients. When I received this article from Caroline Welch, Pharm D. I was excited because I was hoping it would be a positive study. Unfortunately, it did not pan out and based on these …

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paxlovid

Paxlovid (PF-07321332/ritonavir) for Outpatient COVID: EPIC-HR Trial

I have mentioned that I am not a fan of medicine by press release, most recently when covering molnupiravir. Earlier today, 11/5/21, Pfizer put out a press release with the headline in all caps "PFIZER’S NOVEL COVID-19 ORAL ANTIVIRAL TREATMENT CANDIDATE REDUCED RISK OF HOSPITALIZATION OR DEATH BY 89% IN INTERIM ANALYSIS OF PHASE 2/3 …

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molnupiravir

Molnupiravir: From Press Release to Practice

Yesterday (10/01/21 for historical context), there was quite a stir after a press release by Merck Pharmaceuticals after reports that their new antiviral medication, molnupiravir. They claim it shows benefits in early COVID-19. In this post, I plan on updating the newest data that comes out regarding this medication using real data. For now, all …

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baricitinib covid

Baricitinib: Suppressing the Inflammation in COVID Patients

Now that tocilizumab is so difficult to obtain (written on 9/2/21 and obviously subject to change), we need another therapy to help improve outcomes in patients with COVID-19 who are hospitalized and critically ill. Baricitinib has entered the chat. Wow, I am all full of stupid meme references these days. Baricitinib is a Janus kinase …

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COVID-19 & Proton Pump Inhibitors (PPI): Are they Friends or Foes?

Here are some of the issues with COVID-19 patients when they are hospitalized. First, they receive high doses of corticosteroids which have an association to GI bleeds. Second, they are (in some institutions) receiving full-dose anticoagulation with heparin, enoxaparin, or a DOAC. This has led many to just go ahead and pull the trigger on …

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Pregnancy and Severe COVID-19: Separating the Facts from the Fiction

I have been asked about pregnancy and COVID-19 on numerous occasions and I have deferred answering the question because I honestly had not looked much into it. Recently, I was challenged with the task and have stepped up to the occasion of looking into the data of how pregnancy is affected by COVID-19. These are …

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expectations covid

Expectations for Families of COVID-19 Patients on the Ventilator

On 8/9/21 I put out a tweet discussing (in a certain limited number of characters) how difficult it is to get a patient who is intubated and placed on mechanical ventilation because of severe COVID-19 ARDS. I used the analogy of landing an airplane in a hurricane. Definitely not easy. Something came over me where …

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obesity covid

Obesity in Critical Illness & COVID-19: A Very Bad Combination

This is a difficult subject to discuss because we all have people we love who suffer from issues that have led to them having a higher weight than what they should and, in turn, carry the diagnosis of obesity. This post is not intended to shame anyone. But there's definitely a link between obesity and …

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