An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
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 …
Continue reading Atorvastatin for ICU COVID Patients: Not Ready for Prime Time
Yesterday in Instagram and Twitter, I posted the post and caption regarding my curiosity as to when are we going to know the origins of COVID. As one can expect when discussing the origin of COVID, the comments section was quite entertaining. I do have to tip my hat to the several folks who provided …
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 …
Continue reading Paxlovid (PF-07321332/ritonavir) for Outpatient COVID: EPIC-HR Trial
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 …
Continue reading Baricitinib: Suppressing the Inflammation in COVID Patients
I am not going to belabor this too much but we should stop using azithromycin in the community setting for COVID-19. The rationale for this recommendation was based on an article that was published on 4 March 2021 in the Lancet. The article is titled "azithromycin for community treatment of suspected COVID-19 in people at …
Continue reading Azithromycin in Outpatient COVID-19: Not Recommended
Those of us who take care of COVID patients in the ICU wonder what is the best for our patients regarding intubation. We learned early in the course of the pandemic that proceeding with early intubation was not beneficial to our patients. You all have also see the patient who has a PaO2 of 55 …
Continue reading Intubation of COVID-19 Patients: Does Timing Change Outcomes?
I wish this was a positive study regarding hydroxychloroquine (HCQ) for postexposure prophylaxis but unfortunately it is not. Let's start off with a bit of a head scratcher. I'm struggling with how they worded the study "Postexposure prophylaxis". Prophylaxis, by definition, means "action taken to prevent disease" per the Oxford dictionary. But if you are …
Continue reading Hydroxychloroquine (HCQ) for Postexposure Prophylaxis in COVID-19
Bias alert. I am bullish on Vitamin C. Aren't things easier when you don't have to wonder these things? I digress. The article cited for this post was published in the journal Nutrition on 7/25/2020. Obviously, the title of the paper "Vitamin C as prophylaxis and adjunctive medical treatment for COVID-19?" caught my attention. Hat …
Continue reading Vitamin C for COVID: Possible Prophylaxis & Adjunctive Therapy
Check out the addendum from 10/19 at the end of this post. COVID IS SOOOOO FRUSTRATING TO TREAT! Another tool taken out of the tool box with this COVACTA study looking at tocilizumab in COVID-19. Several weeks ago, I covered tocilizumab and cytokine storm in this post. Check it out for further details. I am …
Continue reading Does Actemra/Tocilizumab Actually Work? Update to the COVACTA Study
Please see the bottom of the page with the most recent update to the colchicine literature in COVID-19. This post covers the GRECCO-19, and COLCORONA, and RECOVERY Trials. I have mentioned this many times before, I like readily available, inexpensive medications such as dexamethasone and colchicine to treat our COVID patients. In this case, the …
Continue reading Colchicine for COVID-19: GRECCO-19, COLCORONA & RECOVERY