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
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 …
Continue reading Molnupiravir: From Press Release to Practice
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
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 …
Continue reading Obesity in Critical Illness & COVID-19: A Very Bad Combination
Update: I will cover the I-TECH study published on 2/18/22 on Ivermectin in COVID-19 Patients soon. The link to the article (but not my thoughts just yet) is down below in the citations. I am on service this weekend and don't have time to tackle it appropriately. Spoiler alert: as much as this is a …
Continue reading Ivermectin Doesn’t Help Healthy Patients with COVID-19
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
There have been many times during this pandemic where we have tried to reinvent the wheel when it comes to patient care. What we have learned, however, is that returning back to our evidence-based fundamentals have led to the best outcomes. The PROSEVA trial in 2013 showed us that prone positioning in ARDS patients led …
Continue reading Proning Spontaneously Breathing COVID-19 Patients
I always like to clarify that I am an ICU physician and not an outpatient physician. I personally have never written for fluvoxamine in my career and have never provided it to a COVID patient. That being said, I feel much of the help we need regarding therapies for COVID are to prevent these folks …
Continue reading Fluvoxamine & COVID: A Potential Outpatient Option