Coronavirus Epidemic Update 19: Treatment and Medication Clinical Trials

Welcome to a new edition of MedCram Talks. I am currently in Hawaii at a medical conference, but I will continue to provide these

update

s. On the Worldometer website, you can see that they divide cases into active cases and inactive cases. The numbers continue to rise and it is possible that these numbers are underestimated. We will analyze it in detail later. If we look at the graph, the total number of cases outside of China continues to grow. It doesn't seem like it's exponential. We take the logarithm and can see that it is not completely linear by excluding the mainland Chinese cases.

The data is more sporadic, with some days reaching 79. The most recent day was 22 cases of the total deaths since the beginning of the year. year until mid-February, obviously, since the disease is still developing, this virus has infected mammals like us humans, but let's not forget that humans are a species that can think, act and fight to resist this virus. That's what we're going to talk about today. Some people asked about the drugs being studied. Nature magazine published an article a few days ago. There are more than 80

clinical

trials

underway studying

treatment

s for COVID-19. The gist of the article is that with so many

trials

underway in China, where everyone is trying their best to find potential

treatment

s, there may be a lack of standardization.

What are the standards and definitions of recovery? If there is no double blinding, will there be intentional or unintentional work errors? We have linked to the article below that describes the WHO's attempt to standardize these assays to ensure consistent results. They can be compared to each other. Real and reliable, not just to promote new drugs. Many drugs, such as chloroquine phosphate, have been shown to have good effects on inhibiting the growth of the new

coronavirus

in vitro. Another drug is currently being tested on 100 patients in ten hospitals. Another drug is Favipiravir. Of course, there is also a drug, Remdesivir, which is currently being tested in ten hospitals in Wuhan. for the Ebola virus works in vitro, but does not appear to work in vivo, but is still used as a potential treatment against the new

coronavirus

.

Another approach is convalescent plasma, which is plasma taken from patients who have recovered. Patients with the new coronavirus produce antiviral antibodies; If donor plasma is injected into seriously ill patients with COVID-19, it is hoped that an immune response can be generated. To carry out reliable research it is necessary to use controlled, randomized and double-blind trials. What worries me and many colleagues is whether everyone is already talking about the disease and it looks promising, and the situation is improving. Do they ensure that the research is accurate and reliable? The next thing I want to talk about is that that's what I do.

I'm not an epidemiologist, I'm not a hospital administrator, I don't work for the WHO, I just am. a pulmonary intensivist, caring for patients. When patients arrive at the ICU, their entire system collapses, I am the one who places the central venous and arterial catheters that we give to patients, I have been intubating them and doing bronchoscopies. I have always been very interested in this virus and my job is to treat patients and I wanted to show you what I noticed in my clinic in Southern California. In the past month, I personally saw at least three or four cases of influenza A, and the conditions of these patients were not very good.

Recently, a young man went to the hospital and reported only influenza to severe pneumonia, which progressed to. the need for intubation in 2-3 days. He ended up on ECMO, which stands for cardiopulmonary bypass. The chart below shows the influenza cases confirmed by the Centers for Disease Control and Prevention (CDC), and the majority of the cases were H1N1 in 2009, which was a very bad year, and we noted that those patients also had severely affected heart function. One of my own patients became seriously ill and then went into cardiac arrest after being intubated. The other had ST segment elevation due to viral myocarditis.

Since 2009, the annual flu vaccine covers the H1N1 strain. Since I see so many cases here, it is not too late to urge susceptible people to get vaccinated. Flu season won't end for a few more weeks. Remember to get vaccinated to prevent this deadly influenza A. For those who are interested in our previous lectures, we previously discussed strengthening the immune system through sleep. Check out our previous lectures and our website, where there are many related lectures and information on various topics. types of sleep. Conference on diseases. Thanks for listening.