No social security payments
Any vaccinated? How many total?
If you haven't had the chance to use it, try to get access to baricitinib. We've been using it since the ACTT-2 trial and it's been amazing for the intubated/BiPAP/HFNC crowd. Since the Cov-Barrier trial was released in June, it's been on the NIH protocol as well.
If you haven't had the chance to use it, try to get access to baricitinib. We've been using it since the ACTT-2 trial and it's been amazing for the intubated/BiPAP/HFNC crowd. Since the Cov-Barrier trial was released in June, it's been on the NIH protocol as well.
ACTT-2: https://www.nejm.org/doi/full/10.1056/NEJMoa2031994
COV-Barrier: Baricitinib plus Standard of Care for Hospitalized Adults with COVID-19
NIH:
"For recently hospitalized patients (i.e., those who are within 3 days of hospital admission) who have rapidly increasing oxygen needs, require high-flow oxygen or noninvasive ventilation, and have increased markers of inflammation, add baricitinib (BIIa) or tocilizumab (BIIa) (drugs are listed alphabetically) to one of the two options above."
Hospitalized Adults: Therapeutic Management | COVID-19 Treatment Guidelines
Learn about the pharmacologic management of hospitalized adults with COVID-19.www.covid19treatmentguidelines.nih.gov
Always the ray of sunshine.
Would love to see a 3 arm trial between high dose methylpred, toci and bari…If you haven't had the chance to use it, try to get access to baricitinib. We've been using it since the ACTT-2 trial and it's been amazing for the intubated/BiPAP/HFNC crowd. Since the Cov-Barrier trial was released in June, it's been on the NIH protocol as well.
ACTT-2: https://www.nejm.org/doi/full/10.1056/NEJMoa2031994
COV-Barrier: Baricitinib plus Standard of Care for Hospitalized Adults with COVID-19
NIH:
"For recently hospitalized patients (i.e., those who are within 3 days of hospital admission) who have rapidly increasing oxygen needs, require high-flow oxygen or noninvasive ventilation, and have increased markers of inflammation, add baricitinib (BIIa) or tocilizumab (BIIa) (drugs are listed alphabetically) to one of the two options above."
Hospitalized Adults: Therapeutic Management | COVID-19 Treatment Guidelines
Learn about the pharmacologic management of hospitalized adults with COVID-19.www.covid19treatmentguidelines.nih.gov
I've heard it, but I haven't seen it, especially compared to steroids. The problem with steroids is that they aren't really tapered off unless the patient improves, whereas Toci is one, maybe two, doses and Bari is a 14 day course regardless of the course.
1. Yes
...and here is the negative externality for the anti-Vaxx crowd... I hope ya'll don't need an ICU for a non-COVID reason while all the anti-vaxxers are sucking up resources left and right because their freedum minimal direct consequences.
I wonder what the numbers are if you add those who have been vaccinated and those who have natural immunity.
At least in my neck of the woods, natural immunity doesn’t seem to do much for preventing getting sick from Delta.
By getting sick, do you mean hospitalized or sick but able to stay home?
It's hard for me to believe that anyone has made it through the past 2 years unscathed without either being exposed to the virus in the wild or through more artificial means with the vaccine. Immunity isn't ever 100% and instead falls on a spectrum that varies over time as it's still possible to become infected or a carrier despite varying degrees of immunity. I think SARS-CoV-2 is going to become endemic, continuing to mutate and evolve, intermittently reinfecting people for years to come to a lesser degree and overall population burden than the brunt we've experience during the pandemic to date.
What are you seeing? The data out of Israel seems to suggest you are far more likely to become infected after vaccination than after previous infection. Fairly consistently about 1% of their serious cases are in previously infected people vs ~50% for vaccinated. Very anecdotally that seems about right in my area.... but its so hard to tell.
I have significant difficulty believing the Israeli data applies to what I’m seeing. Unvaccinated with prior infection seems to track pretty similar to unvaccinated first timers. Good protoplasm goes home, bad protosplasm gets really sick. Vaccinated immunocompetent (mostly septuagenarians in my setting) go home and bounce back a couple of times without desatting or being admitted. Vaccinated immunocompromised seem to be getting rogered by Delta and track similar to unvaccinated.
Hi all,
Are you seeing what's being reported in this article?
Is the Delta Variant Making Younger Adults ‘Sicker, Quicker’? (Published 2021)
Many doctors on the front lines say unvaccinated patients in their 20s and 30s are becoming more severely ill, and more quickly. But comprehensive data is lacking.www.nytimes.com
I know a few that are incredibly fearful of COVID and equally as fearful of the vaccine and have had very little exposure to anything the past 2 years, living as virtual hermits.
To be honest, no I haven’t seen a single case of critically ill in 20s and 30s (though I’m sure it exists.) I have seen critically ill in the 40s during this wave, but I saw that last wave too. Unsure of vaccination status.Hi all,
Are you seeing what's being reported in this article?
Is the Delta Variant Making Younger Adults ‘Sicker, Quicker’? (Published 2021)
Many doctors on the front lines say unvaccinated patients in their 20s and 30s are becoming more severely ill, and more quickly. But comprehensive data is lacking.
We have 2 pediatric patients on ECMO for COVID ARDS. And apparently one pediatric patient died last week from the same.
Know any age / comorbidity info?
Teenagers is all I know.
I thought I read (about a year ago, already, believe it or don't) that it's affirmatively an independent risk factor, not just likely.
Obesity, yes. I was making a joke about biscuits and gravy.
Oh, gotcha. I missed that.
Several are in their 20's. You would just give up?
The fact that you work at a pediatric ecmo center leads me to believe you might have a referral bias…
That doesn't match up with any data published so far that I've seen on recovered antibodies and reinfections...or my own experience. All the cohorts studied showed a good immune response after infection and very rare reinfections. ..for how long is still being followed, but they all support that the immune system works...and it's a good thing since the vaccine depends on it
So we don't treat the STEMI because someone is overweight, we don't treat the trauma because they didn't wear their seat belt? That's essentially what you're saying.
I’ve taken care of COVID ecmo. The fact is that once they are at that point, it doesn’t matter that they were a 25 year old marathon runner. They stay on the ECMO cannula for 3 months until they eventually clot/sepsis/code. Their scarred lungs are the problem, which is irreversible. It should not be an indication for ECMO. It’s not giving up anymore than calling an asystole 50 minute downtime code is giving up. That person is dead.
I'm curious if you've seen anything published on the survival rate of COVID patients that go on ECMO. Obviously, it's very low, but it would be interesting to see if the survival is stratified by risk factors, like overall COVID mortality is, or if it's equally high across the board, independent of risk factors, as you're implying.
So, nobody survives ECMO?
Please re-read my actual post.
