7 dec imtermezzo: update on important trials

Thu, 12/10/2020 - 15:47

Dear colleagues,

 

Those who read NEJM every day at breakfast, can skip this episode, because they know what will follow.

 

While I am preparing to share more insights on various vaccines, I read the papers in attach as an intermezzo, but it was a rather disappointing one.

 

  1. No effect of convalescent plasma, although rather high tittered, in patients with severe pneumonia and need for oxygen, median 8 days after symptoms onset, with about half over 65 (in Buenos Aires)
  2. Hydroxychloroquine does not prevent infection or symptomatic disease, after exposure to PCR + cases (in Barcelona), but HCQ does have side effects….  
  3. Official publication of multinational Solidarity trial, showing NO effect of Lopinavir/Ritonavir; Hydroxycholorquine; Remdesivir or subcutaneous IFN in patients of which > 70 % were needing oxygen and showing lesions in both lungs. No effect on mortality, initiation of ventilation and duration of hospitalization….

 

It then comes as a surprise that scientists from FDA write an editorial with the title: FDA Approval of Remdesivir — A Step in the Right Direction  without a question mark???    

It is interesting to read how the authors of the Solidarity paper and of this “oratio pro domo” from FDA argue about the same studies to (dis)prove that Remdesivir should (not) be added to our limited arms arsenal against COVID-19.     

 

So, when you come down with a serious COVID, all our clinical colleagues can offer you, based on solid evidence, is oxygen, dexamethasone, heparin, paracetamol….?  And, if you wish, you can be part of one of the 500+ trials that test any “repurposed” drug you can imagine. You never know how a cow catches a hare (Flemish saying)….  

 

Clearly, despite all the “Corona fatigue”, especially the older colleagues amongst us can better keep a low profile in social life, avoid infection and stay out of the hospital …..

 

I’ll return to my (virtual) vaccine studies….to stay happy and hopeful for 2021.  

 

Best wishes

 

Guido