According to the FDA, there is not enough scientific evidence to link the use of NSAIDs to worsening symptoms of COVID-19

Pregnancy Outcomes in 9 COVID-19 + Patients

An interesting Lancet case series on pregnant mothers with confirmed COVID19 – all 9 moms survived, and delivered healthy babies with no evidence of detectable coronavirus in cord blood, throat, or amniotic fluid in any of the nine babies suggesting a low risk of transplacental transmission.

GI symptoms as a presentation of COVID-19 Patients

Digestive symptoms are common in patients with COVID-19. Moreover, these patients have a longer time from onset to admission and their prognosis is worse than patients without digestive symptoms. Clinicians should recognize that digestive symptoms, such as diarrhea, may be a presenting feature of COVID-19.

Remdesivir: Currently in phase 3 studies.

There is a fast track phase 3 trial of 1,000 patients here and in China. This is a therapeutic “game changer” based on its success when used in compassionate use outcomes in a limited number of people. It has a therapeutic window when used in the first 5-10 days before the cytokine storm sets in. Currently IL-6 inhibitor are being studied to attenuate the inflammatory response i.e. “cytokine storm” caused by the immune response in the lung to COVID19

This week’s MMWR  Report early release; Volume 69; March 18, 2020

It is hard to believe that less than 2 months ago we were pondering “Where have all the Viruses gone?” at Maui Derm. We were also breathing a small sigh of relief that Zika, SARs and other pandemics we have previously seen did not prove prolonged nor significant risks.

Outcomes in the elderly in Italy

Individuals over 70 yo infected with COVID19 had > 35% mortality. This group of patients, particularly those with co-morbidities (diabetes, heart, lung disease, etc) were most severely affected. The lack of available ICU beds in the many severely affected areas likely contributed very significantly to the high mortality rate.

MUST READ: The single BEST epidemiology modeling data based on Wuhan, Korea, Italy, Italy and endemic US. It is in summary form available updated 3/13. 

COVID-19 in children:  2 Very Recent Papers

Commentary by Albert Yan, MD

Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1

As you look at the SARS-CoV-2’s ability to remain airborne consider door handles harboring the virus for 2 days, tight quarters (elevators) and small rooms where a sneeze could leave virus aerosolized for hours.

HCQ vs chloroquine in vitro activity against SARS-CoV-2 and rationale for using HCQ in COVID19 confirmed cases.

The results of this in-vitro cell culture experiment suggest that hydroxychloroquine works better at inhibiting SARS-CoV-2 than chloroquine.