| Epocrates

By vgreene, 21 April, 2020

27% pts died (39% w/ high-dose CQ, 15% w/ low-dose CQ); 15% pts developed QTc interval >500 msec (19% w/ high-dose CQ, 11% w/ low-dose CQ), 2 pts had ventricular tachycardia w/ 2 deaths

By vgreene, 21 April, 2020

Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 SARS CoV 2 Infection A Randomized Clinical Trial

By vgreene, 21 April, 2020

High-dose CQ group halted early due to safety concerns and all pts converted to low-dose CQ; small sample size in low-dose CQ group limits efficacy analysis, but resp secretions negative at day 4 in 6 of 27 tested pts

By vgreene, 21 April, 2020

Double-blind RCT; 81 hospitalized pts (mean age 51y; 77% w/ confirmed COVID-19 at enrollment) randomized 1:1 to high-dose CQ (600 mg bid x10 days) or low-dose CQ (450 mg bid x1 day, then 450 mg daily x4 days); all pts received AZ 500 mg daily x5 days, 90%

By vgreene, 20 April, 2020

acetylcysteine N acetylcysteine NAC

By vgreene, 20 April, 2020

There s no scientific evidence that acetylcysteine or any alternative remedy is effective for COVID 19 prevention tx 1 Available as prescription drug PO IV NEB FDA approved for mucolytic uses acetaminophen OD others and as dietary supplement marketed as a

By vgreene, 20 April, 2020

IPF

(BMJ)—A 64-yo woman presented w/ a 2-wk hx of red, painful swelling and exudation of skin around all her fingernails and toenails. Exam: nail fold destruction. Periungual skin red and blistered. No improvement w/ abx or antifungals. Two weeks later she developed blisters on her trunk, w/o mucosal lesions. What is the dx?

Dermatomyositis

Psoriasis

Chronic paronychia

Pemphigus vulgaris

Squamous cell carcinoma

You are correct. Pemphigus vulgaris was confirmed by histology findings from bx and is an autoimmune blistering dz typically manifesting as cutaneous and mucosal lesions. Mucosal changes are more common than nail changes, but not all pts develop them. Paronychia is the most common nail manifestation of pemphigus vulgaris and can be a sign before pemphigus vulgaris exacerbation or relapse. After 3wk of methylprednisolone (60 mg/day), skin and nail changes improved dramatically, and no new eruptions occurred. Remission was achieved after 8wk on a gradually reducing dose.

BMJ 2020;368:l7007

By vgreene, 20 April, 2020

QOL

By vgreene, 20 April, 2020

27% pts died (39% w/ high-dose CQ, 15% w/ low-dose CQ); 15% pts developed QTc interval >500 msec (19% w/ high-dose CQ, 11% w/ low-dose CQ), 2 pts had ventricular tachycardia w/ 2 deaths

Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 SARS CoV 2 Infection A Randomized Clinical Trial

High-dose CQ group halted early due to safety concerns and all pts converted to low-dose CQ; small sample size in low-dose CQ group limits efficacy analysis, but resp secretions negative at day 4 in 6 of 27 tested pts

Double-blind RCT; 81 hospitalized pts (mean age 51y; 77% w/ confirmed COVID-19 at enrollment) randomized 1:1 to high-dose CQ (600 mg bid x10 days) or low-dose CQ (450 mg bid x1 day, then 450 mg daily x4 days); all pts received AZ 500 mg daily x5 days, 90%

acetylcysteine N acetylcysteine NAC

There s no scientific evidence that acetylcysteine or any alternative remedy is effective for COVID 19 prevention tx 1 Available as prescription drug PO IV NEB FDA approved for mucolytic uses acetaminophen OD others and as dietary supplement marketed as a

IPF

QOL

OD

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