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RheumNow Podcast – COVID Marching Amidst the Madness (8.27.2021)

Aug 26, 2021 10:47 pm

Dr. Jack Cush reviews the news, journal reports and cautions regarding COVID-19

  1. The Predictive Value of Morning Stiffness 
  2. Passive Smoke Exposure and Rheumatoid Risk 
  3. Cognitive impairment (CI) is not a consequence of having rheumatoid arthritis (OR = 1.12, 0.80–1.58). Population survey study of 4262 adults >50 yrs. 63% of RA had normal cognition, 25% w/ CI, 12% dementia (similar to non-RA- 66%, 22%, 12%)
  4. #RA & Driving studied w/ installed auto sensor-based instrumentation - 23 controls compared to 33 RA pts (1292 driving hrs): shows RA & worsening Dz severity assoc w/ poor vehicle control; Braking/accelerating & steering variability liked to CDAI levels.
  5. European Commission has approved tofacitinib (Xeljanz) to treat active polyarticular juvenile idiopathic arthritis & juvenile psoriatic arthritis (PsA) > 2yrs old, not responding to DMARDs (as tablet & new oral solution (weight-based dosing)
  6. European Commission has approved bimekizumab (Bimzelx) for the Treatment of Adults with Moderate to Severe Plaque Psoriasis. Bimekizumab is a dual IL-17 inhibitor (IL-17A and IL-17F).
  7. European Commission approves upadacitinib (Rinvoq)-first JAK Inhibitor for use in adults & adolescents with Moderate to Severe Atopic Dermatitis. UPA is approved for atopic dermatitis in other nations, Russia, Saudi Arabia; pending review in US
  8. 2021–22 influenza season coincides with continued COVID infx & Sxs may be confused betw both. ACIP Influenza vaccination guidelines: 1. Annual flu vaccine rec to all >6mos; 2. COVID Vax can be given w/ Flu Vax; 3. give before Nov 2021
  9. Most recent numbers from the CDC - The agency said 202,041,893 people had received at least one dose while 171,367,657 people are fully vaccinated as of Tuesday.
  10. @EricTopol  In the land of a surfeit of free vaccines, this is the dark day when we crossed the line of over 100,000 hospitalizations, more than 25,000 patients in the ICU (highest for the pandemic), over 1300 deaths, and over 186,000 new cases.
  11. CDC: LA county breakthrough COVID infections: In 43,000 new COVID, 10,895, or 25.3%, occurred in fully vaccinated persons, 1,431, or 3.3%, were in partially vaccinated persons, and 30,801, or 71.4%, were in unvaccinated individuals.
  12. Breakthrough infections: As of Aug. 9, almost 74% of the 8,054 vaccinated people that were hospitalized with COVID-19 were above the age of 65, according to the U.S. Centers for Disease Control and Prevention. ~20% of those cases ended in deaths
  13. MTX impairs COVID Vax responses in IMID pts from Ehrlangen & NYU. BNT162b2 mRNA COVID-19 vaccination in rheumatic pts (82) & 206 controls. Adequate immunogenicity seen in IMID & TNFi Rx >90%, but less (50-72%) w/ MTX (45)
  14. Brazilian national study of 319 SLE & 251,800 nonSLE pts hospitalized with COVID-19 showed that SLE increases risk of death (RR 1.74) & poor outcomeS (RR 1.39). Having lupus doubled (RR 2.2) the risk of risk of death.
  15. Among pregnant women, receipt of the BNT162b2 vaccine was associated with a 78% lower risk of incident SARS-CoV-2 infection. Cohort study tincluded 15 060 pregnant women in Israel. No adverse pregnancy outcome difference in Vax Pts
  16. Comparing COVID vaccines in rheum dz pts - 45 took J&J vax compared to 994 on mRNA vaccines. Detectable Ab responses lower w/ J&J (80% vs 92%, p=0.03) than mRNA vax. RTX, MMF & steroids significantly depressed Ab responses
  17. ACR Guidance on Timing of 3rd Dose Booster with Immunomodulatory Drugs
  18. FDA Approves First COVID-19 Vaccine
  19. Rare Risks Associated with BNT162b2 mRNA Covid-19 Vaccine 
  20. Rheums--have a question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology
The author has no conflicts of interest to disclose related to this subject

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